Got COVID? NYC health commish on what’s behind the sneaky midsummer bump.

COVID-19 is rebounding in New York City, a few weeks ahead of the usual autumn and winter schedule of respiratory disease. But New Yorkers will find that tracking outbreaks has dramatically changed since the last time the coronavirus was thriving.

Federal regulators ended the public health emergency for COVID-19 in May, ushering in a slew of changes in how the disease is reported to the public. For one, PCR testing requirements are largely gone, so the Centers for Disease Control and Prevention no longer reports confirmed cases on a daily and weekly basis. New York state and city health departments still share case figures, though officials and health experts conceded that those numbers meant less and less as official testing dried up.

Hospitals and emergency departments still test for COVID-19 routinely when patients show symptoms and report those results to government officials, so hospitalizations have become the primary mode for gauging whether outbreaks happen.

As of Friday, New York had 657 people hospitalized statewide with COVID-19, and 294 were located in the city. This recent uptick is part of a larger trend sweeping parts of the Northeast — where hospitalization rates are growing by more than 20% week over week. The CDC considers such growth “substantial,” though the overall numbers remain far off from a big wave. In the past, NYC’s worst surges saw hospitalization rates 20 to 40 times higher than current tallies.

NYC Health Commissioner Dr. Ashwin Vasan said this hospitalization bump has so far been driven by incidental cases — where patients visited medical centers for non-COVID reasons and then subsequently tested for the coronavirus. That’s an indication the coronavirus is circulating, but the trend has not overwhelmed hospitals nor yielded large numbers of deaths yet.

Vasan spoke Monday with WNYC host Sean Carlson on All Things Considered about whether a new variant might be driving the trend and what the low uptake of COVID-19 boosters last winter — 7% for NYC children and 18% for adults — could mean for susceptibility, given the updated vaccines help prevent symptomatic infections.

An interview transcript is available below. It was lightly edited for clarity.

Carlson: Let's talk about this recent increase in COVID hospitalizations. About 650 people are currently hospitalized statewide, with 300 of those coming from the city.

How significant is that and how does it compare to previous COVID waves?

Vasan: There's been an increase in COVID-19 cases recorded since early July.

A phenomenon that we've seen over the last year is that the majority of people hospitalized with COVID are actually hospitalized for something else. That makes sense when you have more COVID circulating.

The last time our hospitalization counts were at this level was early- to mid-March of this year. But I will say that overall levels are still quite low, and we're not seeing any concerning outcomes in terms of death or really severe disease like intensive care (ICU) admissions.

Hospitalizations tend to lag behind initial outbreaks.

Is it safe to assume that there's a fair number of infections out there right now?

Absolutely. The majority of these hospitalizations are actually people who are admitted for something else. You might be admitted with some issues around diabetes, but then you test positive because there is objectively more COVID circulating in our communities. So, the likelihood that you're testing positive is greater. But there are three things to consider about the current moment:

No. 1: We're not seeing a lot of severe disease, and we're certainly not seeing any major changes in death. No. 2: We're not seeing any strain on our hospital system, and we're not seeing any issues around staffing or bed capacity.

No. 3: We've got a lot of tools to manage this. New Yorkers can get tested, and tests are still widely available from their providers or from libraries or public event spaces. Treatment is available from your provider or from 212-COVID-19 (212-268-4319). And of course, as I mentioned, vaccines are available and will be updated in September or early October.

Let's talk more about what people can do. It'll soon be time for people to get their flu and COVID shots.

Can you tell us anything more about the updated COVID boosters for this year?

Right now, it's under discussion at the U.S. Food and Drug Administration and the CDC. The manufacturers have a monovalent vaccine that is really tailored to the XBB 1.5 variant, which is the dominant variant that is producing subvariants currently. We think that that will give us the best protection for this upcoming viral season. Much like the flu vaccine is updated every year, we expect that this vaccine is going to need to be updated regularly.

We would recommend that everyone go and get boosted, especially if you're more than six months out from your last dose in order to really ensure that even if you do get COVID over the winter, it's gonna be mild. The updated shot certainly will reduce your personal risk.

Those booster numbers — the amount of folks who got them last year — were not great: 18% of NYC adults, 7% of NYC kids.

Do you have any thoughts on how we could improve those numbers?

I would obviously, as the city's doctor, want more people to get boosted. I think when boosters came online, we were also approaching three years into the pandemic. There's a lot of fatigue around COVID in general. There's a lot of fatigue around vaccines.

This is why we're excited to start routinizing and normalizing COVID vaccines as a part of our annual physicals, annual school physicals and the annual updating of our health that we traditionally do before the colder months set in.

Do we have any theories as to why this uptick is happening now?

I'm sure people tend to get it more when they're crowded indoors, but it's summertime, right? We usually see this kind of thing happening in the wintertime.

Compared to some [viruses and] vaccines that give us up to 10 years or more, or sometimes lifetime immunity, COVID immunity lasts about six months, eight months, maybe 10 months. This is pretty typical of coronavirus.

So updating your immunity is really important. Many people are months, if not more than a year, out from their last vaccine dose, and immunity is starting to wane. That is why it's going to be doubly important that people re-update that immunity as well.

Is there any evidence that this is a new variant that we're seeing?

We're not currently seeing a dominant new variant. We're seeing much like a variant soup.

Though, we are constantly watching to see if one is emerging in other parts of the world because we know what happens there will eventually land on our doorstep in New York City.