Is another COVID surge coming to San Diego?

The U.S. Centers for Disease Control and Prevention (CDC) has been keeping tabs on COVID-19 in San Diego, and its forecast looks less than stellar. According to recent reporting, San Diego County is now in the CDC’s highest level of community transmission, and the agency predicts COVID-related hospital admissions in California will rise in the coming weeks.

While this may seem surprising — cases were steadily decreasing from January through late March — Dr. Abisola Olulade, a family medicine doctor with Sharp Rees-Stealy Medical Group, says the increase in cases is to be expected.

“All we have to do is look to the past,” Dr. Olulade says. “Past trends can be predictive of the future. After holidays, such as Memorial Day, we have always seen a significant increase in COVID cases because people are gathering and spending more time with each other. Now, they’re doing it without masks.”

What the wastewater tells us
The San Diego Epidemiology and Research for COVID Health (SEARCH) organization has been monitoring coronavirus concentration in San Diego’s wastewater. Fragments of the virus are shed in the urine and stool of people with COVID. Greater concentration of the virus in wastewater can be an early sign of possible increases in the number of COVID-19 cases in the community.

“To monitor the prevalence of COVID-19 infections in San Diego, virus concentrations are being monitored at the Encina, Point Loma and South Bay wastewater treatment plants,” Dr. Olulade says. “And this can possibly tell us what is happening in terms of COVID spread at the time of collection, and how things are going to trend in the future.”

Recently, the rate of COVID-19 in San Diego’s wastewater has risen, dominated by the omicron variant and its subvariants. The newest subvariant of omicron, known as BA.2.12.1, is increasing in prevalence and accounts for approximately 37% of all cases in the U.S.

What to expect from the new omicron subvariant
While this new omicron subvariant appears to be the most contagious variant yet, it does not seem to cause more severe illness. To date, the rate of COVID-related hospitalizations and deaths remains stable and far lower than seen during the winter surges of 2020 and 2021.

However, right as we are enjoying decreased pandemic precautions — masks are no longer required in many public spaces, social distancing seems passé, and many have stopped avoiding crowds in favor of gathering again — several studies have suggested that the newer variant might be more likely to evade the protection provided by COVID vaccines or a prior infection.

While Dr. Olulade emphatically states that COVID vaccination with a booster dose — or two booster doses for those who qualify — provides significant protection against hospitalization and death, she admits some protection may be waning. “Even though we know the vaccines are still holding up in terms of protecting against serious illness, the protection against infection has decreased some over time.”

Nevertheless, being vaccinated and boosted remains important and provides significant protection, she says. In fact, according to a CDC study of Los Angeles County residents, during a two-month period when omicron was the predominant variant causing infections, residents who were not vaccinated were 23 times more likely to be hospitalized due to COVID complications than residents who were fully vaccinated and with at least one booster dose.

What test works best after COVID exposure or symptoms
If you learn that you have been exposed to COVID-19, or if you are experiencing COVID symptoms, it is important to be tested for infection. There are two primary types of approved COVID-19 tests used to determine the presence of viral infection in both vaccinated and unvaccinated people:

• PCR tests detect the virus’s genetic material. The tests are highly accurate, but results can take up to 1 week.

• Antigen tests, sometimes referred to as rapid tests, detect specific proteins on the surface of the virus. The sample is taken either at a testing facility or using an FDA-approved at-home test, and results can be produced within minutes.

At-home rapid COVID-19 antigen tests have become widely available in the U.S. However, a recent study found antigen tests caught only 20% of infections on the first day of symptoms, whereas PCR tests caught 80% of infections on the first day.

Antigen tests performed best four days after someone experienced COVID symptoms, catching 77% of infections. The study’s authors concluded people with symptoms who have an initial negative test result using an antigen at-home test should test again one to two days later, when the test results are more accurate, or take a PCR test to confirm the negative result.

If your test result is positive, you should follow all isolation and prevention guidance to protect others from getting sick. In California, this includes staying home for at least five days. Isolation can end after day five if you do not have symptoms and test negative on day five or later.

What to do if you have COVID
Most people with COVID-19 will experience mild to moderate symptoms that can be safely treated at home. The CDC recommends you rest, stay hydrated, and take over-the-counter (OTC) medications, such as acetaminophen, to reduce fever and pain.

Dr. Olulade also recommends people talk with their doctor about whether they are eligible to receive a COVID-19 antiviral medication. These oral medications are taken at home and prevent the coronavirus from replicating, allowing people with COVID-19 who may be at risk for developing severe illness to avoid hospitalization.

“We don’t encourage you to take the antiviral medications simply because you have symptoms,” she cautions. “You should get tested and talk with your doctor about whether these medications, which require a prescription and are available at many local pharmacies, can help you recover. However, it’s important to note they must be started as soon as possible after a diagnosis of COVID-19 and within five days of symptom onset.”

Even when taking an antiviral medication after a COVID diagnosis, the CDC recommends you continue to monitor your symptoms and contact your doctor if you are concerned about developing or worsening symptoms. Seek emergency medical care immediately by calling 911 or heading to the nearest emergency room if you have trouble breathing; pain or pressure in the chest; sudden confusion; the inability to wake up; or bluish lips or face.

Learn more about COVID-19 vaccination, testing and care resources.

For the news media: To talk with Dr. Olulade about COVID-19 case numbers, testing or treatments, contact Erica Carlson, senior public relations specialist, at erica.carlson@sharp.com.