COVID-19 infections are climbing across virtually the entire United States, according to new federal estimates, although serious illness and COVID-related emergency room visits remain at very low levels.
Modeling from the Centers for Disease Control and Prevention indicates that “COVID-19 infections are growing or likely growing in 50 states.” As of mid-August, the agency was not estimating declining infections in any state, while no estimate was provided for Iowa.
The widespread increase does not appear, at least so far, to be producing a corresponding surge in severe disease. The CDC continues to classify COVID-related visits to hospital emergency departments as “very low.”
Wastewater surveillance is providing another window into the summer increase. Because people infected with COVID can shed the virus regardless of whether they have symptoms or seek medical care, sewage monitoring can detect community spread that might otherwise go unnoticed. Wastewater surveillance “can pick up signs of infection even from people who feel perfectly healthy,” according to the CDC.
Hawaii and Mississippi currently stand out as the two states with “moderate” levels of COVID activity detected in wastewater, although the available wastewater information for Mississippi is limited.
The West and South are showing somewhat greater viral activity than much of the rest of the country. Alabama, Alaska, California, Florida, Georgia, Nevada, Oregon, Texas and Washington are currently classified as having “low” wastewater levels, while the remaining states are listed as “very low.”
The increase comes as the XFG lineage remains a major focus of federal health officials. The CDC continues to use genomic surveillance to track the proportions of circulating SARS-CoV-2 variants around the country.
Despite COVID’s current upward trajectory, two other major respiratory illnesses are less prevalent. CDC wastewater monitoring shows influenza and respiratory syncytial virus, or RSV, appearing at lower levels than COVID.
Meanwhile, a newly formulated COVID vaccine designed for the 2026-2027 season is expected to become available beginning this fall. The Food and Drug Administration has advised vaccine manufacturers that the updated shots should use the JN.1-lineage XFG variant in a monovalent vaccine to more closely match viruses now circulating.
The decision followed a May 28 meeting of the FDA’s Vaccines and Related Biological Products Advisory Committee, which reviewed variant circulation, vaccine effectiveness, immune-response data and other evidence before recommending XFG for the new formula.
Manufacturers had indicated to the FDA that they were prepared to produce XFG-targeted vaccines for the upcoming season, and Moderna said in materials submitted to the agency that it was prepared to supply its updated formulation by mid-August.
The latest numbers suggest that the United States is experiencing another period of increased COVID transmission heading toward the end of summer. For now, however, federal data indicate a significant distinction from earlier waves: infections may be increasing broadly, but severe cases remain comparatively uncommon.
