COVID-19 Fall Outlook

Much of the U.S. is currently in the thick of the first uptick in COVID-19 cases in several months. Driven by a new variant, “Eris” (or EG.5), the spike in cases could presage a fall or winter surge as weather gets colder and kids return to school. Meanwhile, a new COVID-19 booster – reformulated last spring to counter the Omicron variant – is hitting pharmacies and doctors’ offices in the next few months. Here’s what an Eris surge could mean for businesses and individuals.

Eris, Boosters, and Back-to-School Surge

In recent weeks, COVID-19 hospitalizations throughout the U.S. have ticked up, with total hospitalizations in the U.S. up 21% in the last week. However, tracking new cases is an inexact science these days: Since the end of the COVID-19 health emergency, federally funded diagnostics have ended, and as the amount of people with some form of immunity has increased, severe illness has become less common, making hospitalizations less reflective of community spread than in the past. Given the cyclical nature that COVID-19 surges tend to take, cases are likely to only increase as children return to schools and weather gets colder, pushing more people indoors.

The majority of the rise in COVID-19 cases in the U.S. is attributable to the new Eris, or EG.5, variant, which currently accounts for 20.6% of new cases in the U.S., the largest share of any individual variant. Like the Omicron strain from which it is descended, the Eris variant possesses a mutation that makes it more adept at evading immunity from previous infection or immunization. However, it does not appear to have mutations that might make it more contagious, more severe, or have novel symptoms, and doctors emphasize that diagnostic treatments continue to be effective against it.

The new surge comes ahead of the expected roll-out of new COVID-19 booster shots, slated to hit pharmacies and clinics in late September or early October. The new boosters, currently being formulated and tested by Pfizer, Moderna and Novavax, are based off the XBB variant (nicknamed the Kraken variant by some) that was circulating more heavily during the late winter and spring, in following with an FDA advisory panel recommendation. The reformulation of the boosters around new variants could leave newborn babies and others who have never had the original vaccines vulnerable to older strains of the virus – a risk the FDA deemed acceptable due to the rapidly evolving nature of the virus. The XBB-focused booster is expected to still be effective against the Eris variant currently dominating transmission in the U.S. and to provide good protection against the XBB-subvariants that represent a significant portion of infections.

The fall roll-out of the new booster is in line with public health experts’ long-term goal to make the COVID-19 booster a routine part of annual vaccinations, alongside the annual flu shot. However, continued vaccine hesitancy and the lowered profile of COVID-19 in general has led to lower and lower uptake of each subsequent round of boosters, a trend that is likely to continue this year. While 80% of Americans received the first dose of the vaccine, just 17% received the most recent updated bivalent booster. Taken together, a new COVID-19 variant and what’s expected to be a tepid uptake of the new XBB-focused booster could cause a significant surge in cases come fall.

COVID-19’s New Reality

While COVID-19 remains a public health concern, public attention and government bandwidth for the virus have decreased. The potential Eris fall surge could paint a picture of future COVID-19 seasons, with limited public communication surrounding upticks in cases or guidance around new vaccinations. Lowered attention will likely mean that interruptions for businesses or individuals will be limited, as individual risk perception and government guidelines continue to decline. Nonetheless, COVID-19 remains dangerous for the elderly and those with compromised immune systems. Individuals concerned about their personal risks should take well-established precautions, including receiving a booster vaccination, avoiding crowds, and masking.

While Eris does not appear to be especially dangerous, experts remain concerned about the potential for more severe variants to emerge. Of primary concern are emerging variants that contain both the mutation that allows the virus to more easily evade previous immunity (which Eris possesses) and another mutation that makes the virus more transmissible. Variants of this type are called “FLip” variants, as they flip two amino acids labeled F and L. The current stage of COVID-19, wherein the virus is endemic and transmits regularly and freely within the population, provides ample opportunity for mutations to emerge and variants to take hold. Even as public behavior surrounding COVID-19 evolves, businesses and individuals should remain aware of the possibility that a new, more transmissible or severe variant could emerge, prompting a return to more cautious COVID-19 protocols.