COVID-19 is once again climbing to troubling levels in California — a worrying trend as health officials attempt to navigate a vaccine landscape thrown into uncertainty by delays and decisions from the Trump administration.
Public health departments in Los Angeles and Santa Clara counties have reported jumps in the coronavirus concentrations detected in wastewater in recent weeks. L.A. County also has reported a small increase in patients hospitalized with COVID.
“There is a lot of COVID out there,” said Dr. Peter Chin-Hong, an infectious disease expert at UC San Francisco. “COVID is coming a little bit later than last year.”
The rate at which COVID lab tests came back positive in L.A. County is 12.6% for the week that ended Aug. 16, up from 7.6% a month earlier. In Orange County, it’s 14.4%, up from 8.1%.
“We are seeing outpatient cases increase,” said Dr. Elizabeth E. Hudson, the regional physician chief of infectious diseases for Kaiser Permanente Southern California. “With back-to-school season in full swing … we are expecting to see an uptick in COVID in children over the next few weeks and this is already being seen in some parts of the country.”
In a blog post, Dr. Matt Willis, former public health officer for Marin County, wrote that “California’s in the middle of a COVID-19 wave, and statewide rates are among the highest in the nation.”
Among senior-age residents in Orange County, emergency room visits for COVID-like illness, as well as hospitalizations for COVID, are also on the upswing, said Dr. Christopher Zimmerman, a physician with the Orange County Health Care Agency’s Communicable Disease and Control Division, and Dr. Regina Chinsio-Kwong, the county’s health officer.
Hudson said the coronavirus subvariant XFG, nicknamed Stratus, accounts for the vast majority of variants seen in wastewater.
“This is another Omicron subvariant, so previous infections with other Omicron variants may offer some residual protection, but, as we know, that protection is not complete, so you can certainly be reinfected,” Hudson said.
It does seem that this summer, COVID season has been less intense than last year.
In L.A. County, for instance, current COVID hospitalizations for the week that ended Aug. 16 are about half the level seen during the same week last year. And in Orange County, emergency room visits related to COVID-like illness are less than half what they were last summer.
“Last summer’s COVID surge was the largest since 2022, so this year’s surge is more on par with our less-severe summer surges,” Hudson said. “People are definitely getting COVID this summer, but the intensity is much less than in 2024.”
The rise in COVID comes as the Trump administration has delayed the rollout of the updated vaccine for the fall. Last year, the federal government had fully green-lighted the annual reformulation of the vaccine by June, in time for a rollout that began in September.
This year, however, the Department of Health and Human Services led by vaccine skeptic Secretary Robert F. Kennedy Jr. has in effect delayed the rollout of this fall’s COVID shot.
“Updated COVID-19 vaccines have been delayed this year due to federal policy changes, and we are awaiting [Food and Drug Administration] licensure of this season’s products,” the L.A. County Department of Public Health said in a statement to The Times. “This means availability in September may be later than what people experienced last fall.”
County health officials noted that the FDA could further revise or limit who can get an annual COVID shot — as the agency signaled in May — “though current evidence continues to show that the vaccines are safe and effective across all ages.”
The California Department of Public Health also warned that because the federal government hasn’t made decisions on licensure approvals and recommendations, “availability and timing of specific COVID-19 vaccine products may be more limited and occur on a later schedule.”
“We’re in an unfortunate limbo, created by an administration that’s uncommitted to vaccines, between the slow shutting down of ’24–’25 vaccine availability and access to the ’25–’26 version,” Willis wrote in the Your Local Epidemiologist in California blog.
Chin-Hong said that the timing of the vaccine rollout is in such flux and he recommends anyone at risk for severe complications from COVID who hasn’t been vaccinated in more than a year to get inoculated now.
People at severe risk for COVID illness include those 65 and older, those who have compromised immune systems, those who are pregnant, and all infants and children age 6 months to 23 months. (Children age 2 to 5 are also at greater risk for complications from COVID compared with older children.)
“If they haven’t gotten it in a year, just go ahead, maybe, get it now,” Chin-Hong said. “Because also, the vaccine that’s being proposed [for this fall] is relatively the same formula as last year. … It’s less important to wait.”
It might also be easier to get the COVID-19 vaccine now ahead of potential changes in federal recommendations and approvals later this year.
Chin-Hong called the delay in formulating a COVID vaccine game plan for this fall “just weird,” as “usually in public health, preparation is everything.”
At this point in previous summers, health officials typically already would be urging people to make plans to get a fall COVID vaccine.
But this time around, “Nobody knows details about who’s going to be eligible, exactly,” Chin-Hong said, except for those age 65 and up and younger people with chronic health conditions.
“We have a whole new discussion, like, ‘When is it coming? Who is it going to be eligible for? … Do kids have to talk to their pediatrician first? Would pharmacists actually allow them to get it? … Would healthy pregnant people [be able] to get it?” Chin-Hong said.
It’s as if officials are talking about a new vaccine and a new illness, but the COVID-19 vaccine has been around for more than four years, Chin-Hong said.
But the federal government’s treatment of COVID shots is not happening in a vacuum. Kennedy has maligned mRNA vaccine technology — the basis for the most commonly administered COVID shots — and ordered the firing of all 17 experts from the Centers for Disease Control and Prevention’s influential vaccine advisory committee.
One person who will lead a committee to review the safety of COVID vaccines for the CDC has described the shots as “the most failing medical product in the history of medical products,” the New York Times reported Friday.
COVID-19 vaccinations averted 2.5 million deaths globally from 2020 to 2024, according to a report published in the journal JAMA Health Forum in July.
The vaccine-skeptic leadership of Kennedy over the Department of Health and Human Services, which oversees the FDA and CDC, has prompted such a split in the medical community that mainstream organizations such as the American Academy of Pediatrics are issuing their own recommendations concerning vaccines.
The CDC, for instance, earlier this year asked that parents talk with a healthcare provider before getting the COVID vaccine for healthy children. That’s an extra step parents may need to take to get their children vaccinated, and could end up being a “super big barrier” for vaccination, Chin-Hong said.
Previously, the CDC recommended everyone 6 months and older get an updated COVID vaccine in the fall.
The CDC also recently offered “no guidance” as to whether healthy pregnant women should get the COVID vaccine.
On Friday, by contrast, the American College of Obstetricians and Gynecologists recommended that people “receive an updated COVID-19 vaccine or ‘booster’ at any point during pregnancy, when planning to become pregnant, in the postpartum period, or when lactating.”
“The COVID-19 vaccines are particularly effective at reducing morbidity from COVID-19 complications in pregnant patients and their infants,” the organization said. “Data also support the benefit of vaccination in reducing pregnancy complications, such as severe maternal morbidity, preterm birth, and stillbirth.”
And the American Academy of Pediatrics on Aug. 19 recommended that infants and children age 6 months to 23 months get the updated COVID vaccine, since they “are at high risk.”
The group also said that children ages 2 and older should be offered the latest COVID vaccine if their parent or guardian wishes.
“The COVID vaccine situation is unsettling. … Differences in guidance from the CDC and other medical professional groups will be challenging for the public,” the Orange County communicable disease control team said.
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