Rates of COVID-19 are rising as the summer ends, with new variants compounding concerns about the virus heading into the fall.

Hospitalizations and deaths are rising by double-digit percentages, according to Centers for Disease Control (CDC) data, though rates remain far below pandemic-era levels.

The change in season also means cooling temperatures, cold season and the return of children to schools around the country — all of which could exacerbate current trends.

Here’s what to know about the current state of COVID-19.

Hospitalizations, deaths on the rise

COVID-related hospitalizations rose by 16 percent from mid to late August, according to the most recent CDC data available. That continues a trend that started in July after record-low hospitalization rates this summer.

Cases could be rising faster, experts believe, with many cases going unreported and an end of pandemic-era data collection.

“Everything is much more gray and hazy now because we no longer have a good sense of how many cases are occurring right now in the U.S.,” said Andrew Pekosz, a professor of immunology at the Johns Hopkins Bloomberg School of Public Health.

“It’s difficult to put those hospitalization and death numbers in context. Are we seeing a 10 percent increase in hospitalizations but a 100 percent increase in cases? That’s where it becomes really sort of difficult to make those population estimates.”

“The numbers are much higher than we think they are,” he said.

Deaths from COVID are also going up, about 18 percent in the same period of August, according to CDC data. Over half of the country saw “substantial” increases in COVID-19 in August, with 26 states seeing hospitalizations rise by more than 20 percent, according to the CDC.

While COVID appears to be more common now, Pekosz said, some of the anecdotal sicknesses may be normal respiratory diseases.

“I think there is something to be said about rising [COVID] rates. I think it’s also important to note that there are other things that cause respiratory infections that go around,” he said.

“That’s where the testing becomes so important because it really allows you to cut through and understand what COVID is contributing to this, versus what are other infections that are normally starting to rise around this time of the year contributing to overall health.”

Vaccine booster coming soon as new variant appears

The major COVID vaccine manufacturers — Moderna, Pfizer and Novavax — are all slated to roll out another vaccine in the coming weeks, pending final approval from the Food and Drug Administration, which could come this week.

That new vaccine is based on the XBB.1.5 variant of COVID, a subvariant offshoot of the Omicron variant which caused massive caseloads late last year.

The CDC already recommends everyone receive an updated COVID-19 vaccine, in addition to the original 2021 shots, and people older than 65 receive a second booster on top of that.

Pekosz recommends everybody get the new COVID vaccine when it becomes available in a few weeks.

Slightly less than half of the country has received updated COVID vaccines, according to CDC data, and even fewer have received additional shots if they are eligible. States in the south tend to have lower updated vaccine rates.

Texas has the lowest rate of people fully up to date on shots, with just 3.3 percent of people receiving all vaccines as of the end of July. Vermont leads the country with 37 percent.

Moderna claims its new vaccine is effective against the newly-emerged B.2.86 variant, unofficially dubbed “Pirola,” which the CDC has warned may be more infectious than other strains among those who have had COVID before.

Pirola currently accounts for less than 1 percent of COVID cases in the U.S., according to the CDC, but has worried experts due to its over 30 mutations from previous versions of the virus.

Are masks coming back?

The rising caseload has reignited debate over whether people should wear masks to protect themselves and others from the spread of COVID-19.

While government mask mandates are not on the table, former White House medical adviser Anthony Fauci said recommendations to wear masks in public could return soon if trends continue to worsen.

“I am concerned that people will not abide by recommendations,” he said in a CNN interview last week. “I would hope that if we get to the point that the volume of cases is such and organizations like the CDC recommends — CDC does not mandate anything — recommends that people wear masks, I would hope that people abide by that recommendation and take into account the risks to themselves and their families.”

Pekosz said that certain businesses and other places could very well see mask requirements return, specifically nursing homes and hospitals.

“Masks work when they’re worn effectively,” he said. “High quality masks, in particular, is something that I think is important for everyone to consider.”

New York Gov. Kathy Hochul announced the state will make free masks and COVID-19 tests available to students as the school year starts this week, in possible anticipation of rising cases.

“Frequent testing for COVID-19 is an important part of keeping our kids safe and preventing an outbreak, and I will continue working to ensure our school districts have the resources they need to provide a safe, in-person learning environment for our students,” Hochul said in a Wednesday statement.

The White House has said President Biden will increase his mask-wearing after first lady Jill Biden was diagnosed with COVID this week. The president has tested negative thus far.

Other protective measures

Common precautions since the start of the pandemic — properly washing hands, wearing masks, avoiding especially crowded areas — still apply three years later, experts say.

“It’s a great time to be reminded of ‘COVID protocol,’ for lack of a better word,” Pekosz said.

Common early symptoms of COVID include a fever, a cough, fatigue, headaches and chills. 

While free test programs from the federal and local governments have concluded, you can pick up a quick at-home test from your local pharmacy for about $20. COVID tests also expire, so ensure your supply is up to date, Pekosz said.

It’s also recommended to stay home if you have any respiratory sickness, COVID or not, to keep the community safe.

Will there be another wave?

While a new wave of COVID sweeping the country is certainly possible, Pekosz said anything comparable to the Omicron wave last year is unlikely.

“We have to understand that COVID is here, and COVID is staying here,” he said. “I expect that we’ll see increases in cases. But I don’t expect to see something that was similar to what we saw across the population where we saw massive increases of cases over a short period of time.” 

“So we’ll see increases, particularly viruses tend to circulate in schools quite effectively. But I don’t see anything concerning with respect to massive surge,” he added.

But Pekosz noted there is a rising risk as summer ends and indoor gatherings become more common.

“It’s important to note that we’re starting with a baseline of cases that’s pretty high, and now we’re seeing a surge in the fall and people are getting into environments where the virus is much more transmissible,” he said.