COVID-19 is surging. Time to mask up or get a booster? What a Boise medical expert says

Another wave of COVID-19 is creeping up just in time for summer. A Boise medical expert says you might want to mask up if you visit — or work in — a hospital or clinic, where sick people are most likely to infect others.

Infection rates in Idaho have been steadily rising since early May, prompting some concern among public health experts as vacation season picks up and people start gathering more frequently.

“We are seeing the beginning of a new surge,” said Dr. David Pate, a retired physician and the former CEO of St. Luke’s Health System.

Pate told the Idaho Statesman by phone that hospitals across the West have begun reporting increased hospitalizations. In Idaho, reporting requirements for COVID-19 positive hospital patients were discontinued in April, according to the Idaho Department of Health and Welfare’s dashboard.

Some hospitals, like St. Luke’s and Saint Alphonsus, are still reporting COVID-19 data on their own websites.

Infection rates rising

St. Luke’s reported a 13% positivity rate among the 815 people it tested over the last 30 days in Ada County. Over the most recent 15 of those days, the percentage has jumped to 22%. In early May, St. Luke’s test positivity rate hovered around 6%. Experts say 5% indicates control of the disease’s spread.

Still, those numbers don’t capture patients who’ve visited other hospitals or urgent-care clinics in the Boise area and those that have taken at-home tests.

“Certainly we’re not doing much reporting anymore,” Pate said. “And the variants we’re dealing with today are far more transmissible than the early variants we dealt with back in 2020 and 2021.”

He said that while evidence shows people with prior vaccinations and infections are more likely to be protected from severe disease, they’re not going to have as much protection against getting an infection, particularly with the latest strains, such as omicron subvariants JN.1, KP.2 and KP.3.

Pate said KP.3 could quickly displace other variants in the U.S., based on the way it’s already taken over in other countries.

The winter’s dominant strain, JN.1, was first detected in the U.S. in mid-November. There was no evidence of the variant in Boise wastewater for the week ending Nov. 27, but by Dec. 4, it accounted for 77% of all circulating COVID-19 variants in Boise, according to the city’s wastewater dashboard. Wastewater sequencing, which is more costly than simply testing for the virus, allows communities to see which variants are most dominant.

Funding loss impacts wastewater testing

The city still reports COVID-19 wastewater levels, but it no longer provides data on what variants are found in it. Wastewater analysis is one of the best methods of tracking the spread, Pate said, as fewer people test and as state agencies no longer report results.

“That was great information,” Pate said. “But there just isn’t a whole lot of interest in investing in these things, which is very unfortunate.”

In 2023, Idaho lawmakers rejected $16 million in federal grant funds that would have supported continued pandemic response efforts, including wastewater surveillance, the Idaho Capital Sun reported. About $2 million of that would’ve gone to Idaho colleges and universities processing wastewater samples, like Boise State University, whose scientists process samples for the city at the Hampikian Lab in Boise.

The city of Boise treats wastewater for Boise, Garden City and Eagle at its two sewage treatment plants, on Lander Street and West Joplin Road.

Samples taken from those plants show a steady increase in COVID-19 since April, though current levels are far below the peak the city saw in January, which was among the highest levels of COVID-19 seen in the samples in nearly two years.

Patients, staff, risk infection at medical sites

Pate expressed disappointment in the lack of effort by many hospitals to combat transmission. In addition to having consistent policies and infection-control practices, he said hospitals should provide avenues for patients at high risk to safely access care.

“If you’re not going to require masking, at least post publicly what you’re doing to decrease the transmission of the virus and be transparent about it,” he said. “We know from the studies that your chance of dying from COVID-19 if you catch it in a hospital are many-fold increased. And that makes sense because those are going to be higher risk individuals in many cases. But I’m also very concerned about the fact that we’re not protecting medical staff.”

The state already suffers from a shortage of doctors and other medical workers, some of whom have been repeatedly infected with COVID-19 since the pandemic began.

With each reinfection, a person’s risk for long COVID-19 and other debilitating disorders increases significantly, he said.

“A lot of people who are immunocompromised contact me for advice on how to protect themselves,” Pate said. “There are times when we have to make decisions about whether they should even seek health care because the risk of whatever the problem is with them is outweighed by the risk of them getting COVID-19. No one should come into the hospital and leave sicker than when they came in.”

Masks limit exposure ‘where sick people go’

Pate said many people don’t want to bother with masking or other precautions. But for those who want to limit their exposure, he recommends wearing a high-quality mask, like an N95, during visits to hospitals, clinics or doctor’s offices.

He also advises scheduling medical appointments at the very start the day, when the rooms have had time to clear out overnight and not many other patients have been in yet.

For other settings, such as crowded supermarkets, offices, bars or indoor concerts, he says to monitor local data and evaluate your risk.

“Your risk of encountering somebody with COVID-19 is much greater in a hospital or urgent care than at an outdoor track meet or a grocery store, because that’s where sick people go,” he said.

Booster shots improve immunity

Pate urges people to stay up to date with COVID-19 vaccines.

The Centers for Disease Control and Prevention recommends everyone 6 months and older get an updated vaccine shot, whether Pfizer-BioNTech, Moderna or Novavax, to protect against serious illness from COVID-19. People 65 and older should get an additional dose 4 months after the previous one, according to the CDC.

Pate said new research has shown that people who have kept up-to-date with their COVID-19 shots have developed a more broad antibody response.

“The vaccines can’t keep up with all of the latest variants, but if you continue to get those boosters, you will have a better immune response,” he said. “I always get one of those when they come out.”

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