The coronavirus is spreading again in Dallas.

In recent weeks, the area has seen an increase in reported cases of covid-19 and increased levels of the virus in wastewater. The outbreak is part of an annual summer surge, according to doctors and officials, and there are many ways to protect against infection amid the surge in cases.

Dallas County had 78 positive Covid-19 cases reported daily on a seven-day rolling average last week, according to Dallas County Health and Human Services website, which was last updated on August 9. But this number doesn’t tell the whole story.

In March, the government stopped requiring suppliers to report test results for covid-19. Reporting cases is now voluntary, and most home tests are not reported.

“You can certainly guess … that people are testing positive at home,” said Steve Love, president of the Dallas-Fort Worth Hospital Council. “There are probably a few more cases out there than people know.”

Answers in wastewater

After reporting requirement changes, effluent monitoring is an important resource for understanding contamination. Wastewater monitoring involves testing wastewater for a virus to track its presence in a community.

Wastewater data collected from Dallas’ central water treatment plant showed that levels of the coronavirus increased with almost tenfold from May to Augustaccording to information from Waste water SCAN.

Rising levels of the virus in wastewater were higher in Texas than in the region and the nation over the past 45 days, according to Centers for Disease Control and Prevention’s National Wastewater Monitoring System.

Dr. Trish Perl, a professor in the school of public health at the University of Texas Southwestern Medical Center, said wastewater data is a “canary in the coal mine” for understanding how cases of covid-19 are trending.

“In general, we see it go up about two to three weeks before we start seeing a lot of human cases,” Perl said.

National positivity is also increasing. CDC estimated in July that covid-19 infections are growing or likely to grow in 35 states and territories, including Texas. National trends for test positivity, emergency room visits, hospitalizations and deaths due to covid-19 all increased this summer, according to CDC data.

A summer wave

Although an increase in cases has been observed in Dallas, it is not necessarily a peak, said Dr. Philip Huang, head of the county health department.

“We know it’s gone up, but it’s certainly not at the same level as what we’ve seen before,” Huang said.

Love said the increase seen last summer is likely to come next summer as well. With more travel and warmer weather encouraging to stay indoors, the transmission of covid-19 tends to increase during the summer months.

“It’s nothing to panic about,” Love said.

While cases are increasing, the hospitalization rate for COVID-19 remains low for Dallas County, according to the CDC. But hospitalizations and even deaths are still being reported from the virus.

“We don’t see a lot of cases filed, but we do see some,” Perl said. “I think there’s a sense that people don’t get really sick anymore. … It’s true that we don’t see a lot of serious illness, but it affects some people very seriously.”

What you should know about vaccines

This summer’s spike in Covid-19 cases may also be due to vaccine protection waning as more time passes between shots, Huang said. This makes it extra important to get an updated vaccine when it becomes available.

The new vaccine should come out later this month or in September, Perl said, and the CDC recommends everyone ages 6 months and older get it. Perl said it’s especially important to get vaccinated if you’re immunocompromised or have a high-risk condition, or if you’re in frequent contact with people in those groups.

Huang recommends sticking to all recommended vaccines before a new school term. The county has several joint vaccination clinicsand other vaccine options can be found at vaccines.gov.

Updated vaccines can also protect against specific circulating variants.

The current circulating strains are all descendants of Omicron, Perl said. In the national data, the KP.3 variant is most prominent, according to Perl, and in Dallas County, JN.1 and LB.1 strains are also circulating. Local data showed that KP tribes were most prominent in the county, she said.

“The new vaccine coming out has been reformulated to target these KP strains,” Perl said. “The initial animal data certainly suggests that it’s much more effective … against what’s circulating.”

What you should know about long covid

Perl said clinics treating patients with long-term covid, a disease in which symptoms persist for an extended period after an initial covid infection, have been busy.

She has no record of long covid diagnoses in Dallas, and researchers don’t always agree on a definition of the disease. But she said the best estimates are that about 10% of covid infections are associated with prolonged covid.

Even people who are asymptomatic when infected with the coronavirus can get long-term covid, Perl said, but people who are vaccinated are much less likely to develop the disease.

Scientists are still trying to understand the long-term effects of the virus.

“A lot of (doctors) are telling me we have to be cautious about what the long-term effects of covid are, because we’re still learning,” Love said.

Take steps to protect yourself

When schools go back into session and flu season approaches, Perl recommends taking extra precautions to protect against respiratory viruses.

“When you start to see an increase in covid, you usually also see an increase in other respiratory viruses,” Perl said. “They kind of all work together.”

Perl recommends good hand hygiene, coughing and sneezing into your arm, encouraging children to wash their hands and staying home if you have respiratory symptoms. If a child has a fever, they should stay home and not return to school until they have gone 24 hours without one, Perl said.

Huang recommends that you consider wearing a mask in crowded, indoor or poorly ventilated areas if you are at high risk of getting sick from covid-19.

Watch for symptoms of the virus, such as sore throat, shortness of breath, cough, new loss of taste or smell, tiredness, runny nose or low-grade fever. Get tested if you have symptoms, Huang said. If you do get covid-19, Huang recommends taking advantage of available treatments.

While the presence of COVID-19 in our lives looks different than it did four years ago, the summer spike in cases is still a good reminder to practice healthy habits.

“With the Covid pandemic, we’ve really gained a very important appreciation for the impact that respiratory viruses can have on human health,” Perl said.