COVID-19 infections are growing across every state in the country during what was once considered the virus's off-season, and federal data suggests the worst of the summer wave is still weeks away.
CDC modeling estimates show infections growing or likely growing in all 50 states as of mid-August 2026, with the South and West seeing the sharpest climbs over the past month. At least 15 states and territories were experiencing active outbreaks as of August 17, according to the Pandemic Mitigation Collaborative, a data-tracking group led by Tulane University researcher Michael Hoerger.
The numbers are still relatively modest compared to last summer's wave. Nearly 4% of COVID tests came back positive in the most recent reported week, less than half the 9%-plus positivity rate recorded during the same stretch in 2025. Wastewater viral activity and emergency department visits both registered as "very low" in CDC surveillance data through August 14. But the trend lines are moving in one direction, and the people who watch them closest say the climb has weeks to go.
Hoerger, an assistant professor at Tulane's School of Medicine who runs the Pandemic Mitigation Collaborative, told Today:
"That is troubling, especially if you're in one of those areas. We're expecting transmission to peak about a week into September."
For years, COVID-19 followed a familiar winter pattern, cases spiked alongside flu and RSV when cold weather pushed people indoors. That pattern has shifted. The 2025 summer surge, driven by the "Stratus" variant, hit harder than the winter wave that followed it in several states.
Dr. Erica Pan, director of the California Department of Public Health, put it bluntly in comments reported by the Los Angeles Times on August 14.
"Our summer peak was much higher in 2025 than it was in the winter."
That fall Stratus wave left Americans battling a persistent dry cough and other symptoms well into autumn. The "cicada" variant, named for its long dormancy before a loud return, surfaced earlier this year. Both strains appear connected to the current uptick, though the precise role each is playing in the 2026 summer surge remains unclear from available surveillance data.
The emerging two-peak annual cycle matters because it reshapes how people need to think about protection. A virus that reliably hit in December gave families one window to prepare. A virus that surges in August and again in winter doubles the exposure calendar, and catches people off guard during vacations, summer camps, and family travel, when almost nobody is thinking about respiratory illness.
Vaccination rates tell a stark story about public fatigue. Fewer than 20% of U.S. adults received the most recent COVID shot, according to the CDC's vaccination coverage dashboard. That figure sits well below flu vaccination rates in a typical year and reflects a population that has largely moved on from pandemic-era urgency, even as the virus keeps circulating and mutating.
The timing compounds the problem. An updated vaccine targeting the XFG variant is expected to become available in early fall 2026, according to the FDA. That means the current surge is hitting before the next round of shots arrives, leaving the vast majority of Americans relying on whatever residual immunity they carry from prior infection or outdated doses.
Claire Hannan, executive director of the Association of Immunization Managers, told NPR on August 14 that the public health message hasn't changed even if public attention has:
"The message is that COVID vaccine and flu vaccine will be available, they're covered by insurers, they're recommended by medical societies. People should get them and get them for their kids."
Under the Trump administration, the CDC moved away from universally recommending COVID-19 vaccines for everyone six months and older. The agency adopted a "shared clinical decision-making model," which puts the vaccination choice in the hands of patients and their doctors rather than issuing a blanket recommendation. Before the change, the shot was recommended across the board for anyone six months of age and up.
Other major medical groups continue to recommend the vaccine for the broader population, though the specific organizations were not named in CDC reporting. NYC Health issued a statement calling COVID vaccines "our best protection" against the virus.
The shift to shared decision-making reflects a reasonable principle: adults and their physicians are better positioned to weigh individual risk than a federal agency issuing one-size-fits-all guidance. But the practical result is a vacuum. When the government stops actively pushing a recommendation, uptake drops, and the under-20% adult vaccination rate bears that out. Whether that tradeoff is worth it depends on whether you believe the government's job is to inform or to direct.
COVID killed 20,685 Americans in 2025, according to death certificate data compiled by the CDC. That figure is a fraction of the pandemic's early-year tolls, but it is not zero, and it is not trivial. For context, it lands in the range of annual deaths from conditions most people take seriously, kidney disease, sepsis, liver disease.
The risk of long COVID, lingering symptoms that can persist for weeks or months after infection, also remains a concern flagged by health officials tracking the current surge. No death figures specific to the 2026 summer wave have been reported yet.
The gap between the virus's actual toll and public perception of it has widened steadily. After years of lockdowns, mandates, school closures, and shifting official guidance that eroded trust, many Americans tuned out entirely. That frustration was earned. But tuning out the virus doesn't make it tune out the population, especially older adults and people with chronic conditions who remain most vulnerable during summer surges that catch the health system looking the other way.
If Hoerger's projection holds, transmission will peak roughly the first week of September, just as schools reopen and Labor Day travel floods airports and highways. The updated XFG-targeting vaccine won't be widely available until sometime after that window opens. The math is simple: the surge arrives before the new shot does.
None of this requires panic. It does require honesty. COVID has settled into a pattern that no longer fits the old seasonal assumptions, vaccination rates are low, and the next peak is weeks away. Americans deserve straight information and the freedom to act on it, not mandates, and not silence either.
