Chicago COVID-19 cases and hospitalizations on the rise; Northwestern team warns of undiagnosed long-COVID consequences

Chicago’s COVID-19 cases and hospitalizations are continuing to steadily rise after reaching pandemic lows earlier this summer.

City health officials say the rise doesn’t present an urgent threat to the public but shows the coronavirus is still spreading and merits attention.

“It’s a good reminder that COVID is here, that COVID can make an impact,” said Massimo Pacilli, the Chicago Department of Public Health’s disease control deputy commissioner. “The pandemic isn’t gone. While there is some desire of putting it behind us, COVID is with us.”

The city is averaging 11 hospitalizations per day, up from 7.8 the week before and 1.4 in mid-July, city data released Thursday shows. Similarly, laboratory-confirmed cases have jumped to 119, up from 98 the week prior and 30 in mid-July. The indicators both remain at “low” risk levels, as defined by the Centers for Disease Control and Prevention.

The small increase has been underway since Chicago’s virus indicators hit pandemic lows in July, Pacilli told the Tribune Wednesday. Hospitalizations and cases have been growing at a linear rate, he said. But the steady increase does not present an urgent threat to the public, he added

Wastewater monitoring — a useful indicator in light of the public’s declining participation in laboratory testing — also shows COVID-19 levels in the city’s sewers are increasing, Pacilli said. However, it is hard to predict the timing and magnitude of the virus’s waves, he said.

The health department’s tracking shows omicron subvariants remain dominant in the city, meaning people who are vaccinated or have recently had COVID-19 are well protected against severe illness, Pacilli said. The city expects to begin administering booster shots when the updated vaccine designed with omicron in mind is approved by regulators and distributed by manufacturers in September or October, he said.

Pacilli emphasized that the increases have been occurring while the city is still at low risk levels as he encouraged people to get vaccinated and isolate when sick.

“It’s not an all-or-nothing,” he said. “We need to continue doing that which helps keep these numbers in the green space.”

Researchers have recently identified a new variant appearing across the world with significant mutations, Pacilli said. The omicron subvariant, BA.2.86, appears effective at spreading broadly, but it’s too early to tell how the mutated virus strain will spread, he said.

“The large number of mutations in this variant raises concerns, but it is too soon to know the real-world impact on immunity,” Pacilli said of the variant some have nicknamed “Pirola.”

Regardless of an individual’s health status or medical conditions, people might opt to wear masks during higher-risk activities like time spent in airplanes or in crowded spaces, said Dr. Aniruddha Hazra, an assistant professor of infectious disease and global health at University of Chicago Medicine.

Hazra urged people to take nuances of comfort levels and risk into account.

“Making these small changes really can be beneficial,” he said.

People who are older or immunocompromised are at a higher risk for severe illness with COVID-19 and should be more cautious than others and mask in crowded spaces, said Dr. Mary Hayden, director of Rush University Medical Center’s infection diseases division.

She said she anticipates continued increases in COVID-19 cases, as well as jumps in seasonal viral illnesses like the flu and respiratory syncytial virus, known as RSV, as school begins and cold weather pushes people inside.

“I expect we will be seeing more, but I’m not terribly concerned or terribly worried. I don’t think people need to be incredibly worried right now,” Hayden said.

Northwestern long-COVID study

For some, COVID-19′s effects can extend beyond short-term illness. Potentially debilitating long-COVID symptoms can leave patients with lasting cognitive impairment, altered lung function and higher heart rates, according to a study released in July by Northwestern Medicine’s Comprehensive COVID-19 Center.

A new study released Wednesday by the center suggests millions of people who never tested positive for COVID-19 may have such lingering symptoms. Because they don’t have a positive test to prove they got sick, they might miss out on care, the center’s co-director Dr. Igor Koralnik said.

“There is a large population in the U.S. and world who are the negative long-haulers. Those patients have been rejected and stigmatized because they have all the symptoms, but they don’t have a positive COVID test,” Koralnik said.

Most post-COVID clinics don’t accept people who haven’t gotten positive tests, Koralnik said. Research on long COVID often excludes them too, he said. The people who haven’t tested positive but experience the disease’s lingering symptoms face delays in getting the care they need, he added.

Koralnik estimates nearly 10 million Americans who don’t have an official COVID-19 diagnosis have experienced the neurological manifestations of long COVID.

“They deserve the same access to care and inclusion in research studies,” the study he co-authored says.

When the Northwestern center tested 29 long-COVID patients, researchers detected antibodies or T-cell responses indicating COVID-19 exposure in 12 of them.

Koralnik said the researchers couldn’t test more patients because the testing is expensive, and COVID-focused research involving patients who have never tested positive doesn’t garner funding.

There are far fewer patients in hospitals now, and the COVID-19 emergency has ended, Koralnik said. But the virus is still spreading and infecting people, and new variants will emerge, he noted.

Long term, a COVID-19 infection can still hurt cognition, make work more difficult and seriously impede life, he said.

“People need to realize that long COVID is really the pandemic within the pandemic,” Koralnik said. “The less people are going to mask and social distance, and the more the virus is going to evolve and mutate, we are going to continue to see a steady number or even an increase in long-COVID patients.”