Hopkins doctor: This COVID surge not as bad as the last but prepare for another. And monkeypox.

The country’s latest COVID-19 surge appears to have crested well before reaching anywhere near the pandemic peak seen in January. But the pandemic isn’t done, and new variants already are emerging around the country that could mean another wave this summer or fall and everyone ought to be ready.

So says Dr. Tom Inglesby, a public health expert who just returned to his post at Johns Hopkins University from a COVID-19 advisory position at the White House.

There are still more than 100,000 cases being reported nationally each day, though this omicron sub-variant appears to be producing far fewer fatalities, about 265 a day, he said. And while some states show declines in cases and others show increases, overall the wave appears to be leveling off in much of the country , he said.

“We are in what appears to be a plateau, but not all plateaus stay plateaus,” said Inglesby, who spoke during a Hopkins news conference Tuesday centered on protection, prevention and preparation.

“As in the past, it looks different depending on where you are in the country,” he said. “And we’re still in a surge.”

Inglesby is the director of the Johns Hopkins Center for Health Security in the Bloomberg School of Public Health, whose scientists have provided research and analysis throughout the pandemic to a range of policymakers, lawmakers and clinicians. Inglesby returned in April after serving as a senior adviser on President Joe Biden’s COVID-19 response team.

In Maryland, COVID-19 infections began rising again in late March but remain far below the January peak that exceeded 17,000 daily cases, according to data from the Maryland Department of Health. There were 1,756 COVID-19 infections reported Wednesday, around the state, though officials believe cases are undercounted significantly here and around the country because tests done at home go largely unreported.

The positivity rate in Maryland is 8.9%, above the 5% threshold where the virus is considered widespread.

The U.S. Centers for Disease Control and Prevention specifically lists Baltimore City and Anne Arundel, Baltimore, Howard and Kent counties as having high community transmission along with other hot spots in the Mid-Atlantic, Northeast and across the nation.

Inglesby urged the third of the country’s population that remains unvaccinated to get the shots, as well as those who are eligible for their first booster (anyone over age 5) and their second booster (anyone over age 50 or at risk for severe disease.)

He also urged Congress to act on a request for more funding from Biden for more improvements to ventilation at schools and other public places and continued testing, vaccinations and treatments.

The antiviral Paxlovid also has become far more accessible in recent months for vulnerable people with infections, Inglesby said.

Inglesby said there could be another surge over the summer, as two newer omicron sub-variants — BA4 and BA5 — have taken root around the country, supplanting the B2.12.1 sub-variant now fueling cases. He and others already say emerging patterns suggest there will be a fall or winter surge.

But, he added, “making predictions beyond the next few months is not feasible.” Everyone hopes the surges “won’t keep happening,” he said, “but we need to prepare as if they will.”

Inglesby said the nation also needs to better prepare for more cases of monkeypox, a disease that isn’t normally found in the United States. It began emerging after cases were discovered last month in the United Kingdom.

The CDC reports no cases yet in Maryland. But infections have been logged in the neighboring states of Virginia and Pennsylvania among the 31 U.S. cases in 13 states.

The virus is known by the rash that develops and has reemerged as a public health threat, though it’s not as contagious as COVID-19 and is spread differently. People can breathe tiny droplets of the coronavirus and become infected, while monkeypox is transmitted mostly from close personal contact.

People share bodily fluids or touch an open lesion or contaminated bed sheets or clothes. Recent cases have been found disproportionately among gay men, though it’s not traditionally considered a sexually transmitted disease.

Inglesby said clinicians need to consider testing people who come in with a rash. The samples currently are being processed in public health labs, but he called for a quicker transition to the private lab network for faster results.

“We need to raise awareness that if there is a rash they should be evaluated for monkeypox,” he said.

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