Summer Covid surge hits 27 states with ‘razor blade throat’

A Covid variant nicknamed “razor blade throat” is fueling an uptick in cases across more than half the country, catching many Americans off guard during what’s typically a quieter season for respiratory viruses. The N.B.1.8.1 strain now accounts for 43% of new infections nationwide, with particularly high transmission rates across the South.

The variant earned its ominous nickname from reports of exceptionally painful sore throats among infected individuals. While throat pain has been a Covid symptom since the pandemic began, some patients describe this iteration as particularly severe, though medical professionals caution against assuming the virus has fundamentally changed its behavior.

States seeing the biggest increases

Covid activity is growing or likely growing in 27 states, with Texas, Illinois, Kentucky, Virginia, and Ohio experiencing notable upticks. The southern region shows the highest test positivity rates, though current levels remain well below last summer’s peak when rates hit 17.9% in August. This year’s positivity rate hasn’t yet reached 5%, suggesting a more moderate surge.

The timing coincides with intense heat waves driving people indoors to air-conditioned spaces, creating ideal conditions for viral transmission. Combined with waning immunity from vaccines or previous infections, the stage is set for continued spread through the summer months.

5 factors complicating vaccine decisions

1. Timing mismatch with new vaccines – Updated shots targeting the LP.8.1 strain won’t arrive until fall, leaving a gap during the current surge. The new formulations will specifically address variants that emerged after current vaccines were developed, potentially offering better protection against circulating strains.
2. Limited availability of current shots – Many pharmacies have depleted their Covid vaccine supplies, making it challenging to find doses even for those wanting immediate protection. Some locations have stopped ordering vaccines ahead of the fall rollout, creating access issues.
3. Restricted approval expectations – The fall vaccines may only receive approval for adults 65 and older plus those with medical conditions increasing their risk. Healthy adults wanting shots might need to pay out of pocket, with doses costing up to $140 each.
4. Waning population immunity – Most Americans haven’t received a Covid shot in over a year, meaning whatever protection they had from previous vaccines or infections has significantly diminished. This creates a population-wide vulnerability despite some residual immunity.
5. Uncertain variant severity – While the “razor blade throat” nickname sounds alarming, hospitalization rates remain low. This suggests the variant may not cause more severe illness despite its uncomfortable symptoms, complicating risk assessments for individuals.

Who needs protection now versus later

High-risk individuals face the most pressing decisions about seeking immediate vaccination. This group includes older adults, people with weakened immune systems, pregnant women, and those with conditions like asthma or heart disease. For these populations, finding any available vaccine now might outweigh waiting for updated versions.

The calculation differs for healthy adults and children. Without significant underlying risks, they may reasonably wait for fall vaccines that better match circulating variants. However, those in states with rising cases who regularly interact with vulnerable populations might consider immediate vaccination if doses are available.

Managing risk without vaccines

For those unable to find vaccines or choosing to wait, other protective measures gain importance. Masking returns as a consideration for high-risk individuals attending indoor gatherings like movies or concerts. Improved ventilation, avoiding crowded spaces during peak transmission times, and maintaining hand hygiene offer additional layers of protection.

The current wave is expected to peak around September before giving way to the traditional winter surge. This two-wave annual pattern has become Covid’s established rhythm, with summer increases driven by indoor gathering and winter peaks coinciding with flu and RSV seasons.