The United States is in the grip of its now-familiar late-summer COVID-19 wave, with the Centers for Disease Control and Prevention's wastewater surveillance showing infections growing or likely growing in 47 states and declining in none, as of the agency's most recent weekly update. Texas currently reports the highest concentration of the virus in sewage of any state, with rates also climbing quickly across the South and West.
Test positivity nationally reached roughly 6% for the week ending August 29 — well below the same week a year earlier, when the positivity rate topped 11%, according to CDC figures. Public health officials tracking the pattern say COVID-19 has now settled into a predictable twice-a-year rhythm, surging each winter and again each late summer as back-to-school gatherings and the tail end of travel season create ideal conditions for spread. Experts have told reporters they expect this wave's transmission to peak roughly a week into September, putting the country near the crest of the current surge.
A milder wave than years past
Despite the wide geographic spread, the CDC continues to classify overall COVID-19 activity as low nationally, and the picture on serious illness looks markedly better than in previous years. According to a summary compiled by the Association of American Medical Colleges, the U.S. recorded fewer than 6,000 COVID-19 deaths by early August 2026 — down more than 60% from the same period last year, and roughly a tenth of the toll seen during the pandemic's peak in April 2020.
Risk remains sharply concentrated among older and immunocompromised Americans. People 65 and older account for 75% to 80% of COVID-19 deaths despite making up only about 16% of the population, and hospitalization rates run far higher among high-risk groups: roughly 6% of high-risk patients who contract the virus require hospitalization, a figure that climbs to between 20% and 50% among people undergoing cancer treatment. An estimated 18 million Americans are also living with long COVID, the AAMC notes.
The wave arrives just as updated vaccines reach pharmacies. The FDA approved four updated COVID-19 vaccines from Moderna, Pfizer-BioNTech and Novavax-Sanofi for the 2026–2027 season in late August, each reformulated to target the JN.1-lineage XFG variant now dominant in U.S. wastewater samples. The shots are approved for adults 65 and older and for younger people with underlying conditions that raise their risk of severe disease, with eligibility varying slightly by manufacturer. Health officials also point to existing tools for people who do get infected: Paxlovid and remdesivir remain the recommended treatments for high-risk patients, alongside the newer antiviral Xocova, approved in June for use after a known exposure, which trial data show cuts the risk of infection by about 67%.
What happens next
With transmission expected to crest in the coming days, health officials say the coming two to three weeks will show whether this wave follows the milder trajectory of the past two summers or proves more severe. Clinics and pharmacies are expected to have the updated vaccines widely available through September, and public health messaging is focused on encouraging high-risk groups in particular to get updated before winter's separate seasonal wave arrives.
