Once again, the US is sinking into what could be another wave of COVID-19, with cases rising nationwide in most states after a two-month drop.
A big stranger?  “We do not know how high this mountain will go,” said Dr Stuart Campbell Ray, an infectious disease specialist at Johns Hopkins University.
No one expects a peak almost as high as the previous one, when the contagious version of the coronavirus broke the population.
But experts warn that the impending wave – caused by a mutant called BA.2 believed to be about 30% more contagious – will wash away the entire nation.  They are concerned that hospitalizations, which have already increased in some areas of the Northeast, will increase in a growing number of states in the coming weeks.  And the wave of cases will be bigger than it looks, they say, because the numbers reported are huge and counted as more people get tested at home without reporting their infections or skipping tests altogether.
At the peak of the previous increase of small, the reported daily cases reached hundreds of thousands.  As of Thursday, the seven-day moving average for daily new cases had risen to 39,521, from 30,724 two weeks earlier, according to Johns Hopkins data compiled by the Associated Press.
Dr Eric Topol, head of the Scripps Research Translational Institute, said the numbers were likely to continue to rise until the wave reached about a quarter of the height of the last “monster”.  BA.2 may well have the same effect in the US as it did in Israel, where it dealt a “blow” to graphs, he said.
Keeping the growth somewhat under control, experts said, is a higher level of immunity in the US from vaccinations or previous infections compared to the onset of winter.
But Ray said the United States could look like Europe, where the BA.2 wave was “significant” in some parts of the world with comparable levels of immunity.  “We could have a significant increase here,” he said.
Both experts said that BA.2 will be moved to the country gradually.  The Northeast has been hit hardest so far – with more than 90% of new infections caused by BA.2 last week compared to 86% nationally.  As of Thursday, the highest rates of new COVID cases per capita in the last 14 days were in Vermont, Rhode Island, Alaska, New York and Massachusetts.  In Washington, D.C., which also ranks in the top 10 for new cases, Howard University said it was moving most undergraduate courses online for the remaining semester due to “a significant increase in COVID-19 positivity” in the district and on campus.
Some states, such as Rhode Island and New Hampshire, have seen average daily new cases rise more than 100 percent in two weeks, according to Johns Hopkins.
In New Hampshire, the rise in cases comes two weeks after the closure of all 11 state-run vaccination facilities, and the governor is being pressured by some supporters to reverse his course.
Joseph Wendelken, a spokesman for the Rhode Island Department of Health, said the measurement they are most focused on at the moment is hospitalization, which remains relatively low.  About 55 patients with COVID-19 are being treated, compared to more than 600 at one point in the pandemic.
Officials credit the high vaccination rates.  Government statistics show that 99% of Rhode Island adults are at least partially vaccinated and 48% have received the booster dose that scientists say is key to protecting against serious micronutrient diseases.
Vermont also has relatively high vaccination rates and fewer patients in the hospital than during the first micron wave.  However, Dr Mark Levin, the health commissioner there, said hospitalizations and the number of patients in intensive care units were both slightly higher, although deaths had not increased.
Data from the Centers for Disease Control and Prevention show that new admissions of patients with confirmed COVID-19 to hospitals have increased slightly in New England and New York.
On the West Coast, modelers from Oregon University of Health & Science predict a slight increase in hospitalizations over the next two months in this state, where cases have also risen sharply.
As the wave travels across the country, experts said states with low vaccination rates could face significantly more infections and more serious cases that end up in the hospital.
Ray said government leaders must be careful to set the right tone when talking to people about protecting themselves and others after the COVID restrictions are lifted.  Philadelphia recently became the first major U.S. city to reinstate its indoor mask mandate after a sharp rise in infections.  However, Vermont’s Levine said there were no plans to reinstate any of the restrictions that had been imposed earlier during the pandemic.
“It will be difficult to introduce restrictive, draconian measures,” Ray said.  “Fortunately, we have some tools we can use to mitigate the risk.  And so I hope leaders will emphasize the importance of people watching the numbers, be aware of the dangers and consider taking precautions such as using a mask and getting vaccinated and boosted if they have not already done so.
Lynne Richmond, a 59-year-old breast cancer survivor living in Silver Spring, Md., Said she plans to get her second souvenir and continue to wear her mask to the public as cases increase in her state and nearby Washington. , DC.
“I never really stopped wearing my mask – I was extremely vigilant,” he said.  “I feel that I have come so far.  I do not want to stick to COVID “.
At the 250-bed New Hampshire Veterans Home in Tilton, staff still wear masks and maintain a social distance.  Veterans are allowed limited excursions to places such as an antique game museum and restaurants, where they may have a separate room and the waiting staff is covered.
Vigilance is a good strategy, experts said, because the coronavirus constantly shoots curves.  One of the last: even more contagious BA.2 variants found in New York State, known as BA.2.12 and BA.2.12.1.  And scientists warn that new and potentially dangerous variants could emerge at any time.
“We should not believe that the pandemic is over,” Topol said.  “We still have to be vigilant.”
Associated Press reporters Wilson Ring in Stowe, Vermont, and Holly Ramer and Kathy McCormack in Concord, New Hampshire, contributed to this report.