As the United States nears an unfathomable tally of 1 million COVID-19 deaths, cases are rising again, outbreaks are mounting and experts believe another big spike is on the horizon.

On Sunday, Johns Hopkins University estimated 999,570 Americans have died from the coronavirus pandemic. In Halifax County, the toll is 159 residents.

Cases are on the rise again, with ever-changing versions of the omicron variant being blamed for the latest spread. Halifax County officially averages 11 new COVID-19 cases per day, according to the Virginia Department of Health. This is the highest level since early February.

However, the official figures probably do not fully reflect the current situation. The results of the at-home tests are now hiding the daily numbers. Simply put, experts believe there are many more diseases that go unreported.

Outbreaks across the state are rising with cases. An outbreak was reported locally at the Berry Hill Health and Rehab Center in South Boston on May 5, Health Department data show.

The exact number is not known, but should be between three and five cases. If there are fewer than five cases at a facility, the health department will protect the exact number from the public to maintain anonymity.

Officials report that at least three infections must be linked to a single environment before it is declared an outbreak.

The Southside Health District — an area that includes Halifax, Brunswick and Mecklenburg counties — remains on a slow growth trajectory, according to the University of Virginia’s Biocomplexity Institute report Friday. That means cases are rising, but not at levels that could be considered an increase.

But most health districts – 22 out of 35 – are on a surge, showing cases have doubled on a scale of 100,000 residents.

While other states are seeing increases, most northeastern states are seeing rapid increases in cases, UVa reported.

In addition, the baseline reproduction number — a number showing how many infections are caused by a single case of COVID-19 — is above one for all Commonwealth regions, an indication that case numbers will continue to rise.

Another subvariant of omicron – this one named BA.2.12.1 – is expected to dominate in Virginia for the next few weeks.

“Multiple signals suggest that BA.2.12.1 is causing a spike in cases across Virginia,” the researchers wrote in Friday’s report. “Modeling suggests cases could continue to increase into July and August.”

As with all forecasts, there are many uncertainties. However, UVa thinks it’s likely Virginia will see another wave of COVID-19 cases and hospitalizations.

The alarms sound from multiple directions. In addition to UVa’s models, the State Department of Health monitors viral loads in wastewater from 25 treatment plants across Virginia. The department also looks into neighboring states to see what is currently happening there.

“Several more populous states such as New York and Florida often lead Virginia by a few weeks when it comes to COVID flare-ups,” UVa researchers wrote. “All of these warning systems report the same thing: A new wave is coming.”

level up

Halifax County has entered the mid-level community for COVID-19.

That means masks are still not recommended for most people. However, the federal agency suggests immunocompromised residents or those at high risk of serious illnesses speak to their doctor to see if they should wear a face covering in public.

Also, anyone showing symptoms or who has been exposed to someone with COVID-19 should wear face coverings, the CDC recommends.

Masks should also be worn on public transport.

In February, the CDC transitioned to a hospital-based system for mask suggestions. This changed from a stance examining how the virus spreads in an area to a goal of not putting a strain on the local health system.

On Friday, Sentara Halifax Regional Hospital was treating two patients for COVID-19.

What to expect

The models vary depending on the intensity of the upcoming wave.

On the current course, UVa is showing a slow and steady increase in cases reaching about 20,000 a week by early June. This scenario peaks at about 75,000 cases by early July.

Another model supports a slightly faster and larger increase, with a peak of 78,000 weekly cases in early July.

A third scenario – the worst of all – projects a large increase. It hits 40,000 weekly cases through June, peaking at nearly 115,000 in the first week of July.

That would dwarf the 113,000 cases at the peak of January’s spike, a record in Virginia.

A fourth model accounts for behavioral changes in Virginians. If that happened – more masking and fewer gatherings – cases could peak at around 90,000 a week in mid-June and drop below 40,000 by August.

“Please do your part to reduce the number of cases,” urged UVa researchers. “Always practice good prevention. Consider covering up in indoor public areas and self-isolating when ill. Please also get vaccinated and refreshed.”

Not reported

There is no system that captures 100% of infections and it is common for many diseases to go unreported.

“For example, the CDC estimates that they detect and catalog less than 15% of all cases of Lyme disease each year,” UVa researchers said.

Epidemiologists even have a special term for this: the ratio of detected cases to total infections is called the “detection ratio”. The smaller the ratio the better as it means more cases will be captured.

“The only surefire way to measure the finding is to systematically study a sample of the population to understand the true rate of infection,” the researchers said.

Home testing has recently impacted the COVID-19 detection rate.

“While they are an essential tool to protect families and communities, at-home test results are only occasionally reported to public health officials,” the UVa report said. “That means many cases that would have previously been reported are being missed.”

This also affects test positive rates, giving an artificially lower number.

During the peak of the Omicron wave, there were likely more than 10 infections for every case identified.

“To put it simply, the Omicron wave was much, much larger than even the record-breaking number of identified cases would suggest,” experts say.

That doesn’t mean the next wave will be just as big, however, the report said.

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