Flu season typically starts in October, and peaks during the winter months. But a recent uptick of respiratory symptoms has people in the area asking themselves if flu season has started early.
One potential answer: “Valley fever.” The non-contagious respiratory illness, caused by a fungus, attacks the lungs and manifests as a fever, persistent fatigue and coughing.
Thanks to the state’s abnormally wet winter and the following dry heat, northern California and the San Joaquin Valley may see more cases of the virus, which is typically seen in the middle Central Valley and the central coast.
But those cases are predicted to grow in the coming months, not necessarily right now.
That leads many people to ask: Is there a “summer flu” going around? According to Dr. Noha Aboelata of Oakland’s Roots Community Health Center, it’s “highly, highly improbable.”
But don’t just take her word for it, she said. Look at wastewater data, which comes from concentrations of viruses, like flu and COVID-19, in sewage — it doesn’t lie, since everyone needs to use the bathroom.
“You can see that the SARS-COV-2 is still very much with us, it's increasing,” Aboelata said. “If you look at flu A and B, it's a completely flat line at zero. There's no flu circulating right now, and it’s not flu season.”
Data compiled by Healthy Central Valley Together, which includes Yolo County, shows no recent flu activity. Data from Sacramento’s Regional Wastewater Treatment Plant shows far lower concentrations of influenza A — and no influenza B — in wastewater, compared to COVID-19.
And overall, wastewater for Sacramento County shows COVID-19 cases are increasing — a pattern reflected across the nation.
“When we were tracking [COVID-19] cases and wastewater at the same time, [we know] that they do track together,” said Dr. Aimee Sisson, Yolo County’s Health Officer. “So we feel confident that as wastewater [COVID-19] levels are increasing, that means that there are more cases in the community. They're just not being reported as cases anymore.”
Test positivity in California — which is an underestimate since more people are checking for sickness via at-home COVID-19 tests — shows a 10.1% increase, with the most recent data from Aug. 8. Walgreens data from tests in California taken from Aug. 7 through Aug. 13 show a 48.3% positivity rate.
The increase in cases coincides with the start of the school year for many, and the rise of a new dominant COVID-19 variant, E.G.5, unofficially known as “Eris”. Its primary symptoms — a runny nose, sore throat, muscle aches among them — can mimic allergies and no longer include fever and shortness of breath.
Sisson, Aboelata and Samantha Mott, a spokesperson for Sacramento County, all recommend wearing a high-quality mask like a KN95 or N95 in indoor places, especially areas like public transportation, and staying home if you’re showing any signs of illness. And they also recommend testing for COVID-19 to confirm your infection, so you can get treatment like Paxlovid if you’re eligible and inform anyone you’ve been in contact with over the past few days.
Aboelata stressed that while the message being broadcasted as school heads back into session is that COVID-19 is “no big deal,” that’s not the case — and it makes sense to want to avoid COVID-19.
She noted research that repeated COVID-19 infection weakens the immune system, the whole-body impacts of the virus and the potential for long COVID.
“You don’t know who’s going to have a bad outcome,” Aboelata said. “It could be the second time you get COVID, or the fourth time you get COVID. Just because you did fine the first time is definitely not a reason to think everything’s going to be okay the next time, so it is still definitely worth preventing infection and reinfection and preventing spread to others.”
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Where to get tests
As soon as you have symptoms, you should look into getting tested, said Sisson.
This current variant’s main symptoms include a runny or stuffy nose, sore throat, coughing, fatigue, muscle aches, sneezing and changes to sense of smell.
“If you're feeling ill and you have a negative COVID antigen test, it could still be COVID, or it could be something else that you don't want to be sharing with other people in your life,” she said. “We continue to encourage those people who have symptoms who are testing negative to stay home and away from other people until they're feeling better.”
At this time, there aren’t any circumstances under which Sacramento County-operated COVID-19 testing sites will reopen, Mott told CapRadio.
“At-home test kits are available in addition to getting tested at a healthcare facility,” she said.
PCR tests (which tend to be more accurate than rapid antigen tests) are available in the area, though are much less accessible than rapid antigen tests.
“Healthcare providers continue to be the best resource for getting a PCR test,” Sisson said.
Rapid antigen tests can be purchased in pharmacies like CVS, Walgreens and Rite Aid, along with select Target locations. Depending on the brand, they cost between $8-$25. (In a medRxiv preprint, researchers found the FlowFlex COVID-19 at-home test — which is among the brands readily available locally — performed the best in an analysis of 34 rapid tests.)
KQED also has a guide for how to improve the accuracy of your COVID-19 at-home tests.
Getting tested:
- Free rapid antigen test kits are available in four outdoor, 24/7 vending machines in Yolo County:
- Esparto Regional Library, 17065 Yolo Ave., Esparto
- Mary L. Stephens Library, 315 E. 14th St., Davis
- Winters City Hall, 318 First St., Winters
- La Superior Market 34 W Court St., Woodland
- Free in-person antigen testing and test kits are available at these Sacramento locations:
- La Familia Maple Neighborhood Center, 3301 37th Ave., Sacramento (Mondays, 9 a.m. to 12 p.m.; registration form)
- Serna Center, 5735 47th Ave., Sacramento (Monday through Friday, 8 a.m. to 4 p.m.)
- For Sacramento City Unified School District students, staff and household members only: Registration is here, and testing is also offered to staff and students on-site if needed during the school year.
- Free PCR testing is available at:10 Acres Pharmacy, 2930 Freeport Blvd, Sacramento (Monday through Friday, 9 a.m. to 5:30 p.m.; registration form)
- Quest Diagnostic locations — only for the uninsured, otherwise it’ll cost $199
- Yolo County libraries also have a limited supply of free test kits, but call before to confirm availability.
- For UC Davis students and employees, the school is providing free test kits to students and employees on campus through Sep. 15 at several locations. Appointments for PCR testing are free to schedule for symptomatic students and employees.
- For Sacramento State students experiencing symptoms, appointments for PCR testing are free to schedule.
- If you’re insured — regardless of insurer — private testing company COVID-19 Premium Health covers PCR and antigen testing for free at a handful of its Sacramento-area sites. Otherwise, a rapid antigen test is $89 and a PCR test is $149.
- Labcorp will ship you a PCR test kit for $79, the same price as its in-person PCR testing service.
- Select CVS locations continue to provide rapid antigen COVID-19 testing for $70.
- Your insurance may continue to cover COVID-19 antigen test kits purchased at pharmacies; Medicaid, for example, will cover over-the-counter tests in full for full-benefit enrollees through at least May 11, 2024.
Where to get free KN95, N95 masks
If you want to upgrade your mask to a respirator like a KN95 or an N95, there are some places you can get them for free in the area.
Sisson with Yolo County said the Davis location for the COVID-19 test vending machine currently also stocks free N95 masks.
And if you’re part of the UC Davis community, you can request free masks from the local mask bloc — a grassroots community group aiming to increase access to high-quality masks.
The nonprofit Project N95 also runs a free mask program, and you can request free masks online.
Should I get my next booster now?
Yes, according to Sisson with Yolo County and other colleagues she’s talked with at the California Department of Public Health.
“What's important, particularly with activity ramping up right now, is that people are protected now,” she said.
While there’s a new booster that’ll be available in fall, both the Federal Drug Administration and the Centers for Disease Control and Prevention need to sign off on the updated vaccine, which is expected to be ready by late September and more widely available in October.
It’ll be manufactured by Pfizer, Novavax and Moderna and target the XBB strains of the Omicron variant of COVID-19, which are the most common in the U.S. outside of Eris.
“We don’t yet know who the updated vaccine will be recommended for and what the timing will be like,” she said. “Right now, with the current bivalent vaccines, two months is the recommended time that should’ve passed between receiving a previous dose and getting either a second dose [of the bivalent vaccine] or getting your first bivalent dose.”
By that timeline, she added, if someone were to get vaccinated now, the two-month timeline would put them into October when they’re due for another vaccine dose.
“Getting vaccinated now shouldn’t prevent somebody from having to delay their updated vaccine in the fall,” Sisson said.
You can find a vaccine near you through the CDC’s vaccine locator.
What to do if you have COVID-19
Testing as soon as possible is important, Aboelata of the Roots Community Health Center said, for a number of reasons.
If you learn it’s COVID-19, she said, you should isolate as best you can as soon as possible and tell “everyone that you were around for the two or three days before you started having symptoms” so they can mask and test themselves accordingly.
“It’s never a good idea to just assume what it’s not,” she said of sickness. “Knowledge is so important, and it can really help — not only for yourself, but for anyone you’ve been around.”
And antiviral treatment for mild to moderate COVID-19 — Paxlovid or Lagevrio — is time-sensitive, so it must be taken within the first 5 days of symptoms appearing.
“It has been proven to reduce the risk of hospitalization particularly in older people, people with underlying conditions and other factors that put them at higher risk for getting sicker,” Sisson with Yolo County said. “Don’t wait till you get really sick [to have the conversation about treatment].”
Paxlovid has also been shown to reduce the risk for long COVID, or persistent symptoms that can last for months to years after the acute infection.
Antivirals are recommended for anyone who’s at risk for worse outcomes from a COVID-19 infection, including people with mood disorders, with diabetes, who are pregnant, who are immunocompromised and who have received an organ transplant. There are a number of medications that interfere with Paxlovid, so Lagevrio may be prescribed instead.
Pharmacists and physicians are both authorized to provide a prescription for Paxlovid (which no longer requires a positive COVID-19 test if you’re unable to get one, but suspect you have the illness).
In California, you have some options to access treatment:
- Call the statewide COVID-19 hotline at 833-422-4255 for assistance.
- Set up a free phone (call 833-686-5051) or video appointment through California’s COVID-19 telehealth service.
- Get a prescription from your doctor or a local pharmacy.
Along with isolating until testing negative and getting treatment as soon as possible, infectious disease scientist Adam Moore urged people to rest as much as possible if they have COVID-19.
“If you are able to take sick leave or miss school, absolutely do it for the duration of your illness,” he said. “Forcing yourself to do anything strenuous (mentally or physically) can increase the risk of developing long COVID.”
“For everything else, I refer everyone to the People's CDC resource on What to Do if You Have Covid,” Moore said.
The People’s CDC is a grassroots group of public health professionals, scientists, healthcare workers, educators and others working to share and compile the latest information about COVID-19. The resource includes information on layers of protection, how and when to isolate, and short-term and long-term recovery.
Why it matters to keep avoiding COVID-19
There are several short-term and long-term reasons why it’s a good idea to take precautions against COVID-19: Being sick isn’t fun, nor is passing viruses hot-potato-style to people around you. Potential “rebounds” of symptoms can increase isolation time, stretching what sick time you might have at work. COVID-19 infections cause brain damage, regardless of how mild your symptoms are.
And COVID-19 infections have been shown to disable people for the long-term, with little rhyme or reason, Aboelata with Roots Community Health Center said.
“We are just scratching the surface of our understanding of the cumulative nature of the harms of COVID and repeat infections,” she said. “We do know that, of course, every COVID infection is an opportunity for a bad outcome.”
Infectious disease scientist Moore added that precautions don’t have to be “all or nothing” — there are more options than “stay inside our homes forever or let the virus run out of control.”
A key precaution, Aboelata said, is wearing “the high quality filtration mask that fits you well, is so important in any indoor environments where you're with others who you don't know if they have COVID.”
“Which is basically everyone [right now] — you don't know if they have COVID,” she said.
She also recommends pre-event testing, holding gatherings outside if possible and increasing indoor ventilation by opening windows and getting HEPA air purifiers, like the DIY Corsi-Rosenthal boxes.
While it can be uncomfortable to be the only person or one of very few masking in a venue, Aboelata said she preps what she’ll say if someone asks her. Her go-tos: “I don’t like getting sick” and “I don’t have time to get COVID.”
Masking can also encourage others to protect themselves and others, she said.
“Oftentimes I'll say that when I'm going into someplace and I'm wearing a mask, sometimes I see others, and … they'll put theirs on too,” she said. “So just know that by you protecting yourself, sometimes you're also helping someone else feel comfortable in doing so.”
Because of COVID-19’s transmissibility — people are infectious even before they feel sick — Aboelata added that the virus’s patterns of spread are different. When someone has the flu, they usually only infect one or two people; one person with COVID-19 can be a superspreader. And flu usually impacts someone once or twice a year, while with COVID-19 “there doesn’t appear to be any upper limit of the number of times you can catch COVID.”
And the Associated Press reported Aug. 10 that doctors are increasingly seeing the heart and vascular system disproportionately impacted when people are infected.
“We’re seeing impacts that could be on any organ of the system,” Aboelata said. “The post-COVID [infection] potential for blood clots is very unique — this does not happen with the flu. So we’re seeing heart attacks and strokes, we can see multi-system inflammatory conditions in adults and children.”
While initial symptoms of COVID-19 may be mild, 10-20% of those infected with COVID experience persistent symptoms, some of which can leave them bed-bound or housebound, for months or even years after the acute infection.
That’s called long COVID, and as of yet, there is no treatment or cure for it. The National Institute of Health is currently running clinical trials for the condition, but both scientists who study long COVID and long COVID patients told StatNews the trials lack needed depth and direction.
“It can happen to anyone regardless of age, health status or severity of the initial infection (including asymptomatic people),” Moore said. “It’s never too late to start masking again.”
For some — as researchers found in a study that tracked people’s experiences across a year — persistent symptoms may stop and start even after a person is testing negative for COVID-19.
“This is especially important as it relates to our children, their brains and bodies are still growing,” Aboelata said of sharing information about COVID and its potential long-term impacts. “I think it's still really important to protect them and to give them the knowledge and information that they need to also make some decisions on their behalf because hopefully, they will be growing up [healthy] and have a lot of quality life ahead of them.”
Staying up-to-date on COVID-19 data, research
There have been some advances in COVID-19 research recently, among them nasal vaccines showing promise in terms of providing antibodies and researchers developing a test to detect COVID-19 in someone’s breath with greater speed and accuracy than the current rapid at-home tests.
But those things are not yet widely available, meaning precautions like masking, testing and isolating remain important.
Through Roots Community Health Center, Aboelata also presents a weekly briefing on the center’s YouTube channel that rounds up the latest COVID-19 research and wastewater data. She recommended the People’s CDC Weekly Briefing newsletter as another source people can reference.
Sisson and Aboelata both recommend keeping an eye on local wastewater to get a sense of what COVID community levels look like.
Healthy Central Valley Together has a continually updating dashboard that displays COVID-19 wastewater data for Yolo County, along with Stanislaus and Merced counties. Sacramento County’s wastewater data is visible here.
Other California residents can monitor wastewater levels in their area here.
Correction: A previous version of this story did not clarify that valley fever is caused by a fungus. It has since been updated.
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