Since the beginning of the pandemic, epidemiologists have been eagerly anticipating the coronavirus to conform to a typical seasonal pattern, with a peak in the winter and a lull in the summer. However, three and a half years into the outbreak, the virus continues to defy expectations. Recently, there has been a slow increase in coronavirus concentrations in wastewater in the southern and northeastern United States, with the Midwest and West now experiencing similar trends. Test-positivity rates, diagnoses of COVID-19 in emergency departments, and COVID hospitalizations are also on the rise. These early indicators suggest the onset of another wave of infections this summer, marking the fourth consecutive summer with a significant increase in coronavirus cases.
Yet, despite the recurrence of summer waves, it is still uncertain whether this is a permanent feature of COVID-19 or if the virus follows a predictable seasonal pattern. The cyclical patterns of respiratory infections, including the coronavirus, are not well understood, according to Sam Scarpino, an infectious-disease modeler at Northeastern University. There is no inherent law dictating that respiratory illnesses must be prevalent in the winter or absent in the summer. The triggers behind these seasonal patterns remain a mystery.
Many diseases, however, do exhibit seasonal fluctuations. Mosquito-borne illnesses, such as Zika and Chikungunya, are influenced by the life cycles of the insects carrying them, while Lyme disease rates correlate with tick activity in temperate regions. The flu, which spreads best under cool, dry conditions, also showcases a preference for winter months. Given the similarities between the flu and the coronavirus in terms of transmission and evolvability, it is expected that SARS-CoV-2 will continue to spread during the winter months in temperate regions. Winter weather, with its cold, dry air and reduced mucus clearance, can make individuals more vulnerable to respiratory infections.
However, the fact that the coronavirus can also thrive during the summer months, despite experts’ uncertainty about the reasons behind this phenomenon, demonstrates that it is not solely dependent on temperature or people retreating indoors. Other viruses, such as enteroviruses and adenoviruses, exhibit year-round transmission and sometimes peak during the hottest months. The explanation for these patterns is likely more complex than simply temperature or indoor activities. Various factors, such as travel during the summer, lower population immunity, and the unique characteristics of SARS-CoV-2, contribute to the manifestation of summer waves.
Contrary to popular belief, there is no clear-cut evidence that immunity is universally stronger in the summer. Seasonal immunological profiles indicate that different immune functions may vary depending on the time of year, but the implications of these variations are not fully understood. Winter, although associated with higher inflammation levels, might also enhance the body’s response to certain vaccinations. The complexities of seasonal patterns in immune responses further complicate the understanding of when and how the coronavirus spreads.
In conclusion, while some experts believe that the coronavirus’s seasonal patterns may be emerging, others caution against premature conclusions. The unique nature of SARS-CoV-2’s interaction with the human population and the various factors at play make it difficult to predict its future behavior. As vaccination rates increase and COVID-19 restrictions diminish, the global landscape becomes more stable. However, uncertainties surrounding viral evolution and the cadence of vaccination efforts prevent definitive statements about the predictability of seasonal waves. Summer waves may be indicative of the coronavirus’s persistence throughout the year or could simply be transient fluctuations in an ongoing pandemic.
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