NCDHHS stopped tracking COVID-19 cases or breaking down metrics by regions, so the best measure of how widespread infections are is from wastewater monitoring.
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The latest data shows 36.6 million COVID-19 particles were detected in wastewater last week; an eight-fold uptick since the lowest point in June. The metric is three times higher than this point last year.
This uptick is spilling into emergency rooms, but not at as high of a rate.
"Usually, the summer times are less busy in the emergency departments. That was not the case this summer," said Dr. Dan Park, a UNC pediatric emergency medicine physician. "Our volumes are sustained. And now we're starting to see some sick patients with respiratory illnesses."
COVID-19 symptoms in the emergency room have been climbing since mid-July and nearly 500 people were hospitalized for COVID-19 last week. This is still about half the number of patients hospitals reported last September.
Park said his department is bracing for an uptick and already has felt the effect on staffing.
"As the cases have gone up, not only are the patients showing up, but the staff are calling out. So this is this is kind of going to be an eternal problem," Park said.
Despite the upward trend, local health experts don't predict many changes to restrictions.
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School districts in other states have canceled classes. Districts in Kentucky and Texas switched to virtual learning for a few days after an uptick in respiratory illnesses, according to reporting by ABC News.
Dr. Zack Moore, the State Epidemiologist with NCDHHS, previously told ABC11 that he did not foresee the state adding any stricter restrictions.
"We know COVID is going to rise and fall, but the big difference now is that we have effective tools to manage that, more like we manage other respiratory viruses, flu, etc.," Moore said.
Sara Dawson works at a library in Wake County and said if cases increase she would like to see the county act.
"I'm hoping that the county is going to resume safety measures if things get really bad again," she said.
She said her job regularly interacts with many people, so the increase in COVID-19 does have her worried.
"I'm terrified because I don't want this to happen again," Dawson said.
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She plans to start wearing a mask full-time as she can't afford to get sick and miss work.
The CDC's latest recommendations state that people exposed to the virus do not need to stay home or test unless they develop symptoms.
If people do test, health experts advise that the use of at-home expired tests can be unreliable. They are OK to use if their expiration date has been extended. You can check if your test kits' expiration date has been extended here.
Park said the symptoms and guidance on protection have not changed drastically since the start of the pandemic.
"Nothing has changed. You know, if you feel sick, stay home. Protect those around you. Protect those who can't protect themselves," he said.
For the latest on COVID-19 testing and vaccine recommendations, you can visit the CDC website.
A new COVID-19 booster is expected to be available later this fall that better targets Omicron variants. A number of new variants have emerged in recent months but health experts remain confident that the new vaccine will remain effective.