COVID-19 Cases Are Climbing, with Donald Alcendor, PhD


Alcendor discusses the recent uptick in cases and hospitalizations, as well as the latest variants of concern and developments in 2023-24 booster doses.

Episode highlights

0:16 Intro
1:36 The current climb in COVID-19: What’s happening?
3:58 Are the variants becoming harder to dodge?
7:01 How the end of the US public health emergency impacted prevention
11:07 Realistic vaccine expectations
13:13 Advancing COVID-19 antivirals
17:32 The future for mRNA vaccines infectious disease
21:27 Public health implications
22:58 A quiet COVID-19 summer: What went well?
25:06 Projecting future waves
28:26 Advice for clinicians in preparing patients

After a historically low-transmission summer, new cases, hospitalizations and deaths due to COVID-19 have increased by approximately 18% in the US over the last week, according to Centers for Disease Control (CDC) data.1

The steady climb in cases comes just as students are returning to classrooms, a week prior to the next CDC Advisory Committee on Immunization Practices (ACIP) meeting to review vaccine booster dose candidates for the 2023 - 24 period,2 and a couple months before the formal beginning of the influenza season in the US. All of these developments are greatly influential as to how the now-endemic SARS-CoV-2 virus will persist in this latest climbing wave.

In a new DocTalk interview, Donald J. Alcendor, PhD, associate professor, department of pathology microbiology and immunology, division of infectious diseases, Vanderbilt University Medical Center, and HCPLive Editorial Advisory Board member, discussed the factors influencing the current iteration of COVID-19 in the US. Put briefly: “The virus is changing, and immunity is waning.”

“Even if you’ve been boosted, it’s been months since you’ve been boosted and we know these vaccines provide you with 4-6 months of protection,” Alcendor explained. “We know that protection wanes over time, and the virus continues to change.”

Alcendor discussed the next anticipated ACIP-supported booster dose, that is designed to target the XBB 1.5 Omicron subvariant—though another 2 variants of concern are circulating in the US.

“We’re in a position where we’re trying to chase this virus with boosters—and we’re losing in a lot of ways, because it stays ahead,” Alcendor explained. New BA 2.86 variant has 35 mutations, and is essentially “an evolutionary jump” from the prior iterations of SARS-CoV-2, contributing to the concern of virologists that the pandemic virus is changing unpredictably—both in infectiousness and characteristics of disease severity.

Alcendor additionally discussed the impact of the White House’s conclusion to the public health emergency for COVID-19 in May, a decision he noted was preceded by a majority of the population receiving ≥1 vaccine dose and “tremendous” decreases in infections, hospitalizations and deaths.

“We have to understand that the federal government spent $5.4 trillion to try and get us through this pandemic, and you know there’s money that still needs to spent, because we’re not. COVID is still out there, causing problems,” he said.

Alcendor stresses vigilance and awareness of potential changes to what has become an endemic virus.

“We might have to be content—and I think it’s unacceptable at this point—with losing 40,000 - 60,000 people every year due to COVID,” he explained. “And when you add that to RSV and influenza…we could be losing in excess of 120,000 people as part of a baseline mortality in America (annually).”


  1. CDC. COVID Data Tracker. Updated August 31, 2023.
  2. CDC. Advisory Committee on Immunization Practices (ACIP). Updated August 25, 2023.
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