One of the major indicators is the level of the virus in wastewater, which has shown an increase in COVID-19 viral levels. It comes as emergency room visits, nationwide, have increased for diagnosed cases.
In the latest available data from the Centers for Disease Control from July 20 to July 27, COVID viral levels in wastewater increased 11.7% nationwide. They reached their highest levels since January.
"Oh wow that's unbelievable," said Steven Washington, of Germantown, as he walked past hospitals in University City. "I can't believe it but I had my (COVID vaccine) shot!"
New Jersey has what's classified as a moderate level of COVID viral levels in wastewater, with a half-percent decrease from July 20 to July 27. The presence of the virus in Pennsylvania wastewater increased by nearly 35%, reaching what the CDC classifies as a "high" level.
In Delaware, the designation is "very high," with levels there rising nearly 39% in the same aforementioned week.
Dr. Carlene Muto, the medical director of Infection Prevention at Temple Health, says wastewater levels are a useful tool.
"It sort of predicts what's going to happen in the next couple of weeks. So we see it in the wastewater then we see the disease incidents go up," she said.
The CDC also reports an increase in emergency room visits related to diagnosed cases of COVID.
While those visits don't make up a huge percentage of emergency room patients, the rate by which the visits increased is worth noting. They were up 26% in Pennsylvania; up nearly 25% in New Jersey; and up 21.8% in Delaware.
"But it's still at a very low level certainly at Mainline Health and I suspect at other hospitals it's not affecting daily operations," said Dr. Lawrence Livornese, an infectious disease specialist with Mainline Health.
Livornese thinks COVID surges could become as common flu surges.
"The flu virus mutates. Each year we have a different vaccine because there will be different strains coming too, and that's really what's happening with COVID as well," he said.
"Immunity lasts with vaccines 4-6 months. So I would recommend getting the vaccine every six months," said Muto.
They advise people to remember the COVID basics of covering their cough, testing if they feel sick, and staying home if they test positive. It's a routine people will have to get used to for a while.
"I suspect COVID is here to stay for the foreseeable future," said Livornese.
Wastewater levels show the presence of a new strain of COVID, but a new vaccine is also on the way this fall.