JOHN YANG: The United States is experiencing what's become a familiar pattern, an uptick in COVID after the holidays and the big gatherings that accompany them.

Hospitalizations have risen eight weeks in a row though they're below what they were in the last post-holiday period a year ago.

Hotspots have cropped up across the country as the new dominant variant JN.1 has quickly spread to account for more than 60 percent of cases.

Jessica Malaty Rivera is an infectious disease epidemiologist at De Beaumont Foundation, which is a philanthropy that promotes public health.

Jessica has this surge right now in any way a surprise?

Or is there anything that's unusual about it?

JESSICA MALATY RIVERA, Infectious Disease Epidemiologist, De Beaumont Foundation: To be honest, it's not quite unusual, the virus that causes COVID-19, SARS-CoV-2 continues to evolve as more and more people become infected, and the virus makes copies of itself.

It mutates it changes it gets better at evading our immune systems and making people sick.

What's encouraging is that because of our hybrid immunity in the population between previous infections and vaccination, not as many people are becoming seriously ill and dying, though we are seeing hospitalizations continue to increase as more and more people become infected.

The fact that it's back the fact that we're seeing a surge, though, is not a surprise.

In fact, it doesn't quite actually have the same seasonality as other viruses like flu or RSV, where we kind of see COVID come every few months in these big surges.

JOHN YANG: As an epidemiologist, what does this suggest to you about the future of our relationship with COVID?

JESSICA MALATY RIVERA: Yeah, it's a great question, because I think we need to be preparing ourselves for living with SARS-CoV-2 virus because COVID-19 because it is well established in the human population and among other populations in the animal kingdom.

And because of that, the odds of us getting rid of it completely eliminating and eradicating it is unlikely.

And so in the same way that we see flu kind of continued to reemerge in our community every year, we'll probably have to be dealing with COVID outbreaks a couple times a year, maybe three, four times a year.

But the hope is that between our previous infections and vaccination, we will become better at preventing those serious illnesses and deaths.

JOHN YANG: Talking about sort of getting used to living with COVID.

Does that mean we can sort of forget about it, that we can sort of be a blase about it?

JESSICA MALATY RIVERA: It certainly does not mean that and I think that's a very important point to raise, because COVID is not quite yet in the rearview mirror.

Yes, the state of emergency has ended.

But COVID-19 is here, and it's here to stay.

And so when I say living with COVID, it means understanding that people will continue to get sick, we need to continue to encourage all the mitigation efforts to reduce infections and severe illness that includes masking, staying home when you're sick testing at the appropriate time vaccination when it's updated and available to folks, because this is going to be part of our lives.

JOHN YANG: And as you say, the Federal Public Health Emergency ended in May, a lot of things went away, the public campaigns about masking, about testing, about getting the vaccinations, and also the tracking also winded.

Is that a handicap to an epidemiologist like yourself?

JESSICA MALATY RIVERA: It is a severe handicap, you know, as a alum of the coma tracking project, our work was focused on tracking all of that data at a very granular level from the state level.

We were tracking testing and cases and hospitalizations and deaths.

And we did on a volunteer basis.

And now because the emergency is over, you're not seeing the kind of funding that we need to be funding both the CDC and those state public health departments to get that granular data.

We have many resources.

We have some dashboards, hospitalization data, we have wastewater surveillance, but we are a bit like we're flying blind when it comes to understanding the full scope of what's happening with the virus in our population.

JOHN YANG: And as you say, we don't have it in the rearview mirror yet, but are you concerned that the public may feel like it's in the in the rearview mirror?

JESSICA MALATY RIVERA: I'm very concerned about that.

I think you know, it's difficult to see a lot of people think about COVID Is not that serious.

Think about masking as something that was an artifact of the past.

It is a very, very normal thing to mask when you're sick to mask when other people are immunocompromised.

It was part of our public health infrastructure and health care settings.

So the, you know, how political it's become, how contentious we've become is quite discouraging because these things are effective at helping out reduce harm which is the basis of public health.

JOHN YANG: Jessica, we asked our viewers what they wanted to ask on this topic.

Rebecca Rose in Philadelphia writes, do you think getting back to 2019 normalcy is currently in place or possible?

JESSICA MALATY RIVERA: You know, I would actually like to pivot the question of it because I think the conditions of 2019 and the many years prior to 2019, is how we got here.

For many, many years, we were dealing with the defunding and the de prioritization of public health, which is why we were so unequipped and unprepared for the impact of SARS-CoV-2, and as a result, we are now reactive instead of being proactive to something this destabilizing.

I don't want to go back to 2019.

I want to see a much more well-funded and much more prioritized public health infrastructure in the U.S. and globally so that we can be better prepared and better responding to something as major as a global pandemic.

JOHN YANG: Laura in New Jersey asked, should we be wearing masks?

Should public places like gyms report when their instructors have COVID and tell the public?

JESSICA MALATY RIVERA: You know, I think masks are a very important part of our Swiss cheese model of protection, right?

It's not one thing that's going to completely eliminate risk.

Risk is subjective and it is also additive or prevention is additive.

So will masks help reduce your risk when you're in very publicly crowded places like airports and malls and an indoor theaters?

Yes, it will.

Mandates, I don't think are going to come back anytime soon.

And so as a result, I think it's a very personal choice.

I encourage mask wearing in high risk settings.

I personally continue to mask and I was settings, and I think it should be part of our public health practice moving forward.

JOHN YANG: Jessica Malaty Rivera, an epidemiologist at the De Beaumont Foundation.

Thank you very much.

JESSICA MALATY RIVERA: Thank you for having me.