It’s July and as if the excessive heat isn’t enough, there is also coronavirus out there.

The surveillance is less widespread, or even timely, these days. But more people who bother to test are positive for COVID-19, and some are being hospitalized, and more virus is being found in wastewater samples. Many of us know of someone at home sick, including President Joe Biden.

“What we see in the local numbers, maybe there is a hint of something happening; I wouldn’t necessarily think it’s anything major yet,” said Andrew Pekosz, a COVID researcher and professor of immunology at the Johns Hopkins Bloomberg School of Public Health.

“In the Southwest of the U.S., there are some crazy increases going on,” he said. “But reporting is slow. People know people who are sick, and it’s not reflected in the data we are seeing from public health sites and hospitals. So we’ll see if the current upward trend continues in Maryland.”

Pekosz said COVID has surged in late fall-winter each year for the past three years, but cases have gone up in summer, too, despite viruses not liking the extreme temperatures. He said COVID seems to be taking advantage of people escaping the heat together indoors. And unlike the flu, there always seems to be enough cases of COVID out there from which a wave can build.

The Maryland Department of Health is still collecting data from laboratories and health care providers that test people for COVID, and officials report the case rate was 4.08 per 100,000 people in Maryland as of July 15, up from 2.77 per 100,000 the week before.

Hospitals, which don’t routinely test every patient anymore, also show a relatively small uptick in cases. There were 119 patients diagnosed with COVID in Maryland hospitals as of July 15, more than double the number from mid-May, but nowhere near the pandemic peaks when cases numbered in the thousands.

At the University of Maryland Medical System, with a dozen hospitals, there’s been a minimal increase among inpatients, said Dr. Gregory Schrank, an infectious disease physician at the University of Maryland Medical Center and assistant professor of medicine at the university’s School of Medicine. There could be a rise in COVID activity in July and August, Schrank said, as there’s been in prior years.

Hospitals have come to expect more cases when families vacation in summer, travel for holidays and go back to school, said Sharon Boston, spokeswoman for LifeBridge Health, which includes Sinai Hospital in North Baltimore.

“LifeBridge Health has seen a slight uptick in patients admitted to our hospitals for COVID, and we are seeing a definite increase in our communities, generally related to people traveling on airplanes and cruises.”

Other sources back this up to a degree, including the Centers for Disease Control and Prevention’s National Wastewater Surveillance System. But that data is also incomplete. The system only has COVID testing data for four counties: Anne Arundel, Washington, Garrett and St. Mary’s.

While Anne Arundel data does show a large increase in COVID over the last 45 days, the oldest data is from February, making it impossible to compare current levels to previous spikes.

The system does show half of the states are listed as having high or very high levels of COVID.

By now, most people have had COVID or been vaccinated so their bodies have developed protections against severe disease, Pekosz said. The exception are people who have not been infected or vaccinated in a while. He said getting boosted is important for them, as well as those who are very young or old or have underlying health conditions.

Unvaccinated people also are more likely to develop long COVID, where symptoms persist or worsen over time. Sick people can infect the most vulnerable people if they do not isolate or take precautions.

The CDC now advises people can return to daily activities once symptoms improve and fever has been gone for 24 hours, though officials say taking precautions such as masking or keeping a distance for longer can prevent spread. It’s the same advice for other infections, such as the flu or RSV.

Pekosz said using rapid COVID tests until you are negative is the best way to protect others.

The CDC recommends anyone 6 months and older get the next COVID shot when it becomes available later this year. Vaccines are expected from Moderna, Novavax and Pfizer to match circulating strains.

A study recently published by Johns Hopkins researchers shows more regular boosters, every three to six months, help people who are immunocompromised fight COVID.

The Baltimore City Health Department has launched new ads specifically calling on older adults to stay up to date on boosters. The department continues to partner with schools, churches and community centers to offer vaccines.

Officials note that most insurers cover the shots, and Walgreens and CVS offer them for free for the uninsured. Appointments generally can be found at vaccines.gov

“The virus has evolved since the height of the pandemic,” said Baltimore City Health Commissioner Dr. Ihuoma Emenuga in a statement. “And just as flu shots are recommended each season, the CDC recommends the updated COVID-19 shots to protect yourself, your loved one and your community against serious illness from COVID-19.”

Baltimore Banner Data Editor Ryan Little contributed to this article.