Local health officials say the Charlottesville area may be at the beginning of yet another substantial surge in COVID-19 cases. But it’s not making people as sick as it was earlier in the pandemic.

The number of people hospitalized with COVID-19 is low, and it’s expected to remain that way. In fact, the UVA Medical Center hit a major milestone in mid-April when — for the first time since the pandemic began — no adults were hospitalized with COVID-19.

The coinciding trends of cases rising and hospitalizations declining have doctors cautiously optimistic about the future of the pandemic — at least for now.

“I’d like to say that, along with this lovely spring that we are having, this is part of a new beginning,” Dr. Reid Adams, UVA Health’s chief medical officer, said at a news briefing last week. “But we have been fooled before, so we’ll just have to wait and see.”

What’s indisputable is that cases here and around the state are rising due to the arrival of a new, and even more transmissible subvariant of Omicron.

The new subvariant is expected to cause a substantial spike in cases between now and mid July, according to projections from the UVA Biocomplexity Institute, which produces weekly models for how the virus is likely to spread. But those same models also predict that “hospitalization rates are not expected to be as dire.”

There are multiple reasons for the decline in hospitalizations, doctors say. One is that the original Omicron surge just happened.

The Omicron variant hit Charlottesville near the end of 2021 and launched the area into its largest surge of cases since the pandemic began. Hospitalization rates also hit record highs.

That means many of the people at most risk of infection have already been sick. While that doesn’t guarantee someone won’t get sick again, it does offer some protection, said Dr. Costi Sifri with UVA Health’s Division of Infection Disease and International Health.

Another positive is that vaccination rates — especially in Charlottesville and Albemarle County — are high.

“If you have completed your vaccination series and received a booster, most individuals are very well protected against the severe consequences of COVID,” Sifri said. “That’s remained a very consistent finding.”

Nearly 70% of people in Charlottesville are fully vaccinated with two shots, and more than 40% have gotten their third booster shot. In Albemarle County the rates are even higher, with more than 80% fully vaccinated and 50% boosted.

Need to get vaccinated or boosted for protection again COVID-19? Many pharmacies now have walk-up services, or you can schedule an appointment at a Blue Ridge Health District site.

Second booster shots are also now available for people 50 and older and anyone who is immunocompromised at least four months after receiving a first booster. It’s also available to anyone who got the single-dose Johnson & Johnson’s Jansen vaccine and a booster.

The final factor contributing to a lower hospitalization rate could simply be that the newer variants are not quite as severe as the older ones, as early research has shown.

Kellen Squire, an emergency room nurse at Sentara Martha Jefferson Hospital, caught COVID-19 in mid-April. He found out he had been exposed to someone with COVID-19, so he took a test to be safe. It came back positive.

“I just had a little bit of a cough,” he said. Had he not taken the test, he would have assumed the light cough and scratchy throat were just allergies.

Squire thinks this was his second time getting COVID-19; he got sick in February 2020, before everything started shutting down in the U.S. It was much worse then.

“I lost all sense of taste and smell,” he said. “I had this horrible dry cough and bone breaking fever. I remember thinking at the time, ‘I’ve never been this sick in my life.’”

With many people now expected to experience light symptoms, health departments don’t have — and probably won’t get — a clear picture of how widespread this surge will be.

“So many people have such mild symptoms or no symptoms at all that we’re never going to know about those cases,” said Ryan McKay, director of policy and planning at Blue Ridge Health District.

But that doesn’t mean that everyone is automatically safe from experiencing severe forms of the disease.

The vaccines are very good at keeping people from getting very sick — but not in all cases, said Dr. Georges Benjamin, the executive director of the American Public Health Association.

“The vaccine is highly protective in most cases, but not for everybody,” he said. “Almost everybody, but not 100%.”

COVID-19 is still dangerous for people with certain pre-existing conditions, he said. And unreliable data on this upcoming surge could make things challenging for those who are still at risk of serious complications. With life opening up and masks coming off, people most at risk have tough choices to make about how they will engage, Benjamin said.

The disease also remains dangerous for unvaccinated people, who continue to experience severe forms of the disease, Benjamin said. That includes children under five who are still not eligible to be vaccinated.

“Unfortunately, we’re still seeing some serious consequences of COVID infection,” said Sifri at UVA Health. “It remains a very challenging disease.”