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What's behind the recent spike in COVID-19 cases in the U.S.

AYESHA RASCOE, HOST:

The number of COVID cases is rising in the U.S. Public health experts believe new variants, summer travel and heat waves, which force people inside, are partly to blame. And since the national public health emergency ended in May, testing and treatment for COVID have become less available and more expensive. Lisa Cooper, a physician and health equity professor at Johns Hopkins University, has been watching this all play out. She joins us now from Clarksville, Md. Welcome to the program.

LISA COOPER: Thank you.

RASCOE: Obviously, COVID can still be serious, but with so many people having caught it or the vaccines, should people still be concerned about seeing an uptick in COVID cases?

COOPER: So I would say yes. We know now that it's sort of part of our everyday existence now. People are going to be exposed to it. So the chance of them really getting sick and having to be put in the hospital is much lower. But that's true for young, healthy people, and it's not true for people who are older or people who have chronic medical conditions - so things like heart disease or diabetes or cancer or if they have a weakened immune system. So we still have to be concerned about those people in our midst who are, you know, more at risk for getting very sick with COVID.

RASCOE: When the public health emergency ended, the CDC said that insurance providers will no longer be required to waive costs or provide free COVID-19 tests. So what impact is that having that people may not get free tests through their insurance providers and things of that nature?

COOPER: Yeah, I mean, I think for people who can afford it, I think it's not having as much impact because those people can just go out to a pharmacy and buy a test. But as you can imagine, there are other people for whom that's not that easy. So there are older people who are on fixed income who have lots of other medications that they have to pay for every month. They're worried about, you know, how much their grocery bill is. And so having to pay out of pocket $20 for a test...

RASCOE: And if you have a large family, I mean, that 20 - I know when I'm trying to get - I have three kids - you're trying - you start buying those tests, you could easily spend a hundred dollars.

COOPER: Absolutely. Suppose you need to test one more time because you - maybe, you know, it's been a couple of days, and people are still feeling sick. Yeah, that's not insignificant.

RASCOE: Just like at the beginning of the pandemic, we saw how people from marginalized groups and communities were at a higher risk of infection. Does that mean that right now that those same groups, with less resources, with less money, less access - that they may be more at risk?

COOPER: I think for sure because if people aren't able to afford those tests, they're going to be going out and maybe unknowingly infecting other people around them. And also, we know that people from those same communities also have higher rates of the chronic diseases - the diabetes, the heart disease - that already placed them at risk for being sicker if they do get COVID. And so we could see these infection rates actually affecting communities of color and, you know, people with low income disparately again.

RASCOE: And there are treatments now. You know, we've talked a lot about Paxlovid. Are people still able to access that?

COOPER: Well, you know, so Paxlovid was available for free during the public health emergency. The federal government paid about $500 for a course of Paxlovid per person. But now that the public health emergency is over, if a person doesn't have health insurance that has prescription drug coverage, they really could have to spend - and, you know, there are lots of people who can't afford to do that.

RASCOE: What options do you have if you're underinsured or uninsured?

COOPER: Yeah, well, so the government has created some programs for people who don't have health insurance so that there will be places where they can go and get free Paxlovid and also free access to tests. I think the problem is that a lot of people don't know where to go for this right now. And so I think what's going to be important is for people to stay in touch with their doctors during this time so that when, you know, someone in their family or when they themselves get sick with COVID-19 - that they can get a prescription and that they can find out where these resources are.

RASCOE: That's Lisa Cooper. She is a physician and health equity professor at Johns Hopkins University. Thank you so much for joining us.

COOPER: Thank you, Ayesha.

(SOUNDBITE OF CHARLIE HUNTER'S "DIFFORD TILBROOK") Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Ayesha Rascoe is a White House correspondent for NPR. She is currently covering her third presidential administration. Rascoe's White House coverage has included a number of high profile foreign trips, including President Trump's 2019 summit with North Korean leader Kim Jong Un in Hanoi, Vietnam, and President Obama's final NATO summit in Warsaw, Poland in 2016. As a part of the White House team, she's also a regular on the NPR Politics Podcast.