COVID-19 Cases Rising in the US as CDC Tracks October Trends

By Emily Carter | Health & Science Correspondent | October 8, 2026

COVID-19 cases are rising in parts of the United States this October. The latest CDC estimates show growth or likely growth in 19 states.

Eight states show declining or likely declining infections. Another 23 states show no clear change.

These figures are estimates. They are not confirmed case counts. Instead, they show the direction of COVID-19 infections in different parts of the country.

The numbers also show how COVID-19 monitoring has changed. Americans no longer receive laboratory tests as often as they did during the height of the pandemic.

As a result, health officials now use several types of data. Wastewater surveillance is one important tool. At-home testing is another.

COVID-19 Cases Rising in the US, but Trends Vary by State

The latest CDC data show a mixed national picture. Nineteen states are in the growing or likely-growing category.

At the same time, eight states are declining or likely declining. Twenty-three states show no change.

This means COVID-19 activity is not moving in one direction everywhere. Some communities may see more infections. Others may see stable or lower activity.

The state numbers also need careful interpretation. A statewide trend does not describe every city or county.

Local conditions can differ. Health-service areas can also show different trends within the same state.

For that reason, the 19-state figure should not be viewed as a nationwide case count. It is an estimate of where infections appear to be increasing.

The current data also do not indicate a return to the emergency conditions of 2020 or 2021. COVID-19 remains a circulating respiratory virus, but the surveillance system is now very different.

Why COVID Wastewater Surveillance Matters in 2026

Wastewater testing has become an important part of COVID-19 surveillance. The process is simple to understand.

People infected with SARS-CoV-2 can shed viral material into wastewater. Scientists can collect wastewater samples and test them for traces of the virus.

Researchers can then compare results over time. A rise in viral levels may suggest that COVID-19 activity is increasing in the community.

A decline may point in the opposite direction. Stable results can suggest that viral activity is not changing much.

Wastewater surveillance has one major advantage. It does not require every infected person to get a medical test.

That matters in 2026. Many people with mild symptoms may not visit a doctor. Others may use an at-home test instead of a laboratory test.

Wastewater can therefore provide a broader community signal. It can also help public-health researchers spot changes in viral activity.

COVID Wastewater Levels Do Not Equal Infection Counts

Wastewater data also have important limits. A wastewater test does not tell researchers exactly how many people are infected.

It also cannot identify the people who may be infected.

Several factors can affect wastewater results. These include sampling conditions, wastewater flow and the size of the population served by a treatment facility.

Coverage can also vary between communities. One wastewater site may show a different trend from another site nearby.

Therefore, COVID wastewater surveillance should not be treated as a direct case count. Instead, it is one part of the broader COVID-19 surveillance system.

Health officials can compare wastewater results with other available information. This approach provides a better view of changing COVID activity.

What the 19-State COVID Increase Means

The 19 states in the growing or likely-growing category show that SARS-CoV-2 remains active across several parts of the United States.

However, the figure does not mean that every community is seeing a rise.

The eight states with declining or likely declining infections provide an important contrast. So do the 23 states with no clear change.

Together, these figures show a varied national picture.

Readers should also be careful when looking at individual states. A statewide estimate can hide differences between local areas.

For example, available September 30 data do not support describing all of Washington as a state with rising COVID-19 infections. Some health-service areas can show different patterns.

The same rule applies to other states. Local wastewater and surveillance results can change faster than statewide summaries.

At-Home COVID Tests Are Still Available

Americans can still buy FDA-authorized at-home COVID-19 tests. These over-the-counter tests are available through online and retail channels.

Rapid antigen tests can provide a quick indication of an active COVID-19 infection. However, a negative result does not always rule out infection.

This point is important when someone has symptoms or a recent exposure. A single negative test may not provide a complete answer.

Some FDA-authorized tests include instructions for repeat testing. Repeated testing can help reduce the chance of missing an infection.

Consumers should follow the instructions supplied with their specific test. The instructions explain how to collect the sample and when to test.

At-home testing also gives people another option when laboratory testing is not necessary or easily available.

Check COVID Test Expiration Dates Before Throwing Tests Away

Older COVID tests can create confusion. A person may find a test with a printed expiration date that has already passed.

That does not always mean the test should immediately be thrown away.

The FDA maintains updated information about authorized at-home COVID tests. The agency also lists products that have received expiration extensions.

Some COVID test expiration dates have therefore changed after additional stability information became available.

However, not every test has an extension.

An expiration extension can depend on the manufacturer, product and lot number. Consumers should check the current FDA information for the specific test they have.

In simple terms, some tests have authorized expiration extensions. Others do not.

Consumers should not assume that every expired COVID test remains valid. They should also not assume that every printed date is always the final authorized date.

Checking the current product information is the better approach. Users should also follow the manufacturer’s storage and testing instructions.

COVID Testing 2026 Is Entering a New Regulatory Phase

COVID-19 diagnostic testing is also going through a regulatory change.

On June 29, 2026, the HHS Secretary determined that circumstances no longer justified certain emergency-use declarations for COVID-19 medical devices.

The affected devices include in-vitro diagnostic products.

The relevant declarations are scheduled to terminate on December 26, 2026.

This date needs careful explanation. It does not mean that all COVID tests will disappear.

It also does not mean that COVID testing will become illegal.

An Emergency Use Authorization is known as a EUA. It is a special regulatory pathway for certain medical products during an emergency.

Traditional FDA marketing authorization is different. Manufacturers can move products toward established regulatory pathways outside the emergency-use system.

Therefore, the end of the relevant EUA declarations is a regulatory transition. It is not a nationwide end to COVID testing.

The status of individual COVID-19 diagnostic tests can also differ. Consumers should rely on current FDA information for specific products.

FDA COVID Tests Are Moving Beyond the EUA Framework

The regulatory change reflects the different environment in 2026.

During the emergency phase of the pandemic, EUAs helped make certain COVID-19 medical products available under special conditions.

The federal government is now moving away from that emergency framework for certain products.

Manufacturers may continue working through traditional regulatory pathways. Some products may therefore remain available under established FDA authorization.

For consumers, the key point is simple. December 26 is not a deadline for all COVID tests to vanish.

It is the scheduled end of the relevant emergency declarations.

Justice Department Continues COVID Testing Fraud Enforcement

Federal agencies are also continuing to investigate alleged COVID-related healthcare fraud.

On October 7, 2026, the Justice Department announced a $20 million settlement involving Heal 360 clinics and owner Dr. Mohammed Amer Mohiuddin.

Heal 360 and Mohiuddin agreed to pay $20 million to resolve False Claims Act allegations involving the COVID-19 Uninsured Program.

According to the Justice Department, the government alleged that higher-level evaluation and management services were billed at COVID-19 testing sites.

The government alleged that the sites mainly performed specimen collection.

Specimen collection means obtaining a sample for testing. Evaluation and management services involve additional clinical work.

The distinction matters for government reimbursement. Healthcare programs generally pay for services that were actually provided and properly documented.

The $20 million Heal 360 settlement resolves allegations. It does not mean the company or its owner was found guilty of criminal fraud.

The Justice Department also stated that the claims resolved by the settlement are allegations. There has been no determination of liability.

COVID Testing Fraud Investigations Continue

The Heal 360 case is part of wider federal enforcement activity.

During the pandemic, government programs processed large numbers of healthcare claims. Those claims included COVID-19 testing and other medical services.

Federal investigators continue to examine allegations involving false billing and improper reimbursement.

Other investigations can involve claims for medically unnecessary testing. They can also involve services that investigators allege were not performed.

These cases should not be confused with legitimate COVID testing.

Millions of Americans have used authorized COVID tests through healthcare providers, pharmacies and at-home testing programs.

Federal enforcement efforts focus on alleged misconduct. They do not make COVID-19 testing itself fraudulent.

What COVID-19 Cases Rising Means for Americans

The latest data provide a useful reminder that COVID-19 remains in circulation.

However, the current situation is different from the early pandemic years.

People can now use several sources of information. These include local health data, wastewater surveillance and rapid testing.

Wastewater can show changes in community viral activity. It cannot provide an exact infection count.

At-home tests can provide fast results. A negative result does not always rule out infection.

Older tests also need a closer look. Consumers should check current FDA information before discarding a test because of its printed expiration date.

Some tests have authorized expiration extensions. Others do not.

It is also important to remember that COVID-19 is not the only respiratory virus circulating in the United States. Readers can compare current COVID activity with the recent U.S. flu season and H3N2 activity.

Public-health monitoring also continues in other areas. That includes ongoing COVID vaccine safety monitoring.

People who are sick or concerned about symptoms should seek appropriate medical advice. People at higher risk of severe illness can discuss prevention and treatment options with a healthcare professional.

COVID-19 Remains a Continuing Health Issue

COVID-19 has not disappeared from the United States.

CDC estimates show growing or likely growing infections in 19 states as of September 30, 2026. Eight states show declining or likely declining infections. Twenty-three states show no clear change.

The numbers do not represent confirmed case totals. They show estimated infection trends.

Wastewater surveillance can help researchers track those trends. At-home tests can also give Americans a convenient way to check for infection.

At the same time, the FDA and HHS are moving COVID-19 diagnostic devices beyond the emergency-use framework. The relevant declarations are scheduled to terminate on December 26, 2026.

Federal investigators are also continuing to examine alleged COVID-19 healthcare billing fraud. The Heal 360 settlement is one recent example.

For Americans, the message is practical rather than alarming. COVID-19 activity can rise in some areas while falling or remaining stable in others.

Understanding wastewater data, checking test expiration information and following current testing guidance can help people make sense of the changing COVID-19 landscape in October 2026.