As a stealth wave of COVID-19 makes its way across the U.S., those who have so far evaded the virus are now falling ill — while others are catching COVID-19 for a second, third or even fourth time.

Several factors have conspired to make the state of the pandemic harder than ever to track. The rise of at-home tests, which rarely make it into official case numbers, have made keeping accurate count of positive cases impossible. Additionally, many U.S. states and jurisdictions are now reporting COVID-19 data only sporadically to the Centers for Disease Control and Prevention. Earlier this week, Washington, D.C., reported case data to the agency for the first time since April…

“The reality is that things are really not going well at the moment,” said Jacob Lemieux, an infectious disease doctor at Massachusetts General Hospital, speaking at a Harvard Medical School COVID-19 briefing on Tuesday. “We all thought that we were in for a reprieve after the devastating omicron wave. And that was clearly the case until a few weeks ago.”