Judging from local wastewater surveillance trends, President Joe Biden has plenty of company in Maryland as he continues to recover this week from his third bout of COVID-19. The state is currently seeing the biggest spike in COVID levels in its wastewater — or sewage — since early January, according to data from the . There were “very high” levels of viral activity, nearly double national levels, measured in the state’s wastewater as of last week.

Hospitalizations from the virus also have more than doubled in the last month — from 60 on June 22 to 135 on Monday, according to data from the — although they remain far below what they were in January, during what has become an annual winter surge. At Sinai Hospital in Baltimore, emergency room doctors are seeing a slight spike in patients with COVID, although most have mild — if uncomfortable — symptoms like fever, body aches, vomiting and diarrhea that don’t require hospitalization, said Dr. Gregory Cocoran, director of the hospital’s emergency department and system director for Lifebridge Health.

But the increase seems unusual for the summer, a season when people typically spend more time outdoors, Cocoran said. He has a theory: It’s been so hot lately that people may have preferred to gather inside, where there’s air conditioning — and where it’s easier for COVID to spread. “With viruses, there’s sometimes a pattern,” he said, “and sometimes, there’s something that’s completely agains.