RALEIGH, N.C. (WNCN) — Rising COVID-19 case counts in other countries and more of the virus showing up in the nation’s sewage systems have doctors concerned that the U.S. could be in for yet another surge.

It could mean the massive improvement seen across North Carolina and the entire country will be short-lived, and — with 98 percent of Americans living in areas where federal health officials say it’s safe to ditch their masks — could provide the first big test of the new way we measure risk.

“We just have to keep an eye on that,” said Dr. David Wohl, an infectious disease specialist at the University of North Carolina School of Medicine. “My prediction is, that will happen here. Hopefully, I’m wrong.”

The BA.2 variant — also known as “stealth” omicron because its mutations make it hard to tell it apart from the delta variant — appears to be fueling the rise.

The Centers for Disease Control and Prevention’s variant tracker shows BA.2 accounting for 12 percent of the samples last week in the southeast region — a seven-state area including North Carolina — compared to 7 percent the week before.

This chart from the Centers for Disease Control and Prevention shows the proportion of COVID-19 variants that are being detected by sequencing labs in the Southeast region that includes North Carolina. (Source: CDC)

Wohl called it “even more catchy than the omicron we’ve been dealing with, which is even more catchy than the delta variant we were dealing with before, and so on and so on.”

North Carolina is averaging fewer than 1,300 new cases per day — less than 4 percent of the more than 32,000 it averaged daily at the worst of the omicron surge. Since that peak, the average has fallen every day but three.

A handful of countries in Europe — including the United Kingdom, Germany, Switzerland and Italy — saw a rise in cases during the past week, according to data from Johns Hopkins University.

“It’s been wise to look at what they’re experiencing and sort of project, ‘Will that come here?’” said Dr. Cameron Wolfe, an infectious disease specialist at the Duke University School of Medicine. “And it hasn’t always, but we’ve often followed them within sort of the month of their increases.”

More COVID is also showing up in our sewage — which during the course of the pandemic has become a reliable way to track spread.

The wastewater monitoring system set up by the CDC to measure COVID levels in sewage shows increases of 1,000 percent or more over the past 15 days at 53 of the more than 400 locations across the country that are part of it.

And here in North Carolina, the state Department of Health and Human Services’ system has picked up increases of 100 percent at three sites — Charlotte, Laurinburg and in New Hanover County.

“So when you put the dots together, we have a couple of things happening at once,” Wohl said.

It could mark the first test of the new way we deal with risk.

It’s only been less than a month since the CDC eased its recommendations for masking, with a new map showing the overwhelming majority of Americans live in places where the agency says it’s safe to ditch the masks.

“We may have to balance how much we can tolerate as far as the suffering of other people in our midst,” Wohl said. “And if it’s pretty minimal, we’ll go for it. But if it’s not, I think we’re going to have to have an honest conversation about what this means.”

And if a new wave is indeed coming, what can do you about it?

Wohl says the most obvious thing is to get vaccinated — “What are you waiting for?” he asked rhetorically — and boosted.

He recommends a second booster shot for those who are immunocompromised. Pfizer is asking the Food and Drug Administration to approve a fourth dose of its vaccine for older Americans and Wohl expects more people to be eligible for that extra shot later in 2022, possibly before the summer.

“We have predictions. We make plans based upon what’s likely to happen,” Wohl said. “And we respond appropriately here to, ‘Let’s keep an eye on it,’ and let’s not be an ostrich with our head in the sand. Let’s know that we’re likely to see some uptick because we’re loosening our mitigation strategies.”

CBS 17’s Joedy McCreary has been tracking COVID-19 figures since March 2020, compiling data from federal, state, and local sources to deliver a clear snapshot of what the coronavirus situation looks like now and what it could look like in the future.