California is in the midst of its third-largest COVID surge of the pandemic, with roughly 19,000 new cases being reported each day, according to The New York Times’s tracker. The true number of people falling sick is undoubtedly even higher, since most at-home tests aren’t included in official case counts.

Omicron subvariant BA.5 has rapidly become dominant in the United States. And it’s especially good at infecting people and bypassing their immune system’s defenses, even if they’ve been vaccinated, boosted and already had COVID, experts say.

“It’s highly immune-evasive, and that is why it’s causing trouble,” said Dr. Eric Topol, a professor of molecular medicine at Scripps Research in San Diego. “And it comes along in California at the same time that we basically have this delusion that the pandemic is over.”