Over the summer, Texas and Harris County saw their COVID-19 levels in wastewater grow to levels higher than those in any other state.

Although COVID-19 infections are declining statewide, 38 wastewater monitoring sites in Texas detected the virus — making the state’s community viral activity level “very high,” according to the Centers for Disease Control and Prevention. The federal agency tests sewage water to detect signs of infection in communities, even from people who feel healthy.

The Houston region also saw its emergency department visits related to COVID-19 peak this year in August, when they accounted for more than 1% of emergency department visits.

Here’s what to know about this summer’s COVID-19 cases and where to get tested.

As of Sept. 16, Texas was one of 13 states in the country where COVID-19 infections were declining, whereas 27 other states saw its infections growing, according to the CDC.

On the other hand, the agency labeled Texas as the only state that had “very high” community viral activity levels for COVID-19 based on wastewater testing. California, Florida and Washington followed the Lone Star State with “high” levels. 

While this summer’s COVID-19 cases were driven by a variety of strains, the most common were SW.2, which made up 21% of positive infections, and XFG.1.1, which accounted for 16%, according to the CDC.

Houstonians can get tested at major pharmacies such as CVS and Walgreens. 

Some insurance plans may also cover at-home COVID-19 tests, which can be ordered through many pharmacies and online retailers.

Urgent care clinics operated by Memorial Hermann and Houston Methodist also provide testing.