With the rise in holiday gatherings during respiratory virus season, what symptoms should you watch for if you think you have been exposed to COVID?
According to "virus hunter" Mary Rodgers, an associate research fellow at Abbott who has been tracking COVID variants around the world, the XEC variant remains dominant in the U.S.
"We've continued to see COVID evolving, and that's to be expected, actually," Rodgers told NBC Chicago. "As people's immune responses develop to one strain, the virus is motivated to change so it can escape from those immune responses. And that's what we're seeing today."
According to Rodgers and the World Health Organization, the XEC variant has not shown signs of being more dangerous than other recent COVID strains, "but it is changing."
"So we need to keep an eye on it," Rodgers said.
Rodgers noted the importance of tracking symptoms when it comes to COVID variants in particular.
"That's how Omicron was first discovered," she said. "Actually, our partner that we work with in South Africa noticed that amongst a group of people in an area that had already recently had a COVID wave, suddenly they were having more severe symptoms and that alerted him that we needed to sequence those samples to see what strain was present. And fast forward, after he got those sequence data back, he alerted the WHO that this was a new variant of concern and that was when Omicron was first named."
As for XEC, Rodgers said the symptoms remain unchanged so far.
But what are they and how can you tell the difference between COVID and the myriad of other respiratory infections spreading this holiday season?
Here's what to know:
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What are the symptoms?
Experts have so far said the XEC variant shows signs it will remain similar to other variants.
As of now, the symptoms for COVID remain the same:
- Cough
- Sore throat
- Runny nose
- Sneezing
- Fatigue
- Headache
- Muscle aches
- Altered sense of smell
- Congestion
- Fever or chills
- Shortness of breath or difficulty breathing
- Nausea or vomiting
- Diarrhea
Earlier reports had centered on potential gastrointestinal symptoms related to the virus.
Dr. Katelyn Jetelina, a scientific consultant for the CDC and epidemiologist, said "gastrointestinal issues including nausea, vomiting, and diarrhea" have been previously identified as possible symptoms of COVID-19.
"We do not have specific data about the incidence of GI symptoms with the current strains of the virus, but COVID-19 symptoms can certainly differ based on the variant and the individual," Jetelina told NBC Chicago in July.
Last fall, a Chicago-area doctor said she's noticed shifts in the most common symptoms her patients reported as the JN.1 variant rose to dominance.
Dr. Chantel Tinfang, a family medicine physician with Sengstacke Health Center at Provident Hospital of Cook County, noted at the time that many of the cases she saw reported less of the fever, body aches and chills, and presented more with sore throat, fatigue and coughing.
"We still see some patients experiencing decreased appetite, a loss of taste or smell. So it kind of depends," she said. "One patient was just very, very tired. Like she couldn't really do much. And that's when you know ... it's different. It's not just coughing and shortness of breath. We still see that though."
How long does COVID last?
As for timing, symptoms can last for several days, but in some cases, even longer.
"Some people who have been infected with the virus that causes COVID-19 can experience long-term effects from their infection, known as Long COVID or Post-COVID Conditions (PCC)," according to the CDC.
Such symptoms can last for weeks and possibly even years.
Previous timing guidelines centered around five to 10 days, however.
How can you tell the difference between COVID and other respiratory viruses?
Experts say the answer is to test.
"The thing is, a lot of these other pathogens have the same initial symptoms, so it's really hard to tell if someone might have COVID versus flu just based on symptoms alone," Rodgers said. "So you kind of have to check in with your health care provider to see what they would recommend. But obviously, testing is going to give you the definitive answer so that you'll know whether or not your family has COVID or flu, which all kind of start with the same fever, sore throat, runny nose and a test is really key in those kinds of situations."
When should you test?
Experts still say at-home testing can be done multiple times for people experiencing symptoms.
According to Rodgers, that's because at-home tests are designed to detect infection when it's at its highest.
"The home tests like Abbott's Binaxnow are really intended to catch infections when people are at their most contagious. So then they have the highest levels of the virus present," she said. "So that means that if you're still feeling sick after a negative test, it would make sense to check in with your health care provider and possibly do another round of testing."
What to do if you test positive?
In March, the CDC updated its COVID guidelines to mirror guidance for other respiratory infections. Those who contracted COVID-19 no longer need to stay away from others for five days, the CDC said, effectively nixing the five-day isolation recommendation.
People can return to work or regular activities if their symptoms are mild and improving and it's been a day since they've had a fever, but the CDC still recommends those with symptoms stay home.
"The recommendations suggest returning to normal activities when, for at least 24 hours, symptoms are improving overall, and if a fever was present, it has been gone without use of a fever-reducing medication," the guidance states.
Once activities are resumed, the CDC still recommends "additional prevention strategies" for an additional five days, including wearing a mask and keeping distance from others.
The agency is emphasizing that people should still try to prevent infections in the first place, by getting vaccinated, washing their hands, and taking steps to bring in more outdoor fresh air.
As part of the guidance, the CDC suggests:
- Staying up to date with vaccination to protect people against serious illness, hospitalization, and death. This includes flu, COVID-19, and RSV if eligible.
- Practicing good hygiene by covering coughs and sneezes, washing or sanitizing hands often, and cleaning frequently touched surfaces.
- Taking steps for cleaner air, such as bringing in more fresh outside air, purifying indoor air, or gathering outdoors.
The change comes at a time when COVID-19 is no longer the public health menace it once was. It dropped from being the nation's third leading cause of death early in the pandemic to 10th last year.
Most people have some degree of immunity to the coronavirus from past vaccinations or from infections. And many people are not following the five-day isolation guidance anyway, some experts say.
Will vaccines prevent against the XEC variant?
Experts have long said the COVID virus will continue to mutate.
This fall's vaccine recipe is tailored to a newer branch of omicron descendants. The Pfizer and Moderna shots target a subtype called KP.2 that was common earlier this year.
While additional offshoots, particularly KP.3.1.1, now are spreading, they’re closely enough related that the vaccines promise cross-protection. It is expected that the vaccines will provide some protection against XEC as well.
"We expect the latest updates to the vaccine to protect people from severe outcomes the same way that the previous versions have also been able to prevent more severe outcomes from the strain that's currently circulating," she said. "It's kind of like how the flu has been in the past where mutations that allow it to spread every season are the ones that we're combating with vaccines.
A Pfizer spokesman said the company submitted data to FDA showing its updated vaccine “generates a substantially improved response” against multiple virus subtypes compared to last fall’s vaccine.
This summer’s wave of COVID-19 isn’t over but winter surges tend to be worse. And while COVID-19 vaccines do a good job preventing severe disease, hospitalization and death, protection against mild infection lasts only a few months.
Where can you get free COVID tests?
On the heels of the summer wave of COVID-19 cases, Americans are now able to get free virus test kits mailed to their homes, with ordering opening in late September.
U.S. households will be able to order up to four COVID-19 nasal swab tests when the federal program reopens, according to the website, COVIDtests.gov. The U.S. Health and Human Services agency that oversees the testing has not announced an exact date for ordering to begin.
The tests will detect current virus strains and can be ordered ahead of the holiday season when family and friends gather for celebrations, an HHS spokesperson said in an emailed statement. Over-the-counter COVID-19 at-home tests typically cost around $11, as of last year.
