With holiday gatherings and New Year's celebrations in the rearview mirror, many Americans are coming down with respiratory viruses and may be wondering what their symptoms mean.
After its initial onset in December 2019 and ensuing worldwide outbreak in early 2020, COVID-19 remains a top concern among health experts, with about 900 people, primarily older adults, dying from the virus each week in the United States over the past year, according to the Centers for Disease Control & Prevention.
The five years of the pandemic have seen numerous mutations and variants, with the delta and omicron variants causing new waves of the infection in late 2021 and early 2022.
According to the CDC, the current dominant variant is called XEC, an omicron subvariant that accounted 45% of variants circulating nationally in the two-week period ending Dec. 21.
The symptoms associated with the XEC variant remain largely similar to previous omicron variants, health experts said, with the following symptoms commonly reported in connection to COVID-19:
- 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.
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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 was 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.
What do we know about long COVID?
Millions of people remain in limbo with a sometimes disabling, often invisible, legacy of the pandemic called long COVID.
It can take several weeks to bounce back after a bout of COVID-19, but some people develop more persistent problems. The symptoms that last at least three months, sometimes for years, include fatigue, cognitive trouble known as “brain fog,” pain and cardiovascular problems, among others.
Doctors don’t know why only some people get long COVID. It can happen even after a mild case and at any age, although rates have declined since the pandemic's early years. Studies show vaccination can lower the risk.
It also isn't clear what causes long COVID, which complicates the search for treatments. One important clue: Increasingly researchers are discovering that remnants of the coronavirus can persist in some patients’ bodies long after their initial infection, although that can’t explain all cases.
