It has been almost exactly three years since the World Health Organization declared COVID-19 a pandemic. But thanks to science, much has changed within those three years. We have effective vaccines, we’ve learned how the virus behaves and we’ve developed treatments that can greatly reduce someone’s risk of hospitalization.
In fact, we may even be on the cusp of the pandemic moving to endemic status. (A bit of background info: A pandemic is an epidemic on at least two different continents at the same time. An epidemic is widespread occurrence of an infectious disease. Endemic is a consistently present disease in a geographic area. The flu, for example, is endemic.)
“Determining when a pandemic or epidemic moves to endemic status is an academic argument,” says Dennis Cunningham, M.D. M.H.A., medical director of infection control and prevention at Henry Ford Health. “It is even more complicated to determine the status with COVID-19 because of new variants. I will hedge and say COVID is endemic now, but new variants have the potential to cause new epidemics/pandemics.”
Here, Dr. Cunningham shares everything to know about COVID-19 now—from the latest information about vaccines and treatments to dominant variants and symptoms.
Current COVID-19 Vaccines + Eligibility
Although life has largely gotten back to normal since the beginning of the pandemic, it is important to keep up with your COVID-19 vaccinations. At least two months after completing your primary vaccine series, you should receive a bivalent booster. Bivalent boosters protect against the original strain of COVID-19 and the Omicron variant.
“Research still shows that people who aren’t vaccinated—and who aren’t up to date with their vaccinations—are at higher risk for developing severe disease,” says Dr. Cunningham. “We may have an annual ‘COVID season’ just like we have an annual flu season. Like the flu, we may need to have an annual COVID shot.”
Pfizer and Moderna both have a bivalent booster and both are recommended for ages six months and up. Learn more about vaccine timing and guidance at the CDC website.
Dominant COVID Variants + Symptoms
The longer a virus is around, the more opportunities it has to mutate and become better at infecting its host. That’s why new COVID-19 variants keep emerging. Right now, Omicron subvariant XBB.1.5 makes up the majority of new COVID-19 infections in the United States. It seems to be the most contagious strand of COVID-19 we’ve had yet, but it doesn’t seem to cause more severe disease than other variants.
As with other variants, symptoms of XBB.1.5 can vary. They include runny nose, mild cough, sore throat, fatigue, nausea, body chills and aches, headache, loss of taste or smell, nasal congestion and fever.
Since XBB.1.5 is a subvariant of Omicron, getting vaccinated—especially getting the bivalent booster—can help prevent infection or reduce the severity of your illness.
Over-The-Counter Treatments To Ease COVID-19 Symptoms
If you have a mild case of COVID-19, stay home, rest and drink lots of fluids. To ease symptoms, you can try these over-the-counter remedies:
- For a fever or body aches, take acetaminophen (Tylenol) or ibuprofen (Motrin, Advil).
- For nasal congestion, try a decongestant (like Mucinex). If you have high blood pressure, talk to your provider before taking it, as decongestants may worsen blood pressure. Antihistamines like Claritin or Allegra are helpful when congestion has an allergic component.
- For a sore throat, try gargling with salt water (use 1/2 teaspoon of salt per drink). Hot tea or cold substances, like a milkshake, may also help.
If you are symptom free five days after testing positive, the CDC says it is okay to end your quarantine but you should wear a mask when leaving your home. You are most contagious in the 48 hours before your symptoms start and during the five days after you test positive.
Outpatient Treatments Available For COVID-19
If you are at high risk for severe disease, there are a few outpatient treatments that can help prevent you from developing a severe case of COVID-19. They work against the Omicron variants, but they must be taken in the early stage of illness. They include:
- Paxlovid (Nirmatrelvir/Ritonavir). This oral antiviral pill must be taken within five days of the onset of symptoms. It is 88% effective in reducing the risk of hospitalization or death. The Food and Drug Administration (FDA) has issued an emergency use authorization for its use in ages 12+ who have underlying medical conditions. Paxlovid has several drug interactions so talk to your doctor before taking it.
- Veklury (Remdesivir). This IV treatment was one of the primary inpatient COVID-19 treatments for a while, but it is now FDA-approved for outpatient use. It must be taken within seven days of the onset of symptoms. You’ll need an IV infusion for three days in a row, but it’s about equally as effective as Paxlovid.
The Continued Threat Of Long COVID
One side effect of COVID-19 that experts are still learning about is long COVID, which occurs when someone has symptoms for at least three months after they’ve recovered from their initial infection. These symptoms can last for months—or years. They can also be new symptoms not experienced during the initial infection.
“Long COVID occurs in about 10% of people infected with COVID,” says Dr. Cunningham. “The risk is greatest in people admitted to the hospital (it accounts for about 50-70% of cases), but long COVID can occur in mild cases as well (it accounts for about 10-30% of cases). Vaccination decreases the chance of developing long COVID—only 10-12% of people who are vaccinated develop long COVID.”
Symptoms of long COVID are wide ranging. They include:
- Brain fog, fatigue, mood changes, difficulty with memory and attention span
- Shortness of breath, cough
- Racing heartbeat, low or high blood pressure
- Loss of smell and taste
- Digestive issues
The cause of long COVID is not known but some of the hypotheses include:
- Dysregulation of the immune system (this means that T-cells—a type of white blood cell—have altered function)
- An autoimmune disease, which is triggered by the initial infection
- Damage to the inner layer of small blood vessels from blood clots
- Persistence of the virus in tissue
“Treatment for long COVID is focused on managing the symptoms,” says Dr. Cunningham. “There are studies looking at various medications for autoimmune disease. Blood thinners seem to help some patients. Other studies are trying supplements such as coenzyme A10 and D-ribose. Paxlovid may also help some patients with long COVID.”
Living Life With COVID-19
Maybe you’re used to living life normally now, maybe you’re still having trouble with it. “Everyone needs to determine their own comfort level with COVID as part of daily life,” says Dr. Cunningham. “If someone has risk factors for severe disease (for example, older age or other medical problems) it is very important to receive the bivalent booster. This group should consider wearing masks if they will be in crowded locations. Other people without risk factors for severe disease should also receive the bivalent booster. Humans are social creatures and I encourage people to enjoy their lives. The world has reopened.”
Henry Ford Health offers the Pfizer bivalent booster to established patients. Appointments can be made via MyChart.
Dennis Cunningham, M.D., M.H.A., is the medical director of infection control and prevention at Henry Ford Health.
