The latest wave of COVID-19 is primarily driven by highly transmissible descendants of the Omicron lineage, such as the XFG subvariant. These variants have continued to evolve, altering the typical illness experience and making symptoms closely resemble those of other common respiratory infections. Understanding this shift is important, as the presence and severity of symptoms are now less predictable than in previous waves. This guide provides an updated overview of the current symptom profile.
Current Symptoms of the Dominant Variant
The symptoms associated with the dominant Omicron subvariants primarily affect the upper respiratory tract, often mimicking a common cold. The most frequently reported initial complaint is a sore throat, which can sometimes be severe. This is typically followed by significant nasal congestion or a runny nose and a persistent dry or minimally productive cough.
Fatigue and general malaise are common, presenting as a feeling of being unusually tired or slowed down. Headaches and muscle aches are also widely reported, though they tend to be moderate. Fever and chills may occur, but they are less frequent than with earlier strains. The classic symptom of new loss of taste or smell is now uncommon, though it can still occur.
How Symptoms Differ from Prior Strains and Other Illnesses
The current symptom profile represents a significant departure from earlier variants, such as Delta, which targeted the lower respiratory tract. Delta infections often led to severe respiratory distress and a higher risk of pneumonia, while current strains mainly cause symptoms above the lungs. This shift contributes to the generally milder illness experienced by many people today.
Differentiating current COVID-19 from the flu or a common cold can be challenging due to symptom overlap. A common cold typically begins with a gradual onset of sneezing and a runny nose, rarely involving fever or severe body aches. In contrast, COVID-19 is more likely to include fever and muscle aches, and often features an intense sore throat early in the illness.
The flu, like COVID-19, often causes a rapid onset of symptoms, including fever and significant fatigue. A key distinction can sometimes be the cough: COVID-19 can cause a dry, continuous cough that lasts for an hour or more, whereas a flu cough may be less persistent. Because of the similarity between the infections, testing remains the only way to know the exact cause of the illness.
Navigating Illness Duration and Severity
The typical incubation period for the dominant subvariants is relatively short, with symptoms often appearing two to five days after exposure. An infected person is generally contagious starting one to two days before symptoms begin and for roughly eight to ten days after onset. The acute phase of the illness usually peaks within the first few days, with most healthy individuals recovering within about a week.
Illness severity is heavily influenced by individual factors, primarily vaccination status and prior infection history. People who are unvaccinated, elderly (over 60), or have underlying health conditions remain at higher risk for severe outcomes. Even with milder acute illness, the risk of developing Long COVID remains a concern, with potential lingering symptoms like brain fog, chronic fatigue, or shortness of breath.
Next Steps After Symptom Recognition (Testing and Care)
Upon recognizing symptoms, prompt testing is recommended to confirm the infection and prevent further spread. Rapid Antigen Tests (RATs) are suitable for quick screening, but if a RAT is negative and symptoms persist, an RT-PCR test is the most accurate method. Isolation is recommended for at least seven days from symptom onset, and should continue until you are fever-free for 24 hours without fever-reducing medication.
For mild to moderate cases, home care should focus on rest, hydration, and using over-the-counter pain and fever relievers. Certain symptoms warrant immediate medical attention, such as a persistent high fever over 102°F for three or more days, difficulty breathing, or chest tightness. Individuals at high risk for severe disease should contact a healthcare provider promptly, as they may be candidates for antiviral treatments.