Since COVID-19 began to spread two and a half years ago, our understanding of the virus has changed drastically. However, that isn’t to say that the ever-adapting pathogen hasn’t kept the medical community on its toes. New highly contagious subvariants have made it more difficult for our bodies to defend against the virus while also changing up the likelihood of which symptoms you’ll feel when you come down with it. In fact, new data now shows that even running a fever isn’t as common as experiencing another sign of COVID. Read on to see which symptom you’re now most likely to feel first with the virus.
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As companies peel back the last of the COVID requirements and restrictions, it can feel like the pandemic is finally moving into the rearview mirror. Case counts have remained on a steady decline for months after a mid-summer spike, with the national daily average dropping 23 percent in the past two weeks to 43,419 as of Oct. 5, according to The New York Times. Even severe outcomes with the disease appear to be decreasing, with hospitalizations dropping 11 percent to 27,184 and deaths from the virus falling eight percent to 391 over the same period.
However, the cyclical nature of the virus has shown that this downturn might not last forever. New data shows that COVID cases are rising again in Europe, with counts up in 15 countries over the past two weeks, per U.S. News & World Report. There’s growing concern that such conditions could mean a rise in other severe outcomes stateside, too.
“If this comes across and comes to us, I would expect that we would probably have the same increase in hospitalizations and death as they would have in England. Generally, what happens in Europe, or in the United Kingdom, happens here within the month,” Mark Pamer, MD, a pulmonologist and critical care physician in Florida, told local CBS affiliate WPEC.
But just as the threat of COVID has constantly evolved, so has the list of which symptoms we might most likely see when we contract the virus. And with the BA.5 and BA.4 Omicron subvariants spreading as the most common cause of the disease in the U.S., it’s making it even more difficult to tell when you’re sick.
“Many people are still using the government guidelines about symptoms, which are wrong,” Tim Spector, PhD, a professor of genetic epidemiology at King’s College London and co-founder of the COVID ZOE study app, told The Independent.
But by missing out on the early signs of the virus, some particularly vulnerable people could find themselves in a dangerous situation. “At the moment, COVID starts in two-thirds of people with a sore throat. Fever and loss of smell are really rare now, so many old people may not think they’ve got COVID. They’d say it’s a cold and not be tested,” Spector told the newspaper.
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The COVID-19 pandemic changed daily life in many ways, including attention to our bodies and health. Widely available free testing made it easy for data collection that could help scientists detect changes in the virus. But experts are now concerned such information will become more challenging to come by as common coronavirus symptoms become muddled with those of seasonal allergies, common colds, or the flu—especially as the virus becomes harder to defend against.
“What we’re finding is the virus is evolving around the immunity that’s been built up through vaccines and countless infections people have had,” Lawrence Young, PhD, a professor of virology at the University of Warwick, told The Independent. “The biggest concern we’re seeing is that in early data these variants are starting to cause a slight increase in infections. In a way, this was to be expected, but it does demonstrate that we’re not out of the woods yet at all with this virus, sadly.”
He also expressed concern that recent policy changes could be setting the scene for a lack of vital information that has helped inform decisions in the past. “We can only detect variants or know what’s coming by doing sequencing from PCR testing, and that’s not going on anywhere near the extent it was a year ago,” Young said. “People are going to get various infections over the winter but won’t know what they are because free tests aren’t available. It’s going to be a problem.”
On the more immediate front, other experts are also afraid that the confusion over symptoms could lead to further outbreaks of the virus. “Someone with a sore throat may assume they have something other than COVID and therefore bother not to get tested. But this could lead to more spread in the community,” Mallika Marshall, MD, a physician at Massachusetts General Hospital and reporter, said during an on-air segment for local Boston CBS affiliate WBZ-TV.
“It’s also really important for people who are at high risk to test for COVID if they develop a sore throat so that they can get treated within the very short time frame necessary to prevent COVID complications,” she added.
But the upcoming winter also marks the first departure from more widespread adherence to public masking and the availability of free at-home tests. Some experts caution that this could disproportionately affect lower socioeconomic portions of the population without the necessary input needed to help them.
“The biggest worry is the burden becoming unnoticed,” Srinivasan Venkatramanan, PhD, an infectious-disease modeler at the University of Virginia and a member of the COVID-19 Scenario Modeling Hub, told The Atlantic. “It’s like flying without altitude or speed sensors. You’re looking out the window and trying to guess.”