COVID-19 may not dominate headlines as it once did, but it remains a persistent health concern. The virus continues to evolve, causing illness and impacting daily life, especially as we navigate through the holiday seasons and beyond. Many people are still uncertain about the current best practices for managing COVID-19. Questions linger: How long are you contagious? What are the latest isolation guidelines? How do you recognize COVID-19 symptoms, and is vaccination still relevant?
“The COVID landscape has indeed shifted significantly since the initial pandemic outbreak in 2020,” explains Dr. Brandon Bet, an infectious disease specialist at Henry Ford Health. “Widespread immunity from both vaccinations and prior infections, coupled with the emergence of new COVID variants, has altered the dynamics. However, it’s crucial to remember that COVID-19 can still lead to severe illness, particularly in vulnerable populations. Vigilance remains key.”
Dr. Bet provides essential insights into understanding COVID-19 during the 2024-2025 viral season, focusing on contagiousness, isolation, and updated recommendations.
Understanding the Current COVID-19 Strain and Symptoms
Q: What is the dominant COVID-19 strain right now, and what symptoms should I watch out for?
A: “Currently, the predominant COVID-19 variant is XEC,” states Dr. Bet. “This is an Omicron subvariant and is projected to remain the most common strain throughout the winter months, accounting for approximately half of all detected cases. Fortunately, initial data suggests that XEC is not inherently more severe or more transmissible than previous recent variants. The symptoms associated with XEC are also largely consistent with those of earlier strains.”
The challenge with COVID-19 lies in the wide spectrum of symptoms it can present. For some individuals, it might manifest as mild cold-like symptoms, while for others, it can resemble a more intense flu-like illness. In more severe cases, the impact can be significantly greater. The intensity of symptoms is often influenced by factors such as age, pre-existing health conditions, and vaccination status. The CDC outlines common COVID-19 symptoms, which include:
- Fever and chills
- Persistent cough
- Shortness of breath or labored breathing
- Sore throat discomfort
- Nasal congestion or runny nose
- Loss of smell or taste perception
- General fatigue
- Muscle aches or body pain
- Headache
- Nausea, vomiting, or diarrhea
Research indicates a potential order in which COVID-19 symptoms might appear, starting with fever, followed by cough, sore throat/muscle pain/headache, and lastly nausea/vomiting and diarrhea. “It’s important to note that this is not a rigid sequence, and you may not experience all these symptoms, nor in this specific order,” clarifies Dr. Bet. “The definitive way to determine if your symptoms are due to COVID-19 is through testing.”
COVID-19 Severity in 2024
Q: How serious is COVID-19 considered now?
A: Thanks to widespread vaccination and effective treatments, hospitalization rates for COVID-19 are significantly lower compared to the pandemic’s initial stages. However, data from as recently as 2023 shows that hospitalizations and fatalities still experience upticks. Individuals who remain unvaccinated against COVID-19 face a higher risk of hospitalization and developing severe illness compared to their vaccinated counterparts.
“Individuals aged 65 and older, along with those of any age with underlying health conditions such as diabetes, chronic heart, lung, liver, or kidney disease, or compromised immune systems, are at a heightened risk of severe COVID-19 infection,” emphasizes Dr. Bet. “Pregnancy also presents a high-risk category. Pregnant individuals are more susceptible to experiencing severe illness from COVID-19, with severe cases potentially leading to pregnancy loss.”
Long COVID remains a significant concern, characterized by lingering symptoms that can persist for months or even years following the initial infection. Symptoms of long COVID are varied and can include brain fog, loss of smell and taste, persistent fatigue, depression, anxiety, and joint or muscle pain. Unvaccinated individuals and those who experienced severe initial COVID-19 infections are at a greater risk of developing long COVID.
Contagiousness and Duration of Contagion in 2024
Q: How contagious is the current COVID-19 variant, and for how long am I contagious if infected?
A: Current COVID-19 strains maintain a similar level of contagiousness to previous variants. However, the timeframe during which an individual is most contagious has evolved.
“When COVID-19 first emerged in 2020, population immunity was non-existent,” Dr. Bet explains. “This meant that a single infected person could transmit the virus to a significantly larger number of individuals, especially before public health measures like lockdowns were implemented.”
Previously, individuals were considered contagious even before symptom onset. However, a 2023 study indicates that peak contagiousness now occurs around day four after symptom onset, mirroring patterns observed with other viral illnesses like influenza and RSV. You remain contagious for an average of eight days with COVID-19 (though this duration can vary based on illness severity). It’s crucial to take precautions during this period to prevent transmission to others.
Updated COVID-19 Isolation Guidelines for 2024
Q: What are the current recommendations for COVID-19 isolation?
A: “Isolation guidelines have been a source of confusion due to changes over time,” acknowledges Dr. Bet. “Initially, a 10-day isolation period following a positive COVID-19 test was recommended. Subsequently, the CDC revised this guidance to allow for ending isolation after five days, followed by wearing a mask for an additional five days.”
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This adjustment considered risk-benefit assessments and data on contagiousness periods. Currently, the CDC recommends.#:~:text=and%20not%20testing%3F-,The%20updated%20Respiratory%20Virus%20Guidance%20recommends%20that%20people%20stay%20home,using%20fever%2Dreducing%20medication).) that if you have been fever-free for 24 hours and your other symptoms are improving, you can end isolation. This means isolation duration can vary depending on individual illness progression. Even after ending isolation, continued precautions are advised: wearing a well-fitting mask, maintaining distance from others, and practicing diligent hand hygiene.
Considering taking another COVID-19 test is advisable, particularly before attending holiday gatherings, especially if vulnerable individuals are present.
“These evolving recommendations reflect the current state of high population immunity to COVID-19, alongside the availability of effective antiviral treatments like Paxlovid,” Dr. Bet notes. Over 98% of the U.S. population now possesses some level of COVID-19 immunity through vaccination, prior infection, or both, according to CDC data.
“Remember that isolation guidelines in healthcare settings may differ from general workplace policies, and your specific workplace policies may also vary,” Dr. Bet clarifies.
COVID-19 Test Accuracy and Timing in 2024
Q: How accurate are COVID-19 tests, and when is the optimal time to test?
A: PCR tests, administered by healthcare professionals, remain the most accurate method for COVID-19 diagnosis. At-home rapid tests are also effective, but the FDA recommends the following guidelines for maximizing accuracy:
- If you have symptoms and receive a negative result, repeat the test 48 hours later to confirm.
- If you lack symptoms but have been exposed to COVID-19 and receive a negative result, take two additional tests, 48 hours apart, to ensure accuracy. It’s best to wait five days post-exposure before initiating testing.
- A positive test result, regardless of the test type, is generally considered accurate.
“With upcoming holiday gatherings, having COVID-19 tests readily available is prudent,” suggests Dr. Bet. “Every household in the U.S. can order four free at-home tests from the government here.”
Updated COVID-19 Vaccine Recommendations for 2024-2025
Q: Is it necessary to get an updated COVID-19 vaccine?
A: The CDC recommends that everyone aged 6 months and older receive an updated COVID-19 vaccine for the 2024-2025 viral season. Similar to the annual flu vaccine, the COVID-19 vaccine is updated annually to target the most prevalent circulating strains.
“Annual vaccine updates enhance effectiveness,” explains Dr. Bet. “It’s not merely a ‘booster’ but an updated vaccine formulation. Vaccination doesn’t guarantee complete prevention of COVID-19 infection, but it significantly reduces the severity of illness if infection occurs.”
Three updated COVID-19 vaccines are available from Moderna, Pfizer, and Novavax. Moderna and Pfizer vaccines are FDA-approved for individuals aged 12 and older and authorized under emergency use for those aged 6 months to 11 years. The Novavax vaccine is authorized for individuals aged 12 and older. The CDC recommends a second dose six months after the initial updated vaccine for individuals aged 65 and older, as well as those with moderate to severe immunocompromise.
Seeking COVID-19 Treatment in 2024
Q: When should I seek medical treatment for COVID-19?
A: If you fall into a high-risk category for COVID-19, initiating antiviral treatment with Paxlovid is recommended as soon as symptoms appear, ideally within 48 to 72 hours of symptom onset.
“Paxlovid is administered as a pill pack containing two medications,” explains Dr. Bet. “One component is the active antiviral agent, while the other enhances its effectiveness. Paxlovid significantly reduces the risk of hospitalization by over 50% and the risk of death by 75%. However, timely initiation of treatment is crucial for optimal efficacy.”
Individuals over 50 and/or those with underlying health conditions experiencing COVID-19 symptoms should get tested promptly and consult their physician as soon as possible. For life-threatening symptoms such as severe breathing difficulty, immediately call 911 or visit the nearest emergency room.
Reviewed by Brandon Bet, D.O., an infectious disease physician at Henry Ford Medical Center – Springport Rd.
