Category Archives: Coronavirus

Your 2024 Guide to Covid Symptoms and Treatment

Roger Straw

[Note from BenIndy Contributor Roger Straw: Please know that COVID is still all around us: “Data from the Centers for Disease Control and Prevention indicated that, as of mid-February, more than 21,000 people were hospitalized with Covid, and there had been roughly 10,000 Covid-related deaths in 2024.”  Even when it’s relatively mild, COVID is no fun when you get it! And… it can be long-lasting. This article from the New York Times is a good update. Read on….]

Rest, fluids and medications are your friends.

New York Times, By Dana G. Smith, March 1, 2024

NYT: Getty images

We’re four years into the pandemic, and by this point, most Americans have had Covid at least once. But when the virus comes for us (again), it can still feel just as alarming as your first bout.

Here’s a guide to what Covid looks like now and how to treat it.

Symptoms

The most common Covid symptoms haven’t changed much since the start of the pandemic, and they remain consistent for the latest dominant variant, JN.1, said Dr. Soniya Gandhi, the associate chief medical officer at Cedars-Sinai Medical Center in Los Angeles. They include fatigue, sore throat, congestion, runny nose, headache, body aches and cough.

“All or any of those in isolation can still be Covid,” Dr. Gandhi said.

Some people may develop conjunctivitis, also known as pink eye, or experience gastrointestinal issues, like nausea, vomiting and diarrhea, but those symptoms are rarer. Anecdotally, experts said, one of the most notable symptoms early in the pandemic — the loss of taste and smell — also appears to be less common these days.

“The biggest change is that people are having milder symptoms overall,” said Dr. Amanda Casto, an acting assistant professor of allergy and infectious diseases at the University of Washington. That’s because virtually everyone has some pre-existing immunity from vaccines, a prior infection or both.

While Covid is mild for most people, it can be dangerous and even fatal for some. Data from the Centers for Disease Control and Prevention indicated that, as of mid-February, more than 21,000 people were hospitalized with Covid, and there had been roughly 10,000 Covid-related deaths in 2024.

Severe illness is a lot less prevalent now than during the first few years of the pandemic, “but we’re still seeing it,” said Dr. Stuart Ray, a professor in the division of infectious diseases at Johns Hopkins Medicine in Baltimore. The people who are getting sickest tend to be those with compromised immune systems and underlying health conditions, such as heart disease, diabetes or lung problems. Adults over age 65 are also at higher risk for severe infections.

Since mild Covid can look like a cold or the flu, it’s important to test yourself if you have symptoms or have had a known exposure, Dr. Gandhi said. Knowing what you have can affect your treatment and how long you isolate from others.

On March 1, the C.D.C. updated its guidance for preventing the spread of Covid and other respiratory viruses. The agency recommended that people isolate until their symptoms have started to improve and they have been fever-free for at least 24 hours. The agency acknowledged that people may still be contagious at this point and should continue to take precautions, like masking and physical distancing, for the next five days.

The antiviral pill Paxlovid is very effective against severe Covid, reducing the risk of death by 73 percent if taken within the first five days of an infection, according to a preliminary study conducted by the National Institutes of Health. Experts urged people who are high-risk to contact their doctors about getting a prescription as soon as they have symptoms or test positive.

“If you’re elderly or you have comorbidities, before you even get worse, you should already seek medical care,” said Dr. Bernard Camins, the medical director for infection prevention at the Mount Sinai Health System in New York. “Your health care provider will then evaluate you if you’re a candidate for antivirals.”

Paxlovid isn’t recommended for everyone. It can interact with several medications, including common ones used to lower blood pressure or prevent blood clots, and it’s also not advised for people with severe kidney disease. If you can’t take Paxlovid, the drug remdesivir could be an option, but it has to be delivered intravenously, so it’s less convenient and harder to obtain.

Paxlovid also doesn’t appear to provide much benefit to young, healthy adults whose risk of severe infection is low, so it isn’t broadly recommended for those groups.

For most people, Covid symptoms can be managed at home and treated like any other respiratory illness, with an emphasis on rest and staying hydrated. “If you have congestion or cough, you’re losing more fluids than you normally would,” Dr. Casto said. “So I would definitely recommend that people stay on top of fluid.”

If you have a fever or body aches, take acetaminophen (Tylenol) or ibuprofen (Advil or Motrin). You can also take over-the-counter cold and flu medicines with decongestants or cough suppressants, though the experts didn’t recommend them strongly because they don’t work for everybody and can cause drowsiness.

If you’re experiencing shortness of breath — meaning you can’t catch your breath or are taking quick and shallow breaths — it’s important to seek medical attention right away.

“The thing that I worry most about is the breathing,” Dr. Casto said. “That’s the most concerning sign, because people can get” worse really quickly. If you’re having trouble breathing, she advised going to the emergency room rather than to your doctor or an urgent care clinic. Experts also said you should see a provider if you experience confusion or chest pain.

If your symptoms don’t improve after several days, or improve and then regress, it could be a sign you have a secondary infection like pneumonia, Dr. Casto said. In that case, or if you’re concerned about your symptoms at all, don’t hesitate to call your doctor.

Dana G. Smith is a Times reporter covering personal health, particularly aging and brain health.


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Doonesbury peeks inside Capitol Hill

[This Doonesbury cartoon puts a predictable and funny-sad twist on the COVID pandemic. I can’t vouch for Garry Trudeau’s 43%, but I found several studies (see below) that confirm his analysis. Enjoy (?) the cartoon… – BenIndy Contributor Roger Straw]

Doonesbury, by Garry Trudeau

Doonesbury, by Gary Trudeau, November 26, 2023

Two important scientific studies:

Journal of the American Medical Association: Excess Death Rates for Republican and Democratic Registered Voters in Florida and Ohio During the COVID-19 Pandemic, July 24, 2023.

“The differences in excess mortality by political party affiliation after COVID-19 vaccines were available to all adults suggest that differences in vaccination attitudes and reported uptake between Republican and Democratic voters may have been a factor in the severity and trajectory of the pandemic in the US.”

Science Direct: The politics of COVID-19: Differences between U.S. red and blue states in COVID-19 regulations and deaths, November 11, 2023.

“CONCLUSION: …this work’s key conclusion is that mass-behavioral changes prescribed through legislation do provide mass-scale dividends in areas that promote these strategies. In highlighting the political divide between COVID-19 legislative and mitigation efforts, researchers do not intend to proselytize one ideology to another but to expand on the notion that differences between dominant political affiliations are equally relevant to consider. Diseases have demonstrated no partisan allegiance, past or present. The individual role of citizens is not without consequence, but to ultimately lessen the aversive effects of COVID-19 and other viral threats in the United States, it is necessary to behave collectively. Given the compelling evidence of mass-behavioral mitigation efforts being successful in pandemic remediation, further legislation should focus on best communicating and implementing these strategies across political landscapes. Focusing on effectively implementing mitigation strategies across ideologies should be paramount if communities are to address disease-based threats with minimal loss and aversive outcomes.”


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How to navigate renewed COVID threat in the Bay Area

Roger Straw

[Note from BenIndy Contributor Roger Straw: Well, it finally ALMOST happened. My wife and I have been ultra careful, and so far are among the increasingly rare few who have not contracted the coronavirus. Mary Susan is immune compromised, so we still wear masks in the grocery and other crowded indoors places. But we were seriously exposed when close family members tested positive a day or two after celebrating a birthday in our own home. They got on Paxlovid right away, and are fine, but only after a really miserable 2 weeks. We isolated and tested negative every other day for 10 days – and whew, still have not got the bug. Thank goodness we celebrated with windows wide open and seated widely spaced at the long dinner table. Please know that COVID is back, it’s around you, and it is no fun when you get it! And… it can be really serious, even long-lasting. Read on….]

How to navigate renewed COVID threat in the Bay Area

San Francisco Chronicle, by Aidin Vaziri, Aug. 22, 2023

Fans wait for Ethel Cain at the Sutro stage during the first day of the Outside Lands Music Festival on Aug. 11. As the Bay Area’s summer COVID-19 swell gains ground, outdoor venues remain a relatively safe environment, even without masks. | Jessica Christian/The Chronicle

UPDATERising COVID cases prompt Bay Area hospital to reinstate mask mandate

A local theater troupe cancels a weekend of performances because cast members have COVID. A Sunday luncheon is postponed because the hostess has fallen ill. A colleague catches the coronavirus on a trip back from Italy. The nearby Walgreens is sold out of home test kits.

There’s no mistaking that the SARS-CoV-2 virus is staging an unwanted comeback in the Bay Area. The uptick in COVID cases evokes memories of summers since 2020. Official figures, though early, back up the anecdotes: The state’s test positivity rate has climbed to 11.8%, its highest level since the beginning of the year, and hospitalizations are up more than 63% in the last month, from a seven-day average of 163 admissions per day in mid-July to 266 per day last week.

Nationally, there were 12,613 new COVID-19 hospitalizations for the week ending Aug. 12, according to data released Monday by the Centers for Disease Control and Prevention. This figure reflects a 21.6% rise compared to the preceding week. Deaths due to COVID-19, a lagging indicator, are also starting to pick up nationwide, with an 8.3% increase over the same period.

While many cases result in mild symptoms, especially for those who’ve been vaccinated or previously battled the virus, COVID’s disruption to work and life is still undeniable. Plus, some evidence suggests that each subsequent bout of the virus may raise the risk of experiencing a persistent state of exhaustion, brain fog, or other symptoms known as long COVID.

Despite the resurgence, a sense of “pandemic fatigue” pervades the population, prompting many people to resume normal activities and overlook the threat, especially if their risk of severe illness is low. Restaurants, movie theaters, concert venues and airplanes are now packed with crowds of almost entirely unmasked people who roll the dice and hope for the best.

But what if you’re not among those willing to wager on chance, either due to underlying health conditions or general concern about adverse outcomes? As the summer swell gains momentum, here is a refresher on the latest expert advice to navigate uncertain times.

When to consider vaccinations and boosters

Throughout 2023, the dominant strains of the coronavirus nationwide and in the Bay Area have been descendants of the omicron family of SARS-CoV-2. The currently available vaccines and boosters were tailored to combat both the original 2020 coronavirus strain and a 2022 omicron derivative, so they offer somewhat diminished protection against the current variants. Yet they still afford greater protection than no vaccination at all. Updated vaccines geared toward more recent variants are set to roll out in late September or early October.

When to consider a booster:

  • Higher-risk individuals: People at higher risk of severe illness, including those with health conditions such as obesity or diabetes, individuals age 65 and above, or those with compromised immune systems due to underlying immunological problems or cancer treatments, should get a booster shot every six months. Some vulnerable people might consider a shot now if it’s been more than four months since their last.
  • General population: If you are in good health, under 65, and have received a vaccine or battled COVID within the past six months, the best option is likely to wait until the fall for the updated booster. Even if it has been more than six months, you might want to hold out for the new booster because it’s better tuned to fighting off current variants.

Masking calculus

Few topics have sparked more debate than masking, with arguments ranging from its efficacy to ideological objections to mandates. Yet the evidence remains clear: Consistent masking has been shown to be an accessible and effective means to reduce transmission, whether you’re at risk of unknowingly spreading the virus or of contracting it.

For those looking for more protection in the current environment, situations where a tight-fitting quality N95 or KN95 mask can be beneficial include:

  • Public transportation.
  • Airport waiting lounges and during aircraft boarding and taxiing.
  • Crowded indoor spaces where people are singing or shouting.
  • Bustling restaurants before and after meals.

Scenarios that may not warrant the same level of precaution include:

  • Walking or hiking outdoors.
  • Open-air concerts or sporting events.
  • Alfresco dining or social interactions.

Navigating social situations and testing

Although there are no definitive rules for safe or unsafe behavior in more intimate social settings, a combination of thoughtfulness and common courtesy can guide most interactions.

  • Home test kits, while still able to detect the latest coronavirus strains, are not as reliable as they were in the past. A positive home test remains a clear indication of COVID, and there’s no need to confirm the diagnosis with an official lab test unless it’s required for work absences or other reasons.
  • A greater concern is the potential for “false negatives” from home tests during the early stages of infection. If you suspect you may be ill and are worried about meeting other people, multiple tests over successive days should clear up any doubt.
  • If you need to have more certainty for some reason, many pharmacies and health providers still provide a polymerase chain reaction, or PCR, laboratory test, which is considered the gold standard. Payment is dependent on insurance carriers, and out-of-pocket testing can cost upward of $100.
  • When visiting at-risk friends or family members, wearing a mask requires minimal effort and can safeguard your loved ones. If you have any reason to suspect you may be sick or have been exposed to the virus, taking a home COVID test before meeting affords a quick — if imperfect — screen.
  • For hospital or nursing home visits, an over-the-counter test ahead of time and masking can help protect vulnerable populations, as well as yourself.

What should you do if you are exposed or infected?

  • In case of exposure: The Centers for Disease Control and Prevention offers a practical risk calculator for determining post-exposure actions following contact with someone who has COVID-19. The first step: Put on a mask to protect others for 10 days, watch for symptoms such as fever, and test yourself on Day 6. If you’re negative, keep masking until Day 10, and then you can stop.
  • If you are infected: In the event of a positive test or development of symptoms, the CDC advises immediate isolation. Wear a high-quality mask if you must be around others. The most infectious period usually spans the first five days after testing positive.
  • When to seek emergency treatment: If you have trouble breathing, persistent pain or pressure in the chest, feel disoriented, unable to wake or stay awake, or experience a change in skin tone, call 911 or your local emergency department.
  • When to end isolation: Those who show no symptoms can end isolation after five days, the CDC says. But if you do have symptoms, you should continue to isolate until you are fever-free for 24 hours without the use of fever-reducing medication.If you had moderate (difficulty breathing) or severe (requiring hospitalization) symptoms, you should isolate through Day 10. Wear a mask until you have two sequential negative test results 48 hours apart.
  • Treatments and medications: For those experiencing mild illness, the CDC advises home recovery, with over-the-counter medications like acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) to help manage symptoms.A Food and Drug Administration-approved antiviral drug, Paxlovid, can effectively treat mild to moderate COVID-19 in individuals who are at greater risk, but treatment must be started within days of symptom onset. Preliminary research also suggests Paxlovid can reduce the risk of developing long COVID.

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What to know about the new COVID variant before you go out this weekend

[Note from BenIndy Contributor Nathalie Christian: Between the Benicia Peddler’s Fair this weekend the start of school next week, we’re entering a period of high risk for COVID exposure. Please take a moment to read about the new, highly transmissible “Eris” variant below and make choices that match not just your risk level, but the risk level of those closest to you – especially the elderly and the immunocompromised. If you’re in a high-risk group, don’t hesitate to reach out to your healthcare provider if you are experiencing symptoms. Not only is Paxlovid plentiful, it is also very effective; in its initial trial involving unvaccinated, high-risk patients, Paxlovid reduced hospitalization or death by 86 percent. Stay vigilant, stay safe.]

What to know about ‘Eris,’ the new COVID-19 subvariant sweeping the US

Lu Foster receives a COVID-19 booster shot at the Lynne and Roy M. Frank Residences in San Francisco in October 2021. The FDA approved a second bivalent booster dose for older adults and people with compromised immune systems. | Brontë Wittpenn for The Chronicle.

Today, by Caroline Kee, August 10, 2023

The EG.5 “Eris” variant is now the dominant COVID-19 strain in the U.S. Here’s what to know about transmission and symptoms.

A new COVID-19 variant called EG.5 is sweeping across the United States as cases and hospitalizations rise. The fast-spreading new COVID subvariant, also referred to as Eris, is now the dominant strain circulating in the U.S., health officials say.

As of last week, EG.5 accounted for the largest proportion of COVID-19 infections in the country compared to any other variant, according to the latest data from the U.S. Centers for Disease Control and Prevention,

Eris is also on the rise in several other countries around the globe. On Wednesday, Aug. 9, the World Health Organization decided to classify EG.5 as a “variant of interest.”

The new subvariant, which experts nicknamed “Eris” on social media, started circulating in the U.S. earlier this spring. Last month, EG.5 quickly overtook the prevailing omicron XBB subvariants, which had been driving the largest share of cases in the country.

During a two-week period ending on Aug. 5, Eris accounted for an estimated 17.3% of new confirmed COVID-19 cases in the U.S., up from 12% two weeks prior, according to the latest CDC data.

Many are wondering if the EG.5 subvariant is more transmissible or severe, and whether it’s causing different symptoms.

What is EG.5 , aka Eris?

EG.5 is a descendant of the omicron XBB sublineage of the virus (specifically, XBB.1.9.2), but it has an extra mutation in its spike protein, according to a WHO risk evaluation report.

“When we look at its sequence, EG.5 is really similar to the other XBB variants that are circulating right now, with a couple of small changes,” Dr. Andrew Pekosz, a virologist at Johns Hopkins University, tells TODAY.com.

The WHO added EG. 5 to its list of variants under monitoring on July 19, 2023, but the variant was first detected in February 2023. “Scientists have known about this variant, and it’s been present in other countries, as well,” says Pekosz.

So far, EG.5 has been reported in 51 countries and there has been a steady increase in prevalence globally — the majority of sequences are from China, followed by the U.S., South Korea, Japan and Canada, per WHO.

XBB.1.16, also called the “Arcturus” variant, remains the most prevalent strain of COVID-19 worldwide.

WHO considers the public health risk posed by EG.5 to be “low” and similar to that of XBB.1.16 and other variants of interest.

Is EG. 5 more transmissible? 

The EG.5 variant is very similar to other omicron variants, which means it’s highly transmissible, Dr. Albert Ko, an infectious disease physician and professor at Yale School of Public Health, tells TODAY.com.

However, EG.5 is likely more transmissible than other XBB variants, Dr. Sharon Nachman, chief of the division of pediatric infectious diseases at Stony Brook Children’s Hospital, tells TODAY.com.

“If it was equally transmissible, then we wouldn’t see it gaining strength number-wise compared to some of the other variants,” says Nachman, adding that EG.5 quickly pushed out other XBB variants in the U.S., which were dominant over the summer.

Why exactly EG.5 is more transmissible is not yet known, Ko says.

“Whether it’s escaping population immunity or it has some intrinsic factor that makes it better able to transmit from one person to another … it’s hard to separate,” he adds.

According to WHO, EG.5 has increased immune escape properties compared to other variants. “EG.5 may cause a rise in case incidence and become dominant in some countries or even globally,” WHO said in a report.

However, Pekosz notes that the EG.5 variant may not be the sole reason for the U.S. summer uptick. “When you have a new variants, and cases creeping up, there’s always concern about whether that variant could be driving the increase,” says Pekosz.

“Right now, it doesn’t look like that variant alone is driving the case increases (in the U.S.) … there’s still a lot of other variants co-circulating,” he adds.

According to CDC estimates, EG.5 accounted for about 17% of COVID-19 cases in the U.S. during the two-week period ending on Aug. 3. — after EG.5, the next most common variants were XBB.1.16, XBB.2.3, and XBB.1.5, which accounted for 15%, 11% and 10% of cases, respectively.

“We’re keeping an eye on (EG.5) because of the uptick in cases, but it doesn’t look like there’s anything particularly concerning about this variant,” says Pekosz.

More data is needed to understand how EG.5’s transmissibility compares to other strains. However, decreased levels of testing and genomic sequencing are making it harder to accurately track new COVID-19 cases and which variants are driving them, Pekosz notes.

“Right now, there’s an awful lot of guesswork,” he says.

Is EG.5 more severe?

The data available do not indicate that EG.5 causes a more severe infection compared to other variants, the experts note.

In its risk assessment of EG.5, WHO said, “There have been no reported changes in disease severity to date.”

Although the U.S. recently saw the first increase in COVID-19 hospitalizations of the year, there isn’t evidence that EG.5 is causing this uptick or that it’s more likely to cause hospitalizations in general, Nachman notes.

“The people that are getting hospitalized often have lots of co-morbidities, and they’re at-risk no matter what COVID strain they get,” says Nachman.

However, it’s possible that hospitalizations could increase even more because of more people getting infected with EG.5, says Ko. “There’s no clear evidence of that at this point, but we have to keep on evaluating,” Ko adds

Population immunity from vaccination and prior infection should protect people from severe illness as EG.5 continues to circulate.

What are the symptoms?

There isn’t enough clinical data about the most common symptoms of EG.5 yet, NBC News previously reported.

“There’s no change in EG.5 symptoms right now,” says Pekosz. So far, the symptoms of EG.5 look very similar to the standard omicron symptoms, says Ko. These include:

    • Cough
    • Sore throat
    • Runny nose
    • Sneezing
    • Fatigue
    • Headache
    • Muscle aches
    • Altered sense of smell

“It may progress to some more significant feelings of difficulty in breathing as the infection spreads into your lungs,” says Pekosz.

Certain groups are at higher risk of developing severe illness or complications, including people over 65 and those who are immunocompromised or have underlying medical conditions.

Can COVID-19 tests detect EG.5? 

All COVID-19 tests — including PCR tests performed by a medical provider and rapid at-home antigen tests sold over-the-counter — should be detecting EG.5, says Pekosz.

The experts emphasize the importance of getting tested as COVID-19 cases increase, and especially during the fall when viruses that cause similar symptoms (such as flu and RSV) are circulating.

“If you’re in one of the high-risk groups for getting severe COVID, you really shouldn’t hesitate to get a test,” says Pekosz, adding that early detection and treatment is key. COVID-19 antivirals such as Paxlovid are effective against EG.5 and other variants, but they work best when taken early, he adds.

Whether your insurance covers COVID-19 testing may have changed since the end of the U.S. federal public health emergency in May, TODAY.com previously reported, so check with your insurer if you have questions about testing costs.

It’s also important to check the expiration date of at-home tests. The shelf life of rapid tests ranges from four to 24 months, according to the U.S. Food and Drug Administration, but the expiration dates of some tests have been extended.

Will I need a COVID-19 booster this fall?

The experts encourage everyone to stay up to date on COVID-19 vaccines, which may include a new booster dose in the coming months. In June 2023, the FDA advised vaccine manufacturers to update their boosters to target omicron XBB.1.5, which was the dominant strain at the time.

These shots haven’t been approved yet, but the FDA could authorize Pfizer’s booster shot by the end of August, NBC News reported.

Although the new boosters will not include the EG.5 strain, they may still provide protection, the experts note. “If I vaccinate you with the vaccine that contains XBB, you will make antibodies that are specific to XBB and pretty close to EG.5,” says Nachman.

“Right now, EG.5 looks like it’s very closely matched to the vaccine that’s going to be available this fall,” says Pekosz.

However, the CDC has not yet released any firm guidance or recommendations around booster doses for the fall.

“The message is to pay attention to the COVID vaccine program that’s going to come out in the fall. … It’s a vaccine that many people (especially high-risk individuals) should consider taking,” says Pekosz.

How to protect yourself from EG.5:

In addition to staying up to date on COVID-19 vaccinations, the experts emphasize taking precautions to protect yourself and curb transmission of COVID-19, including:

    • Washing your hands with soap and water frequently
    • Staying home when sick
    • Avoiding contact with sick people
    • Improving ventilation
    • Wearing a mask in crowded, indoor spaces
    • Covering coughs and sneezes