COVID might not be talked about as much anymore, but it’s still around – it’s still mutating, it’s still making people sick and it’s still making an appearance just in time for the holidays. The problem, however, is that people aren’t sure how to deal with it nowadays. How long do you isolate? How do you know if you have COVID? Do you need to get another shot? Is it still serious?
“The COVID landscape is obviously different now than when the pandemic began in 2020,” says Brandon Bet, D.O., an infectious disease physician at Henry Ford Health. “Immunity from both infection and vaccines, along with new strains of COVID, have changed things significantly. However, despite these changes COVID can still cause severe infection in certain individuals and folks should remain vigilant.”
Here, Dr. Bet shares what to know about COVID during the 2024 – 2025 viral season.
Q: What is the latest strain of COVID and what are its symptoms?
A: “The current predominant variant of COVID is called XEC,” says Dr. Bet. “It’s a subvariant of Omicron and it’s predicted to be the dominant strain throughout the winter, making up about half of cases detected. So far, XEC doesn’t seem to be more serious or more transmissible than other recent strains of COVID. The symptoms that folks experience is also similar to past variants.”
The tricky thing about COVID is that symptoms widely vary. For some it’s just a cold while for others it can mimic a flu-like illness. And for others still, it can be even worse. The severity of your symptoms often depend upon age, health condition and vaccination status. According to the CDC, symptoms of COVID include:
- Fever and chills
- Cough
- Shortness of breath or difficulty breathing
- Sore throat
- Congested or runny nose
- Loss of smell or taste
- Fatigue
- Muscle or body aches
- Headache
- Nausea, vomiting or diarrhea
One study found that COVID symptoms may appear in this order: fever, cough, sore throat/muscle pain/headache, nausea/vomiting, diarrhea. “However, this doesn’t mean your symptoms will appear in this order or that you will experience all of these symptoms,” says Dr. Bet. “The only way to truly know if your symptoms are caused by COVID is by taking a test.”
Q: How serious is COVID now?
A: With vaccines and effective treatments, fewer people are hospitalized now than at the beginning of the pandemic. But as late as 2023, there have still been upticks in hospitalization and death. Those who are not vaccinated for COVID are more likely to be hospitalized and develop severe illness than those who are vaccinated for COVID.
“Anyone age 65+, along with those who have underlying health conditions such as diabetes, chronic heart, lung, liver, or kidney disease and/or are immunocompromised, are at increased risk for serious COVID infection,” says Dr. Bet. “Pregnancy is another category that’s considered to be high risk. Pregnant women are more likely to experience severe illness from COVID. Severe cases can even result in loss of the pregnancy.”
Long COVID is also still a debilitating condition, which can last anywhere from months to years after an initial COVID infection. Symptoms of long COVID include - but aren’t limited to - brain fog, loss of smell and taste, fatigue, depression, anxiety and joint or muscle pain. Those who aren’t vaccinated are more likely to experience long COVID, along with those who have had a severe COVID infection.
Q: How contagious is COVID – and how long am I contagious if I have it?
A: Recent strains of COVID continue to be similar in how contagious they are, but the time frame in which someone is most contagious has changed.
“When COVID first appeared in our country in 2020, no one had any sort of immunity,” says Dr. Bet. “This meant that any one person with COVID was able to infect a much larger number of people than they can today, especially before lockdown measures were put into place.”
People used to be considered contagious even before the onset of symptoms. Now, however, a 2023 study has shown you’re most contagious on day four after the onset of symptoms, which is also the case with other viral illnesses like the flu and RSV. That said, you are contagious with COVID for an average of eight days (although this varies based upon the severity of illness) and you should take precautions to prevent others from getting it during this time frame.
Q: How long should I isolate if I have COVID?
A: “I think this is the question that brings about a lot of confusion because recommendations have shifted over time,” says Dr. Bet. “In the early days of the pandemic, it was recommended to isolate for 10 days after having a positive COVID test. And then a few years ago, the CDC changed its recommendation: you could come out of isolation five days after receiving a positive test and wear a mask for the additional five days.”
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This change came after weighing risk-benefit factors, which included studies that showed when people were most contagious. Now, however, the CDC says if you are fever free for 24 hours and your other symptoms are improving, you can come out of isolation. This means you could have a shorter or longer isolation period depending upon how your illness progresses. It’s still recommended to take precautions even after you come out of isolation, though: wear a well-fitted mask, keep your distance from others and practice good hand hygiene.
You can also take another COVID test to see if you are still COVID positive, which is a good idea especially if you will be going to a holiday gathering – and especially if this gathering includes people who are at high-risk for severe COVID infection.
“These changing recommendations are based upon the fact that population immunity to COVID is high, along with the fact that we have effective anti-viral treatments like Paxlovid,” says Dr. Bet. More than 98% of the U.S. population now has some immunity to COVID from vaccination, prior infection or both, according to the CDC.
“Keep in mind, however, that isolation recommendations in a healthcare setting will be different than at a typical workplace, and your workplace policy may differ from others as well,” says Dr. Bet.
Q: Are COVID tests accurate? When should I test?
A: PCR tests, which are performed by healthcare providers, are still the gold standard for accuracy in diagnosing COVID. At-home rapid tests work too, but the FDA recommends following the below guidelines to increase the likelihood of an accurate result:
- If you have symptoms and receive a negative result, take another test to confirm 48 hours later.
- If you don’t have symptoms but were exposed to COVID and receive a negative result, take two more tests to confirm, 48 hours apart. To get an accurate reading, it’s best to wait five days after exposure before taking your first test.
- If you receive a positive test at any point, assume it is accurate.
“With holiday gatherings coming up, it’s a good idea to have COVID tests on hand,” says Dr. Bet. “Every household can order four free at-home tests from the government here.”
Q: Do I need to get an updated COVID vaccine?
A: The CDC recommends everyone ages 6 months and up receive an updated COVID vaccine for the 2024 – 2025 viral season. Just like the flu vaccine, the COVID vaccine is updated each year to target the most recent strains.
“Modifying the vaccine each year increases its effectiveness,” says Dr. Bet. “It’s not a ‘booster,’ it’s an updated vaccine. Getting vaccinated doesn’t guarantee you won’t get COVID, but it will help to reduce the severity of disease, should you get it.”
There are three updated COVID vaccines from Moderna, Pfizer and Novavax. The Moderna and Pfizer vaccines are FDA approved for everyone ages 12+ and are under an emergency use authorization for ages 6 months – 11 years old. The Novavax vaccine is authorized for ages 12+. The CDC recommends those ages 65+, along with those who are moderately to severely immunocompromised, receive a second dose six months after their first dose.
Q: When should I seek treatment for COVID?
A: If you are in a high-risk group for COVID, it’s best to start an anti-viral treatment called Paxlovid as soon as you start experiencing symptoms, ideally within 48 to 72 hours.
“Paxlovid comes as a pill pack, as it consists of two medications,” says Dr. Bet. “One is the truly active medicine and the other is there to increase its effectiveness. Paxlovid reduces the risk of hospitalization by more 50% and the risk of death by 75%. But it is essential to begin taking it as soon as you can - otherwise it will not be effective.”
If you’re older than 50 and/or if you have health issues and are experiencing COVID symptoms, get tested for COVID and see your doctor as soon as you can. And if you are experiencing life-threatening symptoms like difficulty breathing, call 911 or visit your nearest emergency room right away.
Reviewed by Brandon Bet, D.O., an infectious disease physician who sees patients at Henry Ford Medical Center – Springport Rd.
