We’re four years into the pandemic, and by this point, most Americans have contracted Covid at least once. But when the virus comes for us (again), it can feel just as unnerving as your first fight.
Here’s a guide to what Covid looks like now and how to deal with it.
Symptoms
The most common symptoms of Covid haven’t changed much since the start of the pandemic and remain consistent for the last dominant variant, JN.1, said Dr. Soniya Gandhi, associate chief medical officer at Cedars-Sinai Medical Center in Los Angeles. Angels. They include fatigue, sore throat, congestion, runny nose, headache, body aches and cough.
“All or any of those in isolation could still be Covid,” Dr Gandhi said.
Some people may develop conjunctivitis, also known as pink eye, or experience gastrointestinal problems such as nausea, vomiting, and diarrhea, but these symptoms are rarer. Anecdotally, experts said, one of the most noticeable symptoms at the start of the pandemic — the loss of taste and smell — also seems to be less common these days.
“The biggest change is that people have milder symptoms overall,” said Dr. Amanda Casto, an associate professor of allergy and infectious diseases at the University of Washington. This is because almost everyone has some pre-existing immunity from vaccines, a previous 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 showed that, as of mid-February, more than 21,000 people were hospitalized with Covid and there were about 10,000 Covid-related deaths in 2024.
Serious illnesses are much less common now than in the early years of the pandemic, “but we’re still seeing them,” said Dr. Stuart Ray, a professor in the division of infectious diseases at Johns Hopkins Medicine in Baltimore. People who get sick the most tend to be those with weakened immune systems and underlying conditions, such as heart disease, diabetes or lung problems. Adults over 65 are also at higher risk for serious infections.
Since mild Covid can look like a cold or the flu, it’s important to get yourself tested 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 are isolated from others.
On March 1, the CDC updated its guidelines for preventing the spread of Covid and other respiratory viruses. The agency recommended that people self-isolate until their symptoms begin to improve and they are 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, such as a mask and physical distancing, for the next five days.
Treatment
The antiviral pill Paxlovid is very effective against severe Covid, reducing the risk of death by 73% if taken within the first five days of infection, according to a preliminary study conducted by the National Institutes of Health. Experts urged people at high risk to contact their doctors to get a prescription as soon as they develop symptoms or test positive.
“If you are elderly or have co-morbidities, before you even get worse, you should already seek medical care,” said Dr. Bernard Camins, medical director of infection prevention at Mount Sinai Health System in New York. “Your healthcare provider will then evaluate you to see if you are a candidate for antivirals.”
Paxlovid is not recommended for everyone. It can interact with many medications, including common ones used to lower blood pressure or prevent blood clots, and is also not recommended for people with severe kidney disease. If you can’t get Paxlovid, the drug remdesivir could be an option, but it has to be given intravenously, so it’s less convenient and harder to get.
Paxlovid also does not appear to provide much benefit in young, healthy adults whose risk of serious infection is low, so it is not widely recommended for these groups.
For most people, the symptoms of Covid can be managed at home and treated like any other respiratory illness, with an emphasis on rest and hydration. “If you’re congested or coughing, you’re losing more fluid than usual,” Dr. Casto said. “So I would definitely recommend that people stay hydrated.”
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 medications with decongestants or cough suppressants, although experts don’t strongly recommend them because they don’t work for everyone and can make you drowsy.
When to seek medical attention
If you’re experiencing shortness of breath – meaning you can’t catch your breath or you’re taking rapid, shallow breaths – it’s important to seek medical help immediately.
“What I’m most concerned about is breathing,” Dr. Casto said. “This is the most worrying sign, because people can get worse very quickly. If you are having trouble breathing, advise going to the emergency room instead of 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 if they improve and then go away, it could be a sign that you have a secondary infection such as pneumonia, Dr. Casto said. In this case, or if you are at all concerned about your symptoms, do not hesitate to call your doctor.
