Doctors in the United States say that with the rise of the BA.5 subvariant, peculiar symptoms of coronavirus may be making a comeback.
Forget what you thought you knew about catching COVID-19 more than once. SARS-CoV-2, the virus that causes COVID-19, keeps evolving – and so has information about your risk of being reinfected.
"Two years ago, we thought if you had COVID once that you would never get it again," said Dr. Preeti Malani, an infectious disease physician at the University of Michigan in Ann Arbor. But especially with the variants that have become dominant in the U.S. this summer, that thinking no longer holds.
When it emerged last November, the omicron variant of SARS-CoV-2 showed an ability to reinfect people who'd had earlier versions of the virus. This summer, according to the Centers for Disease Control and Prevention, the omicron subvariants BA.4 and BA.5 are sweeping the U.S., with BA.5 accounting for the majority of COVID cases. Both appear to be even more adept than other omicron subvariants at evading the body's defenses against infection.
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Even having had an earlier version of omicron does not seem to protect against symptomatic infection from the BA.4 and BA.5 subvariants, Malani said. The subvariants also can infect vaccinated people.
"I have friends who have had COVID three times," said Malani, who has co-written an ongoing series of updates about the virus for JAMA. "One of my kids had it twice." And Malani herself recently tested positive for the first time, despite being up-to-date on her vaccinations.
The good news is that despite spreading more easily, the subvariants do not appear to cause more severe disease. And vaccination still protects against severe illness, especially hospitalizations and death.
Read the full story from American Heart Association:
More good news: A new, more traditional vaccine is available. More than one out of five Americans still have not gotten a shot.
Meanwhile, President Joe Biden tested positive for COVID-19 on Thursday and went into isolation with mild symptoms. White House officials went all-out to show that the 79-year-old U.S. leader could power through the virus and keep working because he was vaccinated and boosted.
Explainer: Biden gets COVID-19
How's Biden doing?
President Joe Biden speaks to members of the media after exiting Air Force One, Wednesday, July 20, 2022, at Andrews Air Force Base, Md.
Biden is reporting a runny nose, fatigue and an occasional dry cough, according to a memo from Dr. Kevin O’Connor, the president’s doctor. Biden felt tired Wednesday evening and didn’t sleep well, White House COVID-19 coordinator Dr. Ashish Jha said at a press briefing. Biden tweeted Thursday: “Folks, I’m doing great. Thanks for your concern.”
What kind of test did he use?
President Joe Biden walks on the South Lawn of the White House after stepping off Marine One, July 20, 2022, in Washington.
Biden is routinely screened for coronavirus. His infection was detected first with an antigen test, the same type that many Americans use at home. It was then confirmed with a PCR test, the president's doctor said. The president’s last previous test for COVID-19 was Tuesday, when he had a negative test result.
Is Biden vaccinated?
In this image provided by the White House, President Joe Biden speaks with Sen. Bob Casey, D-Pa., on the phone from the Treaty Room in the residence of the White House Thursday, July 21, 2022, in Washington.
Yes. The president is fully vaccinated and twice boosted. Biden got two doses of the Pfizer vaccine shortly before taking office, a first booster shot in September and an additional dose March 30.
Is he getting treatment?
White House Covid Response Coordinator Ashish Jha speaks about President Joe Biden's positive COVID-19 test during a briefing at the White House, Thursday, July 21, 2022, in Washington.
Biden is taking Paxlovid, which was authorized in the U.S. late last year. In older people and other high-risk patients, the drug was shown to reduce the chances of hospitalization or death from COVID-19. The pills work best if taken within five days of the start of symptoms. The president’s doctor said Biden's vaccination status and early treatment with Paxlovid should keep him out of danger. Biden has temporarily stopped taking a blood thinner and a cholesterol drug as recommended for patients on Paxlovid.
What does he do now?
The memo from the Physician to the President Dr. Kevin O'Connor to White House press secretary Karine Jean-Pierre, photographed Thursday, July 21, 2022, announcing that President Joe Biden has tested positive for COVID-19.
Biden will work in isolation for at least five days and until he tests negative, the White House said. Once he tests negative, he will return to in-person work. The White House said it will provide a daily update on the president’s status.
At age 79, Biden is in a high-risk group for severe illness. About 8 in 10 COVID-19 deaths occur in people over age 65, with risk increasing with age. Also among the most vulnerable are those with other health issues such as diabetes and heart conditions.
Did Biden get the BA.5 variant?
White House Covid Response Coordinator Ashish Jha speaks about President Joe Biden's positive COVID-19 test during a briefing at the White House, Thursday, July 21, 2022, in Washington.
It’s unclear which variant Biden has contracted, though a sample has been sent for genetic sequencing to determine that. The dominant virus variant in the U.S. is the omicron mutant BA.5, which is also prominent worldwide. The variant accounted for three-quarters of new infections reported in the U.S. last week. It’s also been gaining ground globally, making up more than half of sequenced omicron cases. Experts say BA.5 is one of the most transmissible variants yet but they haven’t seen an increase in severity compared with previous omicron variants.
Where did he catch it?
White House press secretary Karine Jean-Pierre speaks about President Joe Biden's positive COVID-19 test during a briefing at the White House, Thursday, July 21, 2022, in Washington.
That's unclear. Symptoms can start two days to two weeks after exposure to the virus. Biden has kept a busy travel schedule lately. During his recent Middle East trip, the president was seen fist-bumping, handshaking and even occasionally hugging. He returned to Washington late Saturday and kept a low profile for the next three days, leaving briefly to attend church and for a Tuesday appearance outside the White House with Ukraine's first lady. He traveled to Massachusetts on Wednesday to announce modest new steps to combat climate change.
What about Jill Biden?
First lady Jill Biden speaks about President Joe Biden testing positive for COVID-19, as she arrives to visit Schulze Academy, Thursday, July 21, 2022, in Detroit.
The first lady said Thursday that she tested negative earlier in the day. She will follow CDC guidance on masking and distancing during scheduled visits to Michigan and Georgia on Thursday, said Michael LaRosa, her spokesperson.
Things to know about coronavirus subvariant BA.5
The highly contagious COVID-19 strain spreads fast
Both federal and local health experts have raised COVID-19 alert levels as the highly contagious COVID-19 variant BA.5 causes both case counts and hospitalizations to climb.
BA.5, an omicron subvariant that is now the dominant strain in the U.S., appears to cause less severe illness than its predecessors, although some people are still at risk, including those who are immunocompromised or over the age of 65.
Here's what health experts know about the circulating strain and what people can do to protect themselves from it:
BA.5 is spreading fast
Pictured are free iHealth Covid-19 antigen rapid tests from the federal government. The subvariant of Omicron, BA.2, is now the dominant strain of Covid-19 in the United States.
BA.5 is most similar to BA.2, another omicron subvariant that picked up speed in Texas in March, although it has a few additional mutations on its spike protein, said Dr. Jeff SoRelle, an assistant professor of pathology at UT Southwestern Medical Center.
The mutations make BA.5 harder for the body's immune system to detect at first, even when someone has protection from the COVID-19 vaccine of previous infections.
Eventually, most immune systems catch on to the virus, but the mutations "give it enough of a chance to sneak past the defenses and start causing some trouble," SoRelle said.
Symptoms to look out for
Health officials warn that more people are expected to get infected with the Omicron and Delta coronavirus variants and they need to stay home and isolate themselves so they don't spread the virus to others.
A BA.5 infection seems to come with the same symptoms as the original omicron strain, including headache, a sore throat, a runny nose, fever and fatigue.
While the loss of taste and smell were tell-tale signs of COVID-19 infection with the alpha and delta variants, they're much less likely with infections from omicron and its subvariants. A May study from researchers at Virginia Commonwealth University found that chances of smell and taste loss were just 17% for omicron, compared to 50% for the alpha variant.
Most people who have healthy immune systems and are fully vaccinated won't end up with severe illness from BA.5, but an infection can still make people feel pretty lousy, said Dr. Thomas Giordano, chief of infectious diseases at Baylor College of Medicine.
"As a clinician, I would say it's less severe, but as a person, I still don't want to get it because I don't want to be knocked out for a week with a flulike illness," he said.
There's also the risk of long COVID, which can lead to sometimes debilitating symptoms like fatigue and neurological issues for months after an initial infection. It's estimated that anywhere from 10% to 30% of COVID-19 patients might experience long COVID, according to the American Medical Association.
Vaccines stil offer protection
Even though BA.5 is particularly good at evading immune responses, the COVID-19 vaccine still offers the best protection against severe illness and hospitalization, health experts say.
Kids 6 months to 4 years old can now get a child-sized dose of the COVID-19 vaccine, while anyone age 5 and older can receive a booster dose. People who are older than 50 or are older than 12 and immunocompromised can get a second booster dose at least four months after their first.
The Food and Drug Administration has asked vaccine makers Pfizer-BioNTech and Moderna to develop vaccine boosters that target BA.4 and BA.5 as well as the original COVID-19 strain, although those shots aren't expected to be ready until the fall.
CDC director Dr. Rochelle Walensky and other federal health officials have repeatedly said that people should get boosted now.
Giordano said that, while the question of whether to get boosted now or wait for the new booster cocktail is a tricky one to answer, he would still recommend getting boosted sooner rather than later.
"I would go ahead and get it and not wait until the new versions of the vaccine are released, especially if you've got anything of significance that you're planning in the next two or three months like a trip or a wedding," he said. "You don't want COVID to mess those plans up."
See for yourself how and where vaccinations are ramping up, plus how COVID-19 deaths are trending in your state and across the nation.
Note: With the decline in public testing sites and rise in unreported home tests, infection rates are widely believed to be undercounted.