There are few constants when it comes to Covid, but one thing has held true over the years: Cases climb in the winter.
In the weeks after the holidays, especially, more people tend to get sick, as we spend time together indoors, sharing germs and spreading infections.
“It seems the wave is coming,” said Dr. Peter Chin-Hong, an infectious disease specialist at the University of California, San Francisco.
Wastewater data from the Centers for Disease Control and Prevention currently shows high levels of the virus circulating nationwide. Deaths and hospitalizations from the virus have ticked up in recent weeks. And a new variant, XEC, now makes up nearly half of Covid cases in the country. Here’s what to know.
Covid symptoms to watch for
Covid symptoms have largely stayed the same over the last few years: cough, congestion, fever, a sore throat, nausea, vomiting, diarrhea, shortness of breath, head and body aches. People with Covid are often exhausted. Some lose their sense of taste or smell.
Covid can feel different every time you’re infected; symptoms don’t always progress in the same way. While you had a sore throat last time, you might have more gastrointestinal symptoms this time.
Complicating matters is that a slew of other illnesses are spreading rapidly in the United States right now: the flu, respiratory syncytial virus, whooping cough, walking pneumonia.
“It’s a cornucopia of a lot of different things this year,” said Dr. Marc Sala, a co-director of the Northwestern Medicine Comprehensive Covid-19 Center in Chicago.
And it can be tricky, if not impossible, to tell what virus has infected you without testing.
When — and how — to test
Lab P.C.R. tests remain the gold standard of Covid diagnostics. They’re available in doctors’ offices, hospitals, emergency rooms and urgent care centers. But at-home rapid tests are more widely accessible. There are also new ones that can detect both Covid and the flu. You can still order four free Covid tests per household from the federal government.
The Food and Drug Administration has said it expects at-home Covid tests to detect the virus at least 80 percent of the time when someone is infected.
If you wake up with Covid symptoms and have rapid tests on hand, you should take one, said Nathaniel Hafer, an associate professor of molecular medicine at the University of Massachusetts Chan Medical School.
If that test is negative, take a second test 48 hours later.
That second test is critical. Past vaccinations and infections make your body more adept at recognizing and responding to the virus. That means your immune system might trigger symptoms before enough virus has built up to turn a test positive.
“It’s always possible for weird things to happen, like many things in life,” Dr. Hafer said. But “if you’re symptomatic and take two tests and you’re negative for Covid, I think you can be pretty confident that what you have is not Covid.”
If you have been exposed to Covid but do not have symptoms, the F.D.A. recommends waiting at least five full days after that exposure before testing.
Some tests may list a past-due expiration date, but the F.D.A. extended the expiration dates for many tests, which you can check here.
If a test truly expired a few weeks ago, and it’s been sitting in a room temperature environment, like a closet, it’s most likely still OK to use, Dr. Hafer said.
But keep an eye on where you store your tests in cold weather. If a test is delivered to your doorstep and left outside in freezing temperatures, bring the test inside and let it come up to room temperature before using it, Dr. Hafer said.
How long are you contagious?
If you do test positive on a rapid test, that’s a signal that you could spread Covid to someone else. The amount of time you’re contagious varies from person to person, but you can typically expect to be contagious for at least five days. However, if you test negative a few days into a bout of the virus, you’re most likely no longer contagious.
Treatment options
People who are at high risk of severe disease from Covid — including people who are over 65 or immunocompromised — can receive treatments for Covid that are thought to be effective if they’re initiated within about a week of developing symptoms. The department of Health and Human Services has a directory of places to obtain Covid treatments near you.
Doctors typically reach for Paxlovid, an antiviral pill that can slow down the rate at which the virus replicates inside the body.
Not everyone can take Paxlovid, though; the drug can interact with some antipsychotic drugs, medications that treat irregular heart rhythms, some migraine medications and other drugs.
There are other, less commonly used options for treating Covid, including remdesivir, an antiviral given through infusions at a health care facility. Doctors may also prescribe the antiviral pill molnupiravir to some adult patients.
The F.D.A. has also authorized a drug to protect high-risk people before they get infected: a monoclonal antibody infusion called Pemgarda.
And vaccines slash the risk of becoming seriously ill, doctors stressed.
Vaccines
The F.D.A. approved updated vaccines in August. Those vaccines target variants of the virus that are very similar to XEC, the dominant variant spreading now in the United States, said Dr. Ziyad Al-Aly, the chief of research and development at the Veterans Affairs St. Louis Healthcare System.
“It’s not like a distant cousin,” he said. “It’s very, very close.”
Immunity wanes a few months after you get a shot, but you’ll still most likely have protection against severe disease if you got the latest vaccines that became available this fall. And if you have not, it isn’t too late.
“Some people clearly still die from Covid, some people still get long Covid, even if they had it before and dodged the proverbial bullet,” Dr. Al-Aly said. “It’s not inconsequential — it’s not the nothingburger that we wish it is.”
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