Health Conditions / Infectious Diseases / COVID-19 (Coronavirus)

When the COVID-19 pandemic was first recognized in 2020, scientists rushed to find a solution for preventing and treating the illness caused by the virus SARS-CoV-2. In part, they’ve made remarkable strides in a short amount of time: We now have strong, widely available vaccines that more than 269 million Americans have received. Yet a giant question mark looms over the future of COVID-19 treatment. Once-exciting monoclonal antibody therapies like Evusheld have been rendered largely ineffective by newer variants of the virus. Meanwhile, the antiviral medication Paxlovid, while effective, isn’t easy to access for many people.Now there’s a new injectable drug in development that’s generating some buzz: It’s called pegylated interferon lambda. Extremely scientific-sounding name aside, the clinical trial results are promising. A new study published in The New England Journal of Medicine (NEJM) in early February included 931 people who received the interferon lambda treatment; 1,018 people were given a placebo. A majority of the participants—83%, to be exact—had been vaccinated against COVID-19. During the study, 25 people in the interferon group and 57 people in the placebo group landed in the hospital with COVID-19—that’s a 51% difference in mainly vaccinated people, a group that already has some protection against the virus. The researchers concluded that the odds of visiting an emergency room or being hospitalized with COVID-19, regardless of dominant virus variants and vaccination status, were “significantly lower” in those who received the treatment compared to the placebo. “This is a very promising finding,” infectious disease expert Amesh A. Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security, who was not directly involved with the study, tells SELF. Thomas Russo, MD, a professor and the chief of infectious disease at the University at Buffalo in New York, who was not directly with the involved study, agrees. “This is really exciting,” he tells SELF. “It’s been long-awaited.”Despite the positive results, experts aren’t sold on this treatment’s potential for swift Food and Drug Administration (FDA) approval. Here’s what we know about it so far.The interferon lambda treatment is given via injection.The interferon lambda treatment has already been compared to Paxlovid—an antiviral medication that’s been authorized for use in high-risk people who have moderate to severe COVID-19—but there are some differences between the two. First, interferon lambda, which also has antiviral effects, is administered via a single injection. Those who are prescribed Paxlovid—which includes two separate, generic drugs, nirmatrelvir and ritonavir—take three pills by mouth twice daily for five days. “The shot may be off-putting for some,” Dr. Russo admits—but in comparison, a single shot is much quicker than taking 30 pills in less than a week.These two treatments work differently in the body too. Paxlovid inhibits an enzyme that SARS-CoV-2 needs in order to continue taking over cells in the body. It essentially prevents the virus from setting up shop in healthy cells, eventually squashing the infection.Here’s how interferon lambda works instead: Interferons are proteins—which can be made by the body’s white blood cells or modified in a lab—that play a key role in stimulating the immune system to fight a virus, as well as other types of illnesses like certain cancers and autoimmune diseases. (The interferon lambda treatment used in the NEJM study was provided for free by a pharmaceutical company.) Essentially, an injection of interferon lambda can help support your immune system by delivering more of these critical infection-fighting proteins, Dr. Russo explains.

Unless you are one of the lucky few who has dodged COVID completely since the start of the pandemic, you’ve probably been infected with the coronavirus, SARS-CoV-2, at least once. The heightened contagiousness of XBB.1.5—the latest omicron subvariant that’s significantly fueling new infections—has made it clear that, even if you’ve had COVID or been fully vaccinated and boosted, there’s a chance you’re going to get sick with the virus over and over again. Depending on the variant you’ve been infected with in the past, a new variant could potentially evade established antibodies, or even hit you a bit harder. On top of that, the vast majority of people are no longer practicing the precautions once widely used to blunt the spread of COVID. The result: The virus is still everywhere, so it’s important to take the possibility of reinfection seriously.However, despite living in what feels like a never-ending, unforgiving pandemic, we’re (finally) getting better at dealing with COVID. By now, you’re probably aware that getting vaccinated and boosted, taking regular at-home tests, isolating post-exposure, starting treatments like Paxlovid if you have access to them, and wearing a high-quality mask can help keep you and your community safe—but there are simple steps that shouldn’t be forgotten, and that you should take to protect your health if you get sick (whether it’s for the first time or you’re headed for round two).Here are three things you don’t want to skimp out on if you’re sick with COVID. Don’t underestimate the importance of sleep. You hear it all the time, but getting enough high-quality sleep is critical when it comes to staying healthy. Research shows that a lack of quality sleep may increase your chances of getting infected by a harmful pathogen, and it could also prolong your recovery if and when you do get sick. Shanina Knighton, PhD, RN, CIC, associate research professor at Case Western Reserve University and executive director at the Association for Professionals in Infection Control, tells SELF that sleep is one key factor in keeping your immune system in tip-top shape. Sleep helps your body produce cytokines, which are protective proteins in your body that fight infections like a cold, the flu, or COVID, including the inflammation these illnesses can trigger. When you’re sleep-deprived, your body pumps out fewer anti-inflammatory cytokines that are needed to stave off infections and help your body heal, says Dr. Knighton. Most adults need around seven to nine hours of sleep a night to optimally support their overall health, including their immune systems. Of course, when you’re sick, sometimes your symptoms—a runny nose or cough, fever, and body aches—can make it impossible to sleep well, which is why it’s so important to take sick days, if you can, when you’re not feeling so hot. If you can’t take off—which, let’s be real, is out of reach for many—try to turn in early at night or squeeze in some deep rest (even if you can’t doze off, the relaxation will be regenerative). “The only way for you to recover is to really sleep when you can,” Dr. Knighton says. Stay hydrated—seriously.Your mucus membrane—a.k.a. the mucosa, or the goo that lines all of your organs and body canals—has a very important job in keeping you healthy. It acts as a barrier against pathogens, like SARS-CoV-2, trapping them in sticky fluid and flushing them out of your body via coughs, sneezes, and postnasal drip. “You want to flush those bad things out of your body. and you can’t do that if you’re not having enough water,” says Dr. Knighton. 

Paxlovid, a treatment given to certain people who test positive for COVID-19, isn’t new: The oral antiviral was given emergency use authorization by the US Food and Drug Administration (FDA) in December 2021. Recently, though, the drug is slightly hard to come by: It’s prescribed in less than 20 to 25% of COVID-19 cases in some states, according to reporting from The New York Times. This isn’t due to Paxlovid’s efficacy: In the 15 months doctors have been prescribing the drug—which was developed to fight SARS-CoV-2, the virus that causes COVID-19—they’ve seen good results, Thomas Russo, MD, an infectious disease expert at the University of Buffalo Jacobs School of Medicine and Biomedical Sciences, tells SELF.For starters, research from the Centers for Disease Control and Prevention (CDC) has shown that taking Paxlovid to treat COVID-19 reduces the risk of hospitalization up to 51% for people 18 and up. That same CDC report also found that, among people hospitalized with COVID-19, those who take Paxlovid are less likely to die.Aside from cutting the risk of hospitalization and death—two potential consequences of COVID-19 that are often, though sometimes mistakenly, associated only with high-risk individuals—Paxlovid can benefit young, otherwise healthy people, Valida Bajrovic, MD, director of antimicrobial stewardship at Mount Sinai Morningside and Mount Sinai West in New York, tells SELF. She points to preliminary research from the US Department of Veterans Affairs (VA), which hasn’t yet been peer-reviewed, that found Paxlovid use reduces the risk of developing 10 of 12 symptoms and complications associated with long COVID—including heart disease, blood disorders, shortness of breath, and neurocognitive impairment, among others. (Reminder: Long COVID can affect anyone infected with the virus, not just high-risk individuals.)On top of this, Dr. Bajrovic says, taking Paxlovid may reduce the number of days you’re sick with COVID-19, should you get infected. “For young, otherwise healthy patients, [taking Paxlovid can mean] fewer days of fever and severe cough,” she explains.Even though the benefits of Paxlovid have been documented, some experts say that the drug still isn’t used enough. Below, experts explain why Paxlovid is underused—and what needs to be done to change that.Who can and can’t get a Paxlovid prescription right now?Right now, Paxlovid is recommended for people who are considered high-risk. Until recently, people actually needed a positive COVID test to get a Paxlovid prescription. But in February 2023, the FDA revised the emergency use authorization (EUA) for the drug, noting the “removal of requirement of SARS-CoV-2 viral testing” for Paxlovid. Though the agency didn’t clarify why they revised the EUA, this could help get Paxlovid to more people, Dr. Russo says.Though some may falsely assume “high-risk” individuals make up a small segment of the population, that’s not the case, Dr. Bajrovic says. In addition to anyone over the age of 65, pregnant people, people with high BMIs, people who haven’t been vaccinated, people with certain mental health conditions (including depression), and people with a wide range of chronic health issues—including diabetes, asthma, cancer, chronic kidney disease, chronic lung disease, and more—are at risk of developing severe disease from COVID-19—and are, thus, eligible for Paxlovid, Dr. Bajrovic says. There’s no way to tell exactly how many people this affects, but a significant percent of the American population can take Paxlovid to treat COVID-19, she adds. (The number of unvaccinated people alone is in the millions: Only 81% of people have received at least one dose, per the CDC.)

All that is to say: Many COVID symptoms can impact a person’s physical, mental, or emotional capacity to work. “If you have brain fog from long COVID, which makes it difficult for you to concentrate in a sustained fashion on anything, that could create difficulty in almost any job,” William Schaffner, MD, infectious disease specialist and professor of medicine at the Vanderbilt University School of Medicine, tells SELF. People who have symptoms that are difficult to cope with—like chronic pain or fatigue—also “face a challenge, no matter what type of job they have,” he adds.Diana Berrent Güthe, the founder of the COVID-19 education and resource center Survivor Corps, tells SELF that she’s seen this play out with plenty of the organization’s members. “One thing I can say for sure is people are having tremendous difficulty navigating the disability process,” she explains. “It’s complicated for lawyers, let alone anyone suffering from cognitive dysfunction, extreme fatigue, and tremendous pain.” (Under the American Disabilities Act, long COVID is not always considered to be a disability, and “an individualized assessment is necessary” to determine whether long COVID “substantially limits” a person’s life. Read more about that here.) Another major issue is that symptoms can come and go, which makes it hard for some people to predict when they’ll actually be feeling well enough to work. “This is a real shade of gray,” Güthe says. “They don’t know whether going to work on Tuesday may prevent them from going to work on Wednesday. People have good days and bad days, good weeks and bad weeks.”What should people with long COVID know about returning to work?“Some people are so incapacitated that there’s no question of whether or not they can return to work,” Güthe says, adding that this can certainly lead to “financial trouble” for some folks. However, she also stresses that there is hope for recovery. “I don’t want to be doom and gloom about this—most people do get better over time,” Güthe says, adding, “I’ve heard of a few very lucky people whose employers have been accommodating to the best extent possible but each person’s situation is as unique as their fingerprint.” People with long COVID have typically found that “working collaboratively with their employer to structure their return to work in a way that is manageable for them” is one of the best accommodations they can ask for, Andrew Wylam, a lawyer and the cofounder and president of Pandemic Patients, a nonprofit organization that supports people who have been impacted by COVID-19, tells SELF. “Gradual return to work is helpful, along with flexible hours and remote options,” he says. “People may want to return to work but they don’t want it to trigger their symptoms.”Wylam says that it’s crucial for people with long COVID to “maintain open, constant communication with” their employer and supervisor about their symptoms and limitations. Of course, not every employer is flexible or even willing to make accommodations for people with long COVID. If you think you qualify for disability financial assistance and you’re struggling to figure out the system, Wylam suggests consulting a lawyer, if you can. They can help you understand what reasonable work accommodations look like, navigate workers’ compensation, and identify disability discrimination. (If you need help with this financially, you can look into Wylam’s Pandemic Legal Assistance Network, a national network of attorneys who provide free legal assistance to people who have been affected by COVID-19. You can also find pro bono legal service providers in your state here.)Even though it can be tough, do your best to prioritize your well-being while navigating all of this. “If you have an empathetic and skilled primary care physician who is helping you, great,” Dr. Schaffner says. (They can help refer you to specialists in your area, depending on your symptoms.) “If not, and you’re within a stone’s throw from a major medical center, inquire if they have a long COVID clinic there so you can get on a treatment plan,” he says. And if you just don’t know where to start because you’re overwhelmed, advocacy organizations like Survivor Corps have resources that may help you find the care you need and deserve, including an interactive map that can help you track down specialized clinics in your state. For Güthe, it’s all about taking things one step at a time. “What is happening now is not necessarily going to be your future,” Güthe says. “There’s a road to recovery here.”Related:

On May 11, the public health emergency (PHE) status for the COVID-19 pandemic will expire, the White House said in a statement on January 30. The novel coronavirus, what we now know as SARS-CoV-2, was first declared a PHE by the federal government in 2020 and has been renewed every 90 days since then; it was last extended in mid-January as the XBB.1.5 variant gained traction in the US. Here’s why that’s a pretty big deal: The PHE status provides access to emergency funding to fight a crisis; allows changes to telemedicine policies; and allows the government to quickly appoint people to respond to an emergency, per the US Department of Health and Human Services (HHS).The move to end the pandemic’s PHE status comes as health authorities are making a broader switch from viewing COVID-19 as an ongoing crisis to treating it like an illness caused by a seasonal virus (even though COVID spikes have happened outside the winter months in the past). For instance, last month, an advisory committee to the US Food and Drug Administration (FDA) met to discuss whether most of the American public should receive just one COVID-19 vaccine a year, similar to the standard guidelines for the annual flu vaccine.The statement announcing the May 11 change noted that legislation backed by Republican lawmakers in the House of Representatives—which would immediately end the PHE status, as opposed to ending it in the spring—could be dangerous, saying it would have “highly significant impacts” and cause “wide-ranging chaos” on our nation’s health care systems if they were forced to immediately revert to prepandemic operations. Aside from policy concerns, some have pointed out that COVID-19 is still an “emergency,” and should be treated like one: Thousands of COVID-related deaths are reported each week. As of February 1, the weekly death count was just under 3,500 people.Unfortunately, the experts SELF spoke with say it seems like much of the public stopped seeing COVID-19 as a crisis long ago. That’s been evident in our vaccination effort: Though it’s always been free, only 15.7% of people in the US have gotten the bivalent booster so far, which was developed to target highly contagious omicron variants.All that is to say: Ending the PHE status could have a ripple effect on our communities. Below, three epidemiologists talk about the potential consequences—good and bad—of the end of the PHE status.If people don’t have access to free tests, case counts may rise.Under the PHE status, COVID tests and treatments were free, and that may change when the status expires, Matthew Fox, DSc, a professor of epidemiology at Boston University School of Public Health, tells SELF. “The impacts [of the end of PHE status] will be felt most by individuals who won’t be able to get free access to testing,” he says.This may eventually cause more illness, Jennifer Lighter, MD, a pediatric infectious disease physician and hospital epidemiologist at NYU Langone, tells SELF. “It will have an effect on case counts because people will get tested less if it’s not free,” she explains. And when people can’t get tested as frequently, they may be more likely to return to work, school, or other public places (like movie theaters and shopping malls) without confirming whether the tickle in their throat is a sign of COVID-19. 

Dr. Van Groningen says that you can also alternate taking acetaminophen and ibuprofen to get better, round-the-clock control of a fever or pain that isn’t responding to one alone. “I will often recommend that my patients stagger them roughly four hours apart.” If you don’t want to juggle an alternating schedule, you can also buy tablets that combine the two.Any time you’re taking over-the-counter medications, make sure you’re following the dosage instructions on the package and keeping track of everything you take and what time you take it. Using a notes app on your phone, the Apple Health app, or a handwritten note can help you stay on top of this. Of course, while options like these can help you manage symptoms long enough to get through a shift, they’re only one piece of the puzzle. Get as much rest as possible.Dr. Van Groningen says that if there are ways to make your work day a bit lighter, now is the time to take those steps. If you normally go above and beyond, do what you can to stay below and near in an effort to give your body as much downtime as possible to recover. If you can, take extra breaks, trade shifts to accommodate more rest, and ask coworkers or a supportive manager to help with more taxing tasks.When your shift ends, do your best to make it an extra early night. Not getting enough sleep has been shown to increase your risk of acquiring a respiratory infection, and sleep is when your body performs necessary tune-ups to all your systems, including your immune system. “The consensus of experts is that too little sleep can prolong your illness,” says Dr. Varma. Feeling under the weather can sometimes make it harder to sleep, but you can try doing relaxing things before bed (like a quick meditation or putting your phone away earlier than usual).Drink plenty of fluids (soup counts!).As SELF has previously reported, it’s important to stay on top of your fluid intake when you’re ill. Sick people lose fluids more easily through excess sweating, vomiting, and diarrhea. Couple any of those symptoms with a job where you sweat due to physical labor, or a work setting where you can’t have food or drinks outside of designated times, and you could find yourself getting dehydrated. If your job offers little opportunity for repeatedly refilling a water bottle or taking hydration breaks, Dr. Van Groningen recommends drinking electrolyte-rich Pedialyte versus water alone. She also swears by an old standard: “Chicken noodle soup is the perfect blend of fluid and sodium, as well as protein and carbohydrates.” In the immortal words of Ina Garten, store-bought soup is fine—and there are lots of break-room-friendly microwavable options that’ll make it even easier to consume.If you’re having symptoms that make it hard to eat or keep food down, Dr. Varma says Gatorade, in addition to Pedialyte, can also be a good source of both sugar- and electrolyte-aided hydration. If it’s been 24 hours and you still can’t keep food or drink down, or you’re experiencing continual vomiting and diarrhea, he advises getting to a doctor to make sure you’re not dangerously dehydrated or sick with something that will need further treatment to improve.  Do your best to minimize the chances of getting others sick.Dr. Van Groningen, Dr. Blackstock, and Dr. Varma all agree that the precautions we all became familiar with early in the COVID-19 pandemic are good ways to prevent the spread of infectious illnesses in general. These include wearing a well-fitting, high-quality mask like a KN95 or N95; staying up-to-date on your recommended vaccinations; frequent and thorough hand washing; social distancing; and good ventilation.

Getting one annual shot could potentially be more palatable to pandemic-weary people, Dr. Russo says. The vaccine rollout has been “haphazard,” he explains, and the public has often been unclear about which COVID vaccines they should get and when.The thinking goes that, with a simple annual vaccine schedule, people will better understand how to protect themselves—and actually get the shots they need. “‘When do I get my next booster?’ is a very, very common question,” Dr. Schaffner says. This proposed shift will hopefully “relieve the vaccine fatigue that’s out there.”However, certain folks may still need extra protection each year. The FDA’s document suggested that older and immunocompromised people—two groups who face a higher risk of severe disease from COVID—as well as “the very young,” who may not have had previous exposure to the virus, may need two shots a year, but it’s unclear what this schedule would look like. During Thursday’s meeting, some committee members expressed hesitation in scaling back. “We need broader protection,” Pamela McInnes, DDS, the former deputy director of the National Center for Advancing Translational Sciences at the National Institutes of Health, said during the discussion, per NBC. “We don’t want to be chasing the virus.” Dr. Russo says that giving most people one annual shot could, in fact, be risky at this stage in the pandemic. “Immunity—whether from prior infection or vaccination—wanes over four to six months,” he says. “You gain extra protection by boosting in that time frame.” While respiratory viruses generally circulate more during the fall and winter months, COVID-19 cases can rise during warmer months, though the spikes are usually less severe. (For example, cases significantly increased during the summer of 2021, when the delta variant first hit.) If and when COVID becomes a seasonal illness, the likelihood of dealing with a wave of infections during spring and summer will likely be less of a concern, Dr. Russo explains. That said, the possibility of contracting COVID at any time still lingers, and we now know that long COVID, which can spur potentially debilitating symptoms, can affect anyone who is infected—even those who initially had a “mild” illness.Will the COVID vaccine formula change as new variants emerge?The committee members also recommended that the bivalent vaccines be updated this year ahead of the start of the 2023–2024 cold and flu season, so the formula provides the best protection possible as the virus mutates, per NPR. They suggested the FDA meet in May or June of this year to discuss the proposed updates, which would allow for new shots to be available in the fall.The process of tweaking the bivalent vaccines each year may eventually look similar to the routine we have in place for the flu vaccine, Dr. Schaffner says: “[Global health authorities] update the influenza vaccine twice a year in an organized fashion, [once for] the northern hemisphere and once for the southern.” That’s not currently the case for the COVID vaccines, which “are different and varied” from country to country, Dr. Schaffner says.

Since late November, a new subvariant of omicron called XBB.1.5 has been steadily gaining traction in the US. During Thanksgiving week, it made up just 1% of COVID-19 cases in the country, according to data from the Centers for Disease Control and Prevention (CDC). But XBB.1.5 picked up speed over the holidays, and it now makes up more than 40% of all cases nationally.Importantly, the total number of COVID-19 cases (caused by all variants of the virus) in the US is rising: At the end of November there were 309,367 reported weekly cases, per the CDC, and as of January 11 that number had grown to nearly 415,000 weekly cases. Deaths have also jumped during that same time period—from a reported 1,769 a week to 3,907—as have hospitalizations. As far as winter spikes go, this one seems to be less intense compared to the last two years: Weekly COVID-19 cases topped 1,600,000 during the first week of January 2021 and hit an all-time high last January, skyrocketing to more than 5,600,000 weekly cases as omicron took hold.If rising case numbers and the emergence of a new variant make you nervous, you’re definitely not alone, but it’s helpful to be informed about XBB.1.5 so you can continue to protect yourself and others. Below, infectious disease experts explain everything we know about the XBB.1.5 variant right now, including the potential symptoms it causes and how our current vaccines may respond to it.Is XBB.1.5 the most contagious variant yet?Experts say it’s hard to pinpoint just how contagious a specific variant is, especially now that many Americans have ditched masks and social distancing guidelines. “Our behavior right now is such that few people are taking any sorts of precautions,” Thomas Russo, MD, an infectious disease expert at the University of Buffalo Jacobs School of Medicine and Biomedical Sciences, tells SELF. Even so, Dr. Russo says, “XBB.1.5 is extraordinarily infectious.”The speed with which XBB.1.5 has taken off in the US has experts’ attention. Andrea Garcia, JD, MPH, the vice president of Science, Medicine, and Public Health at the American Medical Association (AMA), recently said in an update from the organization that the variant jumped from 1% of US COVID-19 cases to nearly a third “pretty quickly.” Though research on the variant is in early stages, the medical community does have some theories as to why it’s spreading so rapidly. “Scientists are reporting that it appears to bind more tightly to cells in the human body than the predecessors,” Garcia said in the update. “It also seems to be more resistant than earlier variants to immune system antibodies.”What potential symptoms does XBB.1.5 cause, and is it more likely to lead to bad outcomes?As of right now, no new COVID-19 symptoms have been associated with XBB.1.5, Bernard Camins, MD, an infectious disease doctor at Mount Sinai in New York, tells SELF. XBB.1.5 symptoms have, so far, appeared similar to those caused by earlier omicron variants, Garcia said in the AMA update. “Those can range from cold symptoms to shortness of breath and low oxygen levels that require emergency medical attention,” she stated.

You’ve probably noticed that face masks aren’t super popular right now. I’ve seen very few people wearing them in grocery stores and shops, on public transportation, and even in some doctors’ offices—which are the only places I’ve seen masks mandated in months.There are a number of reasons why masks have seemingly disappeared from public life. Chief among them: The Centers for Disease Control and Prevention (CDC) isn’t issuing an indoor mask mandate, and most local governments and private businesses in the US have also made masks optional.On top of that, pandemic fatigue has done a number on most of us—after all, it’s been about three whole years since COVID-19 emerged. We’re all desperate to return to “normal,” including not having to wear masks—but, unfortunately, we’re not there yet. This is true despite the fact that the majority of Americans are behaving as if the threat of COVID has simply vanished. But wearing a mask is still imperative—and this is especially crucial because of the current winter surge of non-COVID viruses. Below, infectious disease experts explain why it’s as important as ever to keep an N95 or KN95 handy this winter.Yes, you should still wear a mask in spaces that don’t require them.This year, the CDC has scaled back its masking guidelines time and time again. In February, the agency released updated guidance that stated children didn’t need to wear masks in schools; in April, the TSA’s mask mandate on planes expired (per the CDC’s recommendation); and just three months ago, the CDC eased masking guidelines for workers in health care settings—just before the start of cold and flu season.Despite the conclusions one might draw from these announcements, COVID cases haven’t disappeared, and they still need to be taken seriously, Eleanor Murray, ScD, an epidemiology professor at Boston University School of Public Health, tells SELF. “That has been a huge issue—that we see a lot of talk about this as if COVID is over—but we have had a lot of times this year when we had more cases than at some of the points in the first couple of years [of the pandemic],” Dr. Murray says. Though many people may associate 2020 with the worst of the COVID-19 pandemic, cases reached their highest peak in the US earlier this year, per CDC data. In January, right after the 2021 holiday season ended, the country hit nearly 5,630,000 weekly cases, which was right around the time the omicron variant started to dominate. Cases have leveled out since that particular surge, but that doesn’t mean we are in the clear. In fact, current case counts are still on par with 2020’s numbers—and if past Januarys are a predictor, we’re unfortunately probably going to see another rise in cases here in the next few weeks, Dr. Murray says. “Thanksgiving led to transmission, and it’s reasonable to believe Christmas will lead to transmission,” she explains. Weekly cases in the US have risen by roughly 150,000 since Thanksgiving week—and those aren’t the only stats that will change after the holidays. “Since transmission went up, deaths will go up,” Dr. Murray explains. “We don’t know 100% how much, but deaths are going to go up.”Masks are recommended for many, many people right now.It’s well-established that people with certain underlying conditions—including diabetes, heart disease, and asthma—are more likely to get very sick from a COVID-19 infection. On top of that, anyone over 65 is high-risk (more than 81% of COVID deaths occur in this age group), as are people who take certain medications that weaken their immune systems. Lastly, people who don’t have access to health care may be more likely to get very sick from COVID-19, or to die from it, per the CDC. 

Think back to the last time you had the flu, or just generally felt really unwell. You probably remember hunkering down in bed for a few days while you fought off a fever. But do you remember the symptoms that appeared right before you got blatantly sick? If you’re like me, perhaps you shrugged off those early flu symptoms as sleepiness or a tickle in your throat caused by the dry winter air. They’re easy to ignore but important to pay attention to. Why? Sometimes, before it’s obvious that you’re sick with the flu (or some other illness), you can be pretty contagious, Daniel Pastula, MD, MHS, a professor of infectious diseases, epidemiology, and neurology at the University of Colorado Anschutz Medical Campus, tells SELF. Those early warning signs are your body telling you it’s time to rest up so your immune system can work more efficiently. If you pick up on those clues quickly enough, you could potentially start treatment sooner and recover faster.It can take up to four days for flu symptoms to fully appear after the virus takes root in your respiratory tract, according to the Centers for Disease Control and Prevention (CDC). In the first few days after you’re exposed to influenza, the virus makes copies of itself in your body and begins to spread, primarily latching onto cells in your nose, throat, and lungs. This is when the first signs of infection tend to manifest. They can look and feel slightly different from person to person, Dr. Pastula says, but research suggests these early symptoms generally include:Feeling a little off, run down, sluggish, or achyAn uncomfortable, almost scratchy feeling in the throat when swallowingFeeling more sneezy than usualRunny nose or post-nasal drip (before the full-fledged congestion strikes)At this stage, the immune system is starting to respond to the viral replication by releasing a ton of chemicals to ramp up its defenses—and that can cause people to feel icky, Dr. Pastula says. From an evolutionary standpoint, your body does this to force you to rest, so it can spend less energy on, say, exercise classes and more effort on fending off the virus. A day or so later, and depending on how severe your infection becomes, classic flu symptoms may strike: a fever, persistent chills, a painfully sore throat, and/or a deep-in-the-lungs cough. Even if you don’t get a fever, that doesn’t necessarily mean you don’t have the flu. “You might just have a mild case,” Dr. Pastula says. The timing and intensity of your symptoms depend on the strain and amount of virus you’ve been exposed to, Dr. Pastula says. Your overall health, genetics, and age can also play a role in how sick you end up getting.