Exploring COVID-19: Facts, Symptoms, Testing, Treatment and Prevention
- Victoria Wermers, RN,MSN,FNP, PMHNP
- Sep 16, 2024
- 25 min read
Updated: Sep 7
COVID-19 History-Strains-Symptoms-Testing-Treatment-Prevention-Long COVID
Covid Numbers today
It's still out there and increasing...Again. Routine reporting of COVID cases has gone from mandatory to virtually nonexistent, and people usually do not report home testing, so the true incidence of COVID in 2025 is difficult to determine. However, the National Wastewater Surveillance Program has continued to test community sewage levels to track and pinpoint the spread of COVID-19 throughout the country. Knowing this has allowed for at least some accuracy of the numbers to give us an early warning of whether COVID numbers are rising in different areas. Since the current administration has made changes within the CDC, their site is not currently predictable and questionably reliable, with "delays" in reporting.
AND SO IT BEGINS - ORIGINS AND QUESTIONS OF COVID-19
SARS-CoV-2 is an abbreviation for severe acute respiratory distress syndrome coronavirus 2. The following is a discussion about COVID-19 and its many unknowns.
Origins—The origin of COVID-19 is a mystery (when, where, and how COVID really began). Interestingly, I speak to patients who think they may have had COVID symptoms before the first positive US case was diagnosed in Washington State on that ill-fated day of January 20, 2020. My patients likely had some other virus, but who knows? Exploring COVID-19: Facts, Symptoms, Testing, Treatment and Prevention delves into the many aspects of COVID-19.
There are unknowns about the changes in the virus ("different day, different variant"). COVID-19 frequently evolves with different variants, and we sometimes chase them, creating new vaccines to match. "Does the last vaccine cover the newer variant"? Specifics in COVID-19 are elusive. The flu, on the other hand, is usually a lot more predictable.
COVID-19 symptoms are unpredictable. Everyone seems to have different symptoms; some have symptoms for a few days, some for many days. And then there is "long COVID," which can last for weeks, months, and sometimes years. Does anyone agree on the specific symptoms of long COVID-19? Not really because there are so many potential symptoms. And sometimes, only one or two people catch it in a family, and others in the same household do not get sick at all! One person may have a positive test, and one might have a negative test.
There are different opinions on the testing. Often, patients are unsure if the tests work, if their tests are still good even though they have an expiration date that has come to pass; the best way to test, and when to test after the onset of symptoms.
No one seems to know the true numbers of cases: The true incidence - the number of hospitalizations and deaths - was they due to COVID-19, a comorbid condition like preexisting heart problems, or both?
And...what works for treatment?
Then, some people do not believe any of it at all. "It's all hooey," they say.
And now, it seems people are just in denial that it was there, is there, and will be there in the future. For sure, EVERYONE's lives have been disrupted, and there is a lot of resentment towards this virus because it virtually changed everyone's lives.
I, myself, have been patiently waiting for this to go away...but it never goes away. It is here to stay, disguised as one variant or another. Luckily, not as severe as it was initially.
In early 2020, the ugly face of COVID-19 appeared, making many people sick and killing about three million people around the world ( 1 ). The news media didn't make it any better: I remember seeing photographs of caskets lining the streets of New York City. It got to the point that I was meeting patients with very sad stories - a radiologist at a research hospital who described x-rays of many young people's COVID-19 lungs - they called their findings "ground glass opacities". Many of my patients told me stories about friends or relatives who had passed away from COVID-19. It was a horrific time to be working in healthcare. And, no matter how careful I was with wearing a mask and using air purifiers and disinfectants, I still lived in fear for my health. I was working as an NP with risk factors - some mild obesity, older age, some high blood pressure, and a history of breast cancer with chemo a couple of years before. I look back, and if I did not die from COVID, it would be from Lysol poisoning (where are those disinfectant residual symptom studies anyway?).
Did it originate in a Wuhan, China lab? Was it a conspiracy? Different theories about the origin of COVID-19 appear from time to time. This may sound ignorant, but as far as I am concerned, I do not know, and I do not really care where it came from. What I do know is that it came like a dark shroud, infecting so many people and making them sick. A nightmare for the populace - it changed our lives. It made ME sad, fearful, and angry. As for nurses and other healthcare providers who spent their hearts and lives trying to help patients, if you came out a stronger hero, that's great, but if you left the field of medicine, I don't blame you there either. If you want to know more about the origin of this virus, check back in ten or twenty years when we can see the forest through the trees.
Variants
Since 2020, COVID-19 has evolved. Luckily, the variants and symptoms for most people have evolved into less severe ones than those in the beginning. We also have several antiviral treatments that help make this illness less aggressive and fatal, especially for those at risk of severe disease. This does not mean that you should take it lightly. You may tolerate the symptoms just fine, but if you pass it on to your 80-year-old grandparent or parent, they may not be quite as lucky.
Exploring COVID-19: Facts, Symptoms, Testing, Treatment and Prevention
SYMPTOMS: THE NATURE OF COVID-19
Typical for COVID-19 - you never know. Symptoms seem less predictable than flu. Overall, they are less severe for most people than the original COVID symptoms were. Symptoms can include:
Fever or chills (not always there)
Sore throat
Congestion/runny nose
Cough/shortness of breath, wheezing, or difficulty breathing (one of the most concerning symptoms).
Fatigue.
Muscle or body aches.
Headache.
Nausea/vomiting/diarrhea (less common)
Loss of taste or smell (less common than it was)
Pink eye
Rash
Sometimes, swollen lymph nodes (mostly in the neck - tonsillar and post-cervical)
RISK FACTORS FOR COVID
Age factors and underlying medical conditions may make it harder to fight off COVID-19:
Older age (when you hit 60, your immune system starts to decline, and you cannot fight off infection as well as you could when younger). The most significant risk is over 80 years, but in terms of age, anyone with the following can be at risk:
High blood pressure—An NIH study demonstrated that "hypertension is associated with a 2.5-fold increased risk of both severity and mortality in COVID-19 patients" (3). COVID-19 and hypertension over-activate the immune response, producing excessive cytokine production, making COVID-19 inflammation worse.
Cardiovascular disease, like congestive heart failure (CHF), cardiomyopathy, coronary artery disease, and congenital heart disease (heart defects when born) - this virus can damage the heart further.
Lung problems - like COPD, moderate to severe asthma, lung cancer, cystic fibrosis, pulmonary
Diabetes
History of stroke or dementia
Obesity - increased weight increases inflammation and decreases immunity.
Blood disorders - for example, sickle cell and thalassemia
Immune disorders - especially cancer treatment, organ transplant, HIV/AIDS
Medications that weaken the immune system - For example, long-term or high-dose prednisone,
Chronic liver and kidney disease lowers your immune system.
Mental health conditions - schizophrenia, depression
People with Down syndrome tend to get more severe respiratory infections.
Smokers and vapers (4)
"Brain fog"
IF YOU HAVE ANY OF THESE RISK FACTORS, YOU SHOULD CONSIDER GETTING A COVID-19 VACCINE. If you are unsure whether or not to get a COVID vaccine, speak to a healthcare provider.
Length of COVID symptoms - Typically, COVID lasts 2-14 days (longer if "long COVID").
COVID PREVENTION
Recently, the Journal of the American Medical Association of Medicine (JAMA) cited trials with over-the-counter azelastine nasal spray, stating that it may help prevent COVID-19 (and some rhinoviruses) if used preventively. It may be worth a try, along with avoidance of sick people, plenty of rest, hydration, proper nutrition and multivitamins or zinc.
COVID Vaccines - Like the flu shot, the COVID-19 vaccine tries to target the most common current and anticipated COVID variant, as determined by researchers. The current vaccines (2024-25) reportedly work to prevent the current variations of COVID-19. Newly developed vaccines are changed as variants change and "outsmart" the vaccines. A new 2024-2025 vaccine that targets the more recent variants came out last fall (2024). Available boosters today are produced by Moderna, Pfizer, and Novavax (which works differently from the others and requires two vaccines). Johnson and Johnson also had a newer vaccine on the market, but the FDA did not renew the emergency use authorization of the latter because of its relative lack of efficacy and potential side effects.
How much does a COVID-19 vaccine cost? The COVID-19 vaccination is the most effective way to avoid hospitalization and death from COVID-19. Since the government no longer routinely provides free COVID vaccinations or tests for everyone under the Public Health Emergency for COVID-19 (ended in May 2023), you may end up paying for it
You may not be able to get it.
Because of recent changes at Health and Human Services and ACIP, there is current confusion and indecision about coverage of the COVID-19 vaccine, It is difficult to figure out who is or will be covered by insurance for the vaccine and who will be eligible for the vaccine. These are the current guidelines but will be subject to change on September 18, 2025:
Adults aged 65 and older: Strongly recommended to receive an additional dose of the updated COVID-19 vaccine.
Individuals aged ≥6 months with moderate or severe immunocompromise: Also recommended to receive an additional dose.
General population aged ≥6 months: Eligible for vaccination, but priority is given to those at higher risk.Some people are even required to get prescriptions from healthcare providers. A lot of pharmacy sites have misleading information about coverage because they don't know whats going on either.
If you cash pay, they typically cost around $80-$105. If you use a discount card like GoodRX, depending on where you get it.
How can you get a "free" COVID-19 vaccine?
Most private health insurance plans, Medicare and Medicare Part B and Medicare Advantage plans will cover them if you are over 65. If you have any questions, call your insurance company to check (also check where you have to go to have it covered).
According to a pharmacist I recently spoke to, there is a coupon online that requires some paperwork but can help you get it for free. If your insurance does not cover it, check with your local pharmacist. County Public Health Departments may provide free vaccines; give them a call.
COVID TESTING
Who, When and How Should a Person Get Tested for COVID-19?
It has become more difficult to get free COVID-19 tests. While there is still a stockpile of test kits, as of March 9, 2025, the government no longer sends them out free to people upon request. Additionally, the link to find low-cost and free testing locations is not presently working. The page currently returns the following message:
Your connection is not private...You cannot visit testinglocator.cdc.gov
right now because the website uses HSTS. Network errors and attacks
are usually temporary, so this page will probably work later.
or
"The site cannot be reached"
Hopefully, this link will be fixed soon. In the meantime, if you do not have insurance and cannot afford to buy a self-test over the counter, call around to local health departments, pharmacies, and community centers to check for free testing.
What are the symptoms of the current common COVID variants?
While similar to the symptoms of the original COVID-19 strains (above), more recent Omicron symptoms tend to be milder in most (but not all) cases.
When should I do a home COVID-19 test?
The viral load of the current COVID-19 variant typically peaks four days after symptoms start, making this the best time to conduct ahome test. However, days 1-3 may occasionally test positive. Unfortunately, while waiting four days may produce a more accurate result, delaying the test for that long can also place others around you at risk. If you choose to wait to test, particularly if you are around an at-risk/potentially immunocompromised person, wear a mask, practice good hygiene, and maintain your distance. You should do that when you are sick anyway.
There are other tests (rapid tests done in clinics and pharmacies, and PCR tests from labs), but they also take two to five days to yield a positive result. The send-out lab tests are the gold standard, but results usually take 1-3 days to come back from the lab..
Testing with no symptoms but because you were exposed or testing for the sake of others - Wait five days after exposure, get a PCR test (3-5 days if you have developed symptoms).
If my first home test is negative, when should I retest to be sure? 48 hours
If I test positive, when should I test again? Generally, retesting is a waste of time because some people who have recovered from COVID-19 can still test positive for up to 90 days (5). Sometimes, an employer may request a retest. In this case, you may need to retest anyway, but you may need to have a conversation.
What is the best, most sensitive COVID-19 test to get?
RT-PCR tests for the virus itself are typically sent to a lab. Detect genetic material (RNA) from the virus itself. Most sensitive (specificity nearly 98%) - used to test people early after symptoms begin.
Rapid PCR - These are quick tests done in clinics and some pharmacies (specificity approximately 85%) (6). They are used to test people early on (3-4 days) after the onset of symptoms. Usually, you need to go online and make appointments for these, and pharmacies are often "drive-by" testing -done from your car. They tend to be much less expensive than those done at clinics.
COVID Home Tests—Home tests - or antigen tests (most) - are unsuitable for asymptomatic individuals because they do not work well. They work by detecting proteins ON the virus, not the virus itself. Again, test after four days of symptoms for the most accuracy. Studies regarding the efficacy of specific home tests vary. According to the CDC and IDSA, the sensitivity (ability to detect a positive test) is 84-88%, depending on who performs the test (patient vs clinician, respectively).
The Cost of home tests vs rapid COVID (PCR): If you buy these tests at a standard pharmacy, like Walgreens, CVS, or Walmart, the price can be anywhere from $11 to $ 25 for two home tests.
Are the home tests still good after the expiration date? Yes, you heard right. If you have expired tests at home, check the extended expiration date table, as many expiration dates have been extended. Is your home test still good? Check expiration date extensions here.
What should you do if I have a positive test?
If you are an at-risk patient and want to get treatment, keep your positive test result or a photo of it. You can do a less expensive telehealth visit - the healthcare provider may ask to see your result or documentation of your result. If you are very ill (especially with lung problems), you should see a healthcare provider in person to evaluate your symptoms.
In the meantime:
STAY AWAY FROM OTHER PEOPLE - in other words, isolate - this is especially important if you are around at-risk people (see above) - like older people, they can get VERY sick and sometimes die.
Wear a suitable mask (N95) if you happen to be around others.
If you are "high risk," you can take antiviral medications: Paxlovid, molnupirivir, and others (see below).
Other approaches? Consider zinc, Pepcid, and elderberry (see options below)
Wash hands often
How long am I contagious? Currently, COVID-19 is considered infectious for 5-7 days (up to 10 days for severe COVID-19). The viral shedding begins to decline on day five after symptoms start. If most of your respiratory symptoms and fever are gone, you can come out of isolation, but consider wearing a mask for several more days.
When can I go back to work? The rule of thumb is that you can return to work 5-7 days after initially getting sick. It would be best to return when you are sure most of your respiratory symptoms have subsided, and you no longer have a fever. If your boss tells you to get another test to be sure you are negative, you might mention to that person that a COVID test can remain positive FOR UP TO 90 DAYS.
TREATMENT AND SUPPORT OF COVID-19 SYMPTOMS
If you test positive for COVID-19 and are VERY ill, you should consult with a healthcare provider - especially if you have risk factors (above). However, if you are under 60 and have a good immune system, you can usually treat the symptoms with conventional over-the-counter medications and weather through COVID successfully.
Many Upper Respiratory Viruses Have The Same Over-the-Counter Approaches
Multi-symptom over-the-counter medicines for the flu
Whether you try Tamiflu or one of the other options, you will still, initially, need to treat your symptoms to make the flu bearable. While using a multi-symptom medication may be easiest, it is not always the wisest: You usually don't need all the components of these, and it can be counterproductive. Often, the smartest thing to do is to treat each symptom as it comes. The Case Against Multi-symptom Medications:
1. Risk of "overdose"- Many people take cold and flu medications AND, at the same time, acetaminophen (common: Tylenol) or ibuprofen (Common: Motrin, Advil) on the side. They do not realize that the multi-symptom medication almost always contains one of these as well, and they end up taking far more than the recommended or safe dose. While not typically fatal, this can be harmful to your kidneys (ibuprofen) or liver (acetaminophen). If you take a multi-symptom cold and flu medicine, READ YOUR LABELS before taking anything else! Be sure you are not duplicating medications.
2. Side effects of some medications - There are some ingredients in multi-symptom over-the-counter medications you may not need. They can be counterproductive or cause side effects. For example, if you have a runny nose, the cold and flu medicine may help dry it up and make it more tolerable. But, that cold and flu medicine can also make your mucus more dry, and thicker and if you are "lucky" enough, you might even end up with a sinus infection!
3. Symptoms change - Flu symptoms change over time. What may start as a dry, hacky cough and runny nose can become a productive cough, thicker sinus drainage, and ear pain. The medicine you treat with for symptoms in the beginning of your illness may not be what you need later because your symptoms change.
If you take a multi-symptom over-the-counter medicine, match it with your symptoms. I'd recommend Nyquil at bedtime (this is not an advertisement: It is one of the only multi-symptom medications I recommend because so many patients say it helps them sleep through their symptoms. Nighttime cold and flu products usually contain dextromethorphan (cough medicine), acetaminophen (fever and pain reducer), an antihistamine (to help with congestion and runny nose), and sometimes alcohol. Because of the drying agents in this medicine, it is imperative that you stay well hydrated otherwise your mucus can get very dried up and tends to fester.
During the day, you can also take a multi-symptom daytime medication, like Dayquil, to match your symptoms. These contain similar medications to night-time preparations but are non-drowsy (decongestants instead of antihistamines).
If you decide to treat your symptoms individually
In general, use as directed over-the-counter
Acetaminophen (common: Tylenol) or ibuprofen (common: Motrin, Advil, Naproxen) for a fever and body aches
A decongestant to stop a drippy nose during the day
An antihistamine for the runny nose at night
A cough suppressant like plain dextromethorphan (common: Delsym, Robitussin)
and - as directed - but again, stay well hydrated. Use guaifenesin (Mucinex)as directed over the counter if your mucus gets too thick (will almost always be like this in the morning). Note: links in blue (above) will provide further information about treating these symptoms.
According to the Mayo Clinic, people also NEED to get enough sleep to optimize recovery.
Hydration is also essential.
NATURAL/HERBAL SUPPORT FOR COVID-19
Unfortunately, few clinical trials have been done on herbal medicines and COVID-19. Because of this, never assume that the herbs and supplements will treat COVID-19. This is unfortunate because so many herbs have potential antiviral properties.
There is a presumption that herbs and herbal combinations may have kept COVID-19 cases at a minimum in Africa when there were not enough COVID-19 vaccines.
Some possible support herbs are listed as follows:
-Neem
-Star Anise (caution advised because some varieties may have a degree of toxicity)
-Monolauren (a component of virgin coconut oil)
-Guava
-Papaya
PRESCRIPTIVE TREATMENT OF COVID-19
There are several medications that you can get from a healthcare provider if you test positive for COVID-19.
Paxlovid (nirmatrelvir and ritonavir together) - FDA approved. It is considered the most effective medication against COVID-19 if you take it within the first five days. The side effect most complained about is a nasty taste in the mouth. The tricky thing about this drug is that it has a lot of potential drug interactions, including common cholesterol drugs—a no-go for people with liver and chronic kidney problems. Paxlovid may help prevent hospitalization, death, and long COVID.
Paxlovid is no longer well-covered for marginally-covered individuals, for those on Medicare, Medicaid, or the uninsured. A person with COVID, seeking to avoid long-COVID and for those at risk for COVID complications, this medication can be obtained at a much lower cost at To enroll Pfizer's USG PAP, call 1-877-219-7225 or visit the PAXCESS Patient Portal.
Lagevrio (molnupirivir) is not FDA-approved because its efficacy is not as high as that of Paxlovid, but I have seen very good results in patients on this medication. There are no known drug interactions. It is not for people under 18 and must be taken within five days of symptom onset. Lagevrio may help prevent hospitalization, death, and long COVID.
Veklury (IV Remdesivir)-FDA approved for certain people - Used within seven days of the onset of symptoms. It is usually given in a hospital setting.
-Chloroquine and its derivative, hydroxychloroquine: - These treat malaria (a parasite), rheumatoid arthritis (an autoimmune disease), and lupus (an autoimmune disease). COVID is a virus. Chloroquine may have antiviral effects. There are numerous studies for and against this medicine as a treatment for COVID-19. According to 14 studies that were reviewed by Cochrane Reviews (considered the gold standard of reviews), this medicine does not prevent COVID-19 or deaths. I have had two patients in my clinic who were on these medications (one was on a course for COVID-19, and one was on it regularly for rheumatoid arthritis). Both were quite ill with COVID symptoms. It would NOT be my choice for someone with COVID.
Ivermectin is another antiparasitic drug. This is not FDA-approved, and most reputable agencies recommend against using this drug for COVID-19 in humans (ask AI).
The FDA has approved both baricitinib (Olumiant) and tocilizumab (Actemra)—both antiarthritic drugs—for people hospitalized for severe COVID-19. Both are anti-inflammatories, and baricitinib has some antiviral properties.
Antibiotics: Antibiotics kill bacteria, not viruses. One of the only antibiotics I have seen given to people with COVID-19 consistently is Zithromax (the "Z-Pack"). In addition to antibiotic properties, It has anti-inflammatory properties as well. It is typically
given to high-risk people and those suspected of having underlying secondary bacterial pneumonia. It is not recommended as a standard treatment for COVID-19.
Corticosteroids: Prednisone and dexamethasone - These steroids have great anti-inflammatory properties (including a decrease in cytokines that cause problems in COVID). They have their place in very sick people and people with underlying illnesses (especially lung disease) who develop COVID-19. Steroids are not recommended for standard treatment for COVID patients because they have some potentially harmful side effects.
While it was free until the end of 2023, Paxlovid now costs around $1400.00 to $1500.00 for an entire course (that's wild). Molnupirivir costs over $900 for a course, cash price. They know a good thing when they've got it. Does insurance cover the typical COVID medications? Most insurances cover at least part of the costs of Paxlovid or molnupirivir but may not cover it well. If you have a high copay, have Medicare and Medicaid, utilize military healthcare benefits, are over 65, and are retired, and if you utilize Indian Health Services, you may get cheaper Paxlovid, or try the PAXCESS portal to see if you can qualify for free Paxlovid. Also, check with a pharmacy; they can tell you about current government programs for the uninsured. The makers of these medications also have deals on the medication. For example, the makers of molnupirivir have a way to get it for less: check their site.
Payment plans change often.
LONG COVID
What is "long COVID"?
When a person has "long COVID," it means that they continue to have some ongoing symptoms long after their initial infection began. According to Yale Medicine, long-term COVID-19 is the reemergence or continuation of COVID-19 symptoms for at least three months after the acute illness began. The symptoms last at least two months, and no other explanations exist for those symptoms (7).
What are the symptoms of LONG COVID-19?
As of 12/2024, 20 million Americans had been diagnosed with long COVID. According to the Mayo Clinic, COVID-19 can attack several different organs and cause damage. This includes damage to the heart, kidneys, gastrointestinal, neurological system, immune, ren renal, hematologic, skin, and nervous system - including the brain. This damage likely causes Long COVID. COVID is non-discriminating: Some people sustain organ damage, and others do not. However, older people, those with weakened immune systems or preexisting risk factors are more likely to sustain damage and are more apt to develop long-term problems.
There are nearly 200 symptoms that can be manifestations of long COVID. There is just no norm for long-term COVID. Some of the more common symptoms may include the following:
-Chronic pain (especially joints)
-Brain fog. The COVID-19 virus does cross the blood-brain barrier.
-Dizziness
-Shortness of breath
-Cough
-Chest pain
-Heart palpitations/tachycardia
-Intense fatigue
-Insomnia
-Anxiety and other mental health problems
-Headaches
-Body aches - muscle pain
-Loss of taste and smell
-Stomach pain
-Menstrual irregularities
-Neuropathy (numbness and tingling of extremities)
-Diarrhea
-Mood changes
-Depression
-Nausea
-Abdominal pain
-Hair loss
-Lightheadedness
-Rash
-Lower endurance
-POTS (postural orthostatic hypotension) - increased heart rate, lightheadedness, etc., when standing.
A person may have a combination of different long-COVID symptoms. The virus can also make an existing physical problem worse, but most people recover.
On rare occasions, people have reportedly developed long COVID-like symptoms after having had the vaccine, or "Long VAX".
There is no easy way to diagnose long-term COVID-19 except through diagnosis by exclusion, whereby a healthcare provider rules out every explicable cause of the presenting problem through an extensive exam, testing, and review of the health history (especially do recall developing these symptoms after you had COVID?).
Like "everything else Covid," there are no absolute explanations for why some people develop long Covid. There are several possible explanations. It is surmised that some people get long COVID because a small amount of the virus, or pieces of it, remains in their system. The body continues to fight these off as an immune response, and the immune response causes inflammation. The inflammation causes ongoing symptoms. Another possibility is that the virus has caused some tissue destruction, which continues to manifest symptoms, depending on where the initial destruction is: the lungs, the heart, the brain, etc. A third possibility is that the virus stays dormant in the body. Similar to shingles. When a person has chickenpox (varicella), it never goes away. The varicella stays dormant in the basal ganglia of a nerve, living forever in a person's body. When a person is physically or mentally stressed, that virus reemerges again as a nasty, painful rash called "shingles." So, somehow, the COVID-19 virus continues to manifest symptoms.
Some cities have long-COVID clinics to help diagnose and treat people, but these are few and far between. Otherwise, going to a specialist for the specific problem would be the key. They can order specific labs, scans and do other procedures and treat them with various therapies and medications. Specific specialists might include pulmonologists (for lung problems), cardiologists (for heart symptoms), orthopedists (for musculoskeletal problems), psychologists/psychiatrists for mental health problems, and so on. If you have questions, speak to a healthcare provider.
Some studies suggest that the COVID-19 vaccine can reduce the incidence in developing long COVID.
What are major changes in the variants of COVID?
COVID-19 Mutations
All viruses can mutate, and COVID-19 viruses tend to mutate quite frequently. One small change in a virus's RNA can create a new variant, often bringing new symptoms.
The CDC has identified multiple COVID-19 variants of concern (VOC), each differing in prevalence; some have spread widely, while others remain far less common. As of May 2025, the most common variant in the US is XB8.1.
The following is a fairly simplistic outline of the more common variants that have arisen in the US, primarily from the Omicron variant, in chronological order. If this is not interesting to you, feel free to skip it and read on. My point is that the thing just keeps on mutating. It does that so it can survive.
Note: (alpha, beta, delta, gamma - Greek names attached if the variant was significantly different from the others. Letters like BA, B, XBB, Q, and B in naming the variants are scientific nomenclature)
Nov 2019: 2019-nCoV—Not long after, the name was changed to SARS-CoV-2. This was the original COVID-19 virus first detected in a sick person in Wuhan, China.
The most prevalent variants today in the US are variants of the Omicron virus, which generally create less severe symptoms than the Delta variants.
Below is a list of COVID variants: Alpha, Beta, Delta, Gamma, and Omicron (most variants today are variants of the Omicron virus).
SARS-CoV-2 spun off a contagious mutant D614G, which spread worldwide
Subvariants:
ALPHA B.1.1.7 UK then spread worldwide - very transmissible- around Sept/Nov 2020
(Alphas now gone) - could be severe
BETA: B.1.351 (late 2020) - not common in the US, considered very severe
DELTA (Gone)—In late 2020, it was highly transmissible, and symptoms tended to be much more severe, especially in unvaccinated people.
GAMMA: P.1 Late 2020
OMICRON Nov 2021 (less likely to cause severe symptoms than the Delta variety) ( 2 )
BA 1 Dec 2021
BA 2
BA 1 and 2 had more than 50 subvariants and 300 subvarieties
BA.2.12.1
BA.2.86 Summer 2023
BA 4
BA 5
Sept 2023
EG.5 (ERIS)
FL.1.5.1
XBB.1.16.6
Jan 2024 - Current - (Moving forward, most strains are FLiRT variants of Omicron - the JNs and KP's)
KP2 - Dominant variant as of April 12, 2024 (24.9% of cases)
JN1 - There is some question about whether the antibodies induced by the COVID-19 vaccines can fight this one off (22% of cases).
JN.1.7 (13% of cases)
KP.2 (5/24 - 28% of cases)
KP.3
August 20, 2024 KP.3.1.1 (37%), KP.2.3 (14.4%), KP.3, KP.2, and, as well as LB.1(14.1%)
October 2024 KP 3, KP 3.1.1 (predominant), XEC (a combination of two subvariants KP.3.3 (a descendant of the FLiRT variants) and KS.1.1.)
November 2025 KP 3.1.1 (predominant), XEC
December 2024 KP 3.1.1, XEC (predominant),
January 2025 LP. 8.1 (growing), KP 3.1.1, XEC (predominant)
March 2025 LP. 8.1 (predominant), XEC (decreasing), XFC (growing)
May 2025 LP. 8.1 (predominant 73% of cases in US), XFC (growing), XEC (has declined to the third most common). NB1.8.1 (growing-quite contagious but symptoms similar to other recent Omicron variants).
July 2025 NB.1.8.1 43% LP. 8.1 31%
August 2025 XFG Predominant (growing)
Note: Common COVID tests do not determine the variant of COVID that a person has.
There are so many questions and so many answers about COVID that we still do not know.
How long after having COVID-19 do I need to wait to get the COVID-19 vaccine?
This depends on what you read. The CDC says to wait "up to three months," but the Cleveland Clinic recommends "as soon as you are out of isolation." you sure do not want to potentially compound your symptoms by getting a vaccine while you are ill (my guess is about ten days minimum and symptoms are gone).
Are the current COVID-19 vaccines dangerous? For most people, no, but for some people, yes. Like the flu vaccination, a person may feel under the weather for a few days with fatigue, a headache, soreness at the injection site, or an occasional low-grade fever. These are the most common side effects. Rarely, the following side effects may occur: POTS (Postural orthostatic tachycardia syndrome), Myocarditis, pericarditis, tachycardia (fast heart rate), Guillain-Barre and other neurologic conditions, eye problems, HSV activation (including shingles) and a whole host of other potential side effects that probably will not happen but sometimes do. The benefits of getting the vaccine are reportedly more significant than the risks. But, again, this is related to the unpredictability of COVID-19 and its variants, so who really knows?
If you have not had problems with previous vaccines and have no contraindications or allergies to them, seriously consider getting the 2024-25 COVID-19 vaccine. If you have had the vaccine and do catch COVID-19, the symptoms will more likely be milder. With the vaccine, the likelihood of catching COVID is far less.
Other Means of Prevention
Stay away from sick people.
As mentioned, beware of large crowds, conventions, large gatherings, airports, planes, and Disney (even though it is fun for most people, be careful). I see so many travelers
when they get back from business or pleasure trips.
Wear a mask in crowded places.
Keep things clean- disinfect surfaces if someone is sick. Consider using Lysol disinfectant (Lord knows some of us used a lot of Lysol (antibacterial and antiviral). If COVID did not kill us, I wonder if breathing in a lot of Lysol would. I have been looking for studies on Lysol and all the other disinfectant chemicals we use during COVID-19 (follow instructions for use).
Take care of yourself—rest, hydrate with plenty of fluids, take multivitamins and minerals (zinc), try famotidine (Pepcid), and take supplements.
COVID Q&A
How long is the incubation period of COVID-19? How long does it take to come on after exposure?
According to WebMD (6), the average incubation period of COVID-19 is 5.6 days. This means some people got it earlier (as early as two days after exposure and up to 14 days after exposure). People have rarely developed symptoms after 14 days of exposure. In my experience, people exposed to large numbers of people at events like conferences, airports, concerts, and so on start showing symptoms about three days after these events. A lot of our patients who test positive for COVID are travelers.
How long will I have immunity after I have had COVID-19?
When you get COVID, your body makes antibodies to help "kill" it off. Those antibodies keep fighting for a while. How long do those antibodies hang around in your system? There are a few different answers, but one NIH study suggests that immunity lasts up to eight months but wanes over time. If a person gets reinfected several weeks after the first infection, they may have caught another variant or have a weakened immune system.
So, if I get one variant of COVID, can I catch another one not long after?
Yes. Just like everything else, COVID-19 is unpredictable. You can catch the same or another variant shortly after you have a different variety. However, according to the CDC, 98% of the US population has some degree of immunity from having had the vaccine, active COVID-19, or both. People with COVID-19 and the vaccine have better immunity than just one alone.
Can I get a PET scan or mammogram to check lymph nodes just after I have had active COVID or the vaccine?
Discuss this with your healthcare provider. Often, you get some lymph node enlargement after COVID-19 or a COVID-19 vaccination so these tests may be false positives. Typically, it is advised to wait two weeks.
Are over-the-counter self-tests still accurate for testing current strains of COVID-19 (5/2025)
Yes. According to Harvard Health, current COVID tests do work to test for present strains of COVID (May 2025) as long as the expiration date is still good.
Do the current COVID-19 vaccines work against today's COVID variants?
Yes, they reportedly are still effective; however, since the variants are changing so rapidly, the pharmaceutical companies are planning to manufacture more targeted vaccines.
So, if I get one variant of COVID, can I catch another one not long after?
Yes. Just like everything else, COVID-19 is unpredictable. You can catch the same or another variant shortly after you have a different variety. However, according to the CDC, 98% of the US population has some degree of immunity from having had the vaccine, active COVID-19, or both. People with COVID-19 and the vaccine have better immunity than just one alone.
Can I get a PET scan or mammogram to check lymph nodes just after I have had active COVID or the vaccine?
Discuss this with your healthcare provider. Often, you get some lymph node enlargement after COVID-19 or a COVID-19 vaccination, so these tests may be false positives. Typically, it is advised to wait two weeks.
Who made a profit on COVID-19?
Most hospitals maintained a decent profit margin due to government-issued COVID-19 subsidies. Others made out even better (Forbes).
What is a "COVID rebound"? This is the recurrence of COVID-19 symptoms 2-8 days after recovering from COVID. Initially attributed, in part, to taking Paxlovid, it can occur in anyone with COVID-19.
