Runny Nose, Sore Throat and More

• Global healthcare officials have labeled XBB.1.5, a subvariant that is currently responsible for the bulk of new COVID-19 cases, as the most contagious Omicron mutation they’ve seen to date.
• XBB.1.5 — which some experts are calling the “Kraken” strain — is thought to be about five times more contagious than earlier Omicron strains and has characteristics that allow it to spread easier among both vaccinated and recently recovered individuals.
• Common symptoms associated with this strain can be easily dismissed as seasonal illness or flu, but data suggests flu infections are declining, which means Americans should treat these symptoms seriously.
• Being sick and experiencing a chronic cough, elevated fever, sore throat or a runny nose should prompt you to get a COVID-19 test to ensure you are not contagious.

Having quickly become the primary strain in new COVID-19 cases currently in the United States, a virus variant known as XBB.1.5 — called the “Kraken” by some in the healthcare field — is likely spreading among Americans due to misleading symptoms that may be dismissed as seasonal illness.

XBB.1.5 may be one of the most virulent strains of SARS-CoV-2, the virus that triggers COVID-19, and has adapted to better evade some of the antibody protection that newer bivalent vaccines offer. Many outlets, from USA Today to the Washington Post, have highlighted leading experts’ testimony which suggests that this particular strain is about five times more contagious than earlier Omicron variants (which were already spreading rapidly in years past).

Sherrill Brown, M.D., medical director of infection prevention for Los Angeles-based AltaMed Health Services, tells Good Housekeeping that the XBB.1.5 variant is the most infectious strain that experts have come across recently — which officials at the World Health Organization (WHO) confirmed in January, per ABC News.

“Viruses mutate in order to become more fit and have the ability to be passed from one person to another person more effectively,” she explains. “The XBB.1.5 variant is a mutant variant of the Omicron strain and has been shown to be the most contagious variant of Omicron that we have seen so far.”

Current data provided by the Centers for Disease Control and Prevention (CDC) indicate that the XBB.1.5 strain makes up more than 60% of current cases in the U.S. Meanwhile, CDC data suggests that influenza rates are dipping to their lowest since September, despite concerns of a “tripledemic” earlier this winter. Some in public healthcare, however, worry that this figure could expand in the weeks to come; with many still overcoming lingering coughs and stuffy noses, alongside compromised immune systems impacted by seasonal sickness, there’s concern that respiratory symptoms associated with COVID-19 may go ignored or misdiagnosed.

Luckily, infections caused by XBB.1.5 are not proving to be more serious or deadlier compared to earlier variants. Recent research suggests that bivalent COVID-19 booster vaccines provide some level of protection against these newer variants — and better protection compared to earlier versions of COVID-19 vaccines.

Immunization experts are worried, however, that a mild COVID-19 case may not be the reality for all Americans; there’s some concern that each breakthrough case may increase risks of long COVID and its most prominent symptoms, including brain fog.

Potential XBB.1.5 variant symptoms to recognize:

Infectious disease experts have established that XBB.1.5 spreads more effectively due to a genetic mutation providing “stronger binding capabilities” to hosts, according to materials published by UCDavis Health. But Dr. Brown adds that because a majority of Americans have experienced at least one (if not more) COVID-19 infection recently, their immune systems may present signs of sickness that could be interpreted as something less serious.

“Because most people have either developed a COVID-19 infection-related immunity, or have had their vaccines, individuals are starting to have more mild symptoms when they become infected,” Dr. Brown says. “[XBB.1.5] symptoms may include a runny nose, mild cough and a sore throat. The loss of taste or smell is still possible, but reported less frequently now.”

It’s important to note CDC officials haven’t named any particular group of symptoms as being directly associated with the XBB.1.5 variant — like other variants before it, any combination or severity of common COVID-19 symptoms is possible in new infections.

According to the CDC, these are potential symptoms to monitor if you believe you are sick:

1. Fever
2. Body chills
3. Chronic cough
4. Headache
5. Sore throat
6. Nasal congestion or runny nose
7. Fatigue
8. Nausea and vomiting
9. Diarrhea
10. Shortness of breath, or difficulty breathing
11. New loss of taste or smell

Particularly, four of the symptoms that are commonly associated with XBB.1.5 variants — nasal congestion, sore throat, cough and fever — are also frequently dismissed as seasonal colds or flu, according to CDC materials.

“You cannot tell the difference between flu and COVID-19 by symptoms alone because some of the symptoms are the same,” the agency shares on its website, advising Americans to immediately get tested to determine if they are infectious to others.

Most symptoms often resolve within five to 10 days, but your recovery likely hinges on whether you are fully up-to-date on your vaccinations. “People that are not have been shown to be still at risk for more severe symptoms, including shortness of breath, leading to hospitalization or death,” Dr. Brown adds.

Can XBB.1.5 easily cause COVID-19 reinfections?

If you’ve recently recovered from a COVID-19 infection last fall, your earned immunity against this new virulent strain may not be as protective as you think. There’s clear evidence that XBB.1.5 replicates faster than other variants that affected under vaccinated communities earlier in the pandemic; CDC data illustrates that in January alone, infection rates associated with the variant climbed upwards of 8 to 10% per week, a concerning rate. Combined with limited research that suggests vaccine immunity isn’t as strong as it was prior to the arrival of variants, some healthcare experts believe that breakthrough reinfections are more likely now than in years past.

Studies aside, it’s crucial to stay up to date on your COVID-19 vaccinations, given that healthcare officials are clear that any measure of protection is crucial, especially for those at risk for severe complications.

“Being up-to-date with the COVID-19 vaccine, including the last updated bivalent booster, is the best way to protect yourself from severe COVID-19, including the XBB.1.5 strain,” Dr. Brown says.

As more information about the coronavirus pandemic develops, some of the information in this story may have changed since it was last updated. For the most up-to-date information on COVID-19, please visit online resources provided by the CDC, WHO, and your local public health department.