There’s a new pattern to covid this fall. It’s milder, following a course similar to the common cold or other upper-respiratory tract illnesses.
The Mayo Clinic says that the most common symptoms for the current variants are fatigue, headache, runny nose, sneezing, and sore throat.
In a common scenario, the illness starts with a headache and just feeling a little tired, less energetic. It then progresses to sneezing and a runny nose, followed by a sore throat and raspy voice. The fatigue increases. Occasionally, laryngitis develops with a complete loss of the voice.
It can look like allergies, a cold, RSV, flu. Many people who thought they were suffering with their usual fall allergies have been surprised to discover they had contracted covid, resulting in a delay in treatment and unknowingly exposing friends and family. This similarity to other common diseases is why it’s becoming harder to accurately diagnose, doctors are saying.
For some people, it can be more like the stomach flu with nausea, vomiting, and diarrhea.
Coughing, especially a persistent dry cough, is no longer a primary diagnostic symptom. Loss of the sense of taste or smell is now a rare, though still diagnostic, symptom.
It takes roughly two to three weeks now for covid to run its course. The sore throat that develops within the first week or so often lessens. With this there may come a few days of fever and chills. The fatigue and muscle aches tend to lift after a few days, but the congestion may linger for several weeks.
This is the new pattern. But along with this, many people are experiencing a wide range of secondary effects not usually seen in a cold or flu. These may include rashes, cramps, and fast shooting pains that can affect any area of the body.
But while milder, the new covid is still a serious illness with around 85 deaths per day, 600 deaths per week nationwide. As disturbing as that number is, it pales beside the 25,000 deaths per week in the U.S. at the peak of the pandemic.
The national and Maryland death rates are both down over the past two weeks, but hospitalizations are on the rise.
Hospitalizations from covid are at a daily average of 12,550 for the week ending September 29. That’s a 3.7% increase over the previous two weeks. Of those hospitalizations, 1,693 were admitted to the Intensive Care Unit (ICU), representing an increase of 3.6%.
These covid-related deaths and hospitalizations are not spread evenly across the country. There are hot spots that spike first in one community then spread to another city or state. Currently, Maryland with 12.6 hospitalizations per 100,000 population has the second highest hospitalization rate in America. A few weeks ago, Maryland was number one, now North Carolina is with a rate of 13.6.
The rate starts to drop significantly from there with South Carolina at third highest and an 8.4 rate. Nearby, Pennsylvania is fifth highest with a rate of 7.6 while Delaware is sixth with a rate of 6.1. It continues to drop with most states having rates between two and four hospitalizations per 100,000 population.
These are fast-changing statistics and may change significantly in the coming weeks as hot spots flare and fade.
In Maryland, the number of cases declined steadily from a high in January of over 1,000 new cases per week to under 200 in mid-June. Then new covid cases and the resulting hospitalizations and deaths began to rise again. During August and into September, deaths per day in Maryland usually ranged from zero to four or five, occasionally higher.
The table below shows the five states with the highest rates of hospitalization for covid plus four other nearby states and the District of Columbia. The second table has covid death and new case rates for the nine counties on the Eastern Shore. Both tables show seven-day averages, and are as of October 2, 2023.
On the Eastern Shore, Wicomico and Dorchester counties have the highest rates of covid cases. Wicomico reported 0.8 per 10,000 population while Dorchester has 0.7. Kent and Queen Anne’s have the lowest rates on the Shore at 0.3 and 0.28, respectively. Queen Anne’s case rate is the lowest in the state.
Statewide, Allegheny County has the highest case rate at 1.06 per 10,000 population. Garrett is second at 0.95 while Wicomico on the Shore has the third highest in the state.
Current variants
The two most prevalent strains circulating now are officially named EG.5 and FL.1.5.1, nicknamed Eris and Fornax. Both are subvariants of the Omicron variant which became widespread in late fall of 2021. Together they account for 30% of tested cases nationwide.
A new sub-variant, BA.2.86, known as Pirola, has come to the attention of researchers who are watching it closely because it’s such a highly mutated strain of Omicron. Not enough cases have been detected yet for it to be included in the CDC’s official statistics, but it has been reported in Maryland as well as several other states including Virginia, Pennsylvania, and New York. It has also been found in the Midwest in Ohio and Michigan, and further west in Colorado and Texas. So far it doesn’t seem to cause more serious illness, but scientists are watching it and other new variants for new symptoms and any capacity to evade current tests, vaccines, or treatments.
Monoclonal antibodies, which used to help in recovery from covid, are no longer recommended as they are not very effective with the new variants. Paxlovid is still effective at reducing the incidence of severe cases.
The best preventative of both infection and severe disease is still the vaccine booster. The newest booster, which became available in mid-September, should be covered by insurance including Medicare and Medicaid, though there may be co-pays. The payment issue seems to be unclear at this point. Those who have had covid recently should check with their doctors and CDC guidelines before getting the booster. They may be counseled to wait two to three months from recovery before getting a vaccine booster. For everyone else over six months, a booster is recommended.
Sources and More Information:
Covid-19 in Maryland: Track death, hospitalization and case data from the state and CDC, Baltimore Sun, Update dated Sep 26, 2023
Covid-19, Center for Disease Control (CDC).
https://www.cdc.gov/coronavirus/2019-nCoV/index.html
“Covid Map Shows 9 States Where Cases Are Rising This Month,” Nick Mordowanec, Newsweek.
“Covid hospitalizations: See the latest trend and current count,” Joe Murphy, September 1, 2023, NBC News.
New York Times Interactive Covid Tracker.
https://www.nytimes.com/interactive/2023/us/covid-cases.html
Jane Jewell is a writer, editor, photographer, and teacher. She has worked in news, publishing, and as the director of a national writer's group. She lives in Chestertown with her husband Peter Heck, a ginger cat named Riley, and a lot of books.
Title image: Pond at Pickering Creek Audubon Center, Talbot Co. Photo: Jan Plotczyk