Surge in Winter Infections: Is it Just a Cold or Could it be Covid?

As the winter season sweeps across the country, it seems like almost everyone has experienced at least one bout of illness. The telltale sniffles and coughs that were once dismissed as “just some bug” are now raising questions about the possibility of a Covid infection. However, even without a Covid test, there’s a significant chance that those seemingly harmless sniffles were indeed caused by the virus. The United States is currently facing its largest surge in daily Covid infections since the emergence of the Omicron variant, with an estimated 2 million new infections per day. Surprisingly, this surge has gone relatively unnoticed by many.

The driving force behind this surge is the JN.1 variant of the coronavirus, which first appeared in September and has quickly become the dominant strain. Fortunately, the rate of hospitalizations remains lower than what was seen at this time last year, with 90 admissions per million people in the US, roughly 65 percent of last year’s peak. According to Eric Topol, a professor of molecular medicine at the Scripps Research Translational Institute, “It’s really encouraging that we don’t have a big parallel spike of hospitalizations.”

However, it’s important to note that infection rates have not yet peaked, and experts anticipate that hospitalizations and deaths may increase in the coming weeks. This is a cause for concern, especially during the winter flu season. Mark Cameron, an infectious disease researcher at Case Western Reserve University School of Medicine, emphasizes the worry associated with a rapidly spreading variant.

Accurately tracking Covid infections has become more challenging, in part due to the dismantling of testing and tracing infrastructure in the US. To gauge the situation, researchers are turning to unconventional methods, such as sewage surveillance, to get a sense of Covid trends. While this approach provides some insights, the absence of comprehensive tracking by the CDC makes it difficult to assess the true extent of the current wave.

Adding to the complexity, the timing of this surge couldn’t be worse, as it coincides with the seasonal presence of respiratory viruses like RSV and the flu. In response, the CDC has issued health alerts, urging healthcare providers to administer vaccines for flu, Covid, and RSV to prevent severe illness that could strain hospitals. Some healthcare facilities are reintroducing mask requirements due to the convergence of these respiratory illnesses. Cameron warns, “Secondary infections with different agents make health outcomes worse and worse.”

While we’ve been dealing with seasonal respiratory viruses for decades, Covid continues to evolve rapidly, and its impact extends beyond the cold and flu season. JN.1 is causing significant waves in both hemispheres, including southern regions during the middle of summer. “Covid is on its own schedule,” says Cameron.

Since 2021, all dominant Covid variants have originated from Omicron. Despite the differences between JN.1 and the previous XBB.1.5 strain of Omicron, preliminary research from China and the US suggests that the latest vaccines are still effective against JN.1.

However, vaccine uptake remains a concern. In the US, over 80 percent of the population has not yet received the updated 2023–2024 booster shot. Many low-risk individuals have ignored the booster rollout, posing a risk to the broader community. Cameron Wolfe, a professor of infectious disease at Duke University, emphasizes the importance of staying up-to-date on vaccinations to protect vulnerable individuals within the community.

While the 2023–2024 booster may not provide perfect protection against infection, it appears to reduce the risk of long Covid by approximately 70 percent, according to recent meta-analysis. This is a significant benefit for individuals, especially considering the potential severity of Covid infections.

As we navigate the fifth year of the pandemic, individuals are encouraged to assess their own levels of protection and exposure, and to consider the well-being of their communities. Vigilance, vaccination, and testing are recommended strategies. Cameron suggests planning vaccinations, masking, and testing ahead of significant events, such as weddings or vacations, to minimize the risk of illness.

Although extra precautions can be beneficial, JN.1 does not appear to cause more severe outcomes than previous variants. Covid’s impact has become comparable to other respiratory viruses like RSV and the flu for many people. “We’ve sort of forgotten about how socially immobile we had become,” says Cameron Wolfe. Despite the challenges, experts believe that we are in a better position to deal with the virus than we were a few years ago.