Though COVID-19 in the U.S. has plateaued, uncertainty still surrounds the trajectory of the pandemic and symptoms associated with the virus.
Michael Osterholm, PhD, director of the Center for Infectious Disease, Research and Policy at the University of Minnesota in Minneapolis, referred to this phase of the pandemic as a 'stay-tuned moment' in a July 13 interview with Becker's and maintained there are still many unknowns a month later in an Aug. 18 interview.
"My most frequently used three words in my vocabulary right now are, 'I don't know,'" he said, adding that he is puzzled about what the next six months could look like.
A change in COVID-19 symptoms
Omicron subvariants BA.4 and BA.5 quickly rose to dominance in the U.S. — with BA.5 accounting for 88.8 percent of cases in the week ending Aug. 13 — and brought along their own set of symptoms.
COVID-19 patients have reported a wide range of symptoms, with some appearing more often in different variants. Loss of taste and smell were associated with the alpha variants but have been reported less with omicron. A study published Aug. 17 in JAMA Network Open found that 56 percent of omicron-infected adults were asymptomatic and unaware they were contagious.
While there isn't "systematically collected data" to compare symptom changes between variants, the general sense is that symptoms reported at the start of the pandemic are less frequently observed among new cases, Dr. Osterholm said.
A newer omicron symptom is "very sore throats," Dr. Osterholm said.
"These have been described as like drinking broken glass," he said. "People who actually say that their throat hurts so much that they can't swallow their own saliva [and] have to spit it out. It's too painful."
Pandemic trajectory
Dr. Osterholm described the pandemic in the U.S. as a rollercoaster.
"When omicron first came, we had this huge peak, but once we got to the BA.4, BA.5 predominance in early summer, we've been just flat. It's like a high plateau," he said. "If you look at hospitalizations, you look at deaths, the two major data pieces we can use to try to illustrate what's going on in the community. It's amazing to see how flat it's been, a few percent up and a few percent down week from week to week."
The daily average of cases has decreased by 19 percent in the last 14 days, with 96,275 new cases as of Aug. 18, according to HHS data tracked by The New York Times. Hospitalizations have also dropped by 6 percent over the same time period, and deaths have dropped by 3 percent. These figures are likely an undercount, however, since most rapid at-home tests are not included.
Dr. Osterholm said he doesn't expect to see a peak again "like we saw before" unless the virus develops a major ability to evade immune protection.
"But at the same time, will it just fade away?" he asked. "Over time, we just see fewer and fewer severe illnesses, hospitalizations and deaths. We just don't know. And that's, that's an immediate term. That's not even years from now."