Health

Some infected by COVID FLiRT report the most unpleasant symptoms yet

As summer travel season resumes, COVID cases and hospitalizations are rising in Los Angeles County — and some of those recently reinfected are finding their latest bout is the worst yet.

There is no sign at this point that the latest coronavirus variants are causing more severe illness, either nationally or in California.

But some doctors say this new wave of COVID cases challenges a long-held myth: While new COVID infections are often mild compared to a first bout with the disease, they can still cause serious illness. Even if a person doesn’t need to go to the emergency room or be hospitalized, they sometimes describe excruciating symptoms.

“The dogma is that every time you get COVID, it’s less severe. But I think we need to keep an open mind to the possibility that some people will have more severe symptoms,” said Dr. Peter Chin-Hong, an infectious disease expert at UC San Francisco.

Every time you get COVID, he said, it’s “kind of like playing COVID roulette.”

This underlines the need to exercise caution when travelling and engaging in summer activities, even though the overall risk remains relatively low.

Because everyone’s experience with COVID-19 is different and influenced by a number of factors, it’s difficult to quantify how many people are experiencing more acute symptoms now than during previous infections. But anecdotally, including on social media, people are expressing shock at the extent of their illness from the latest sub-variants, which have been collectively dubbed FLiRT.

“I’ve had COVID a few times, but this is the worst time I’ve had it,” one person wrote on Reddit. The person reported a recurring fever, nasal congestion so bad they couldn’t breathe through their nose, “terrible sinus pressure and headaches… and I can’t stand for too long without feeling like I’m going to pass out.”

“COVID used to feel like a common cold, but this strain is wreaking havoc,” the person wrote. “I hate to complain like this, but I’m shocked at how much this is incapacitating me.”

Another person wrote that her “throat felt like razor blades” and that she felt like she was “living in misery.”

“I have so much phlegm but it hurts so bad to cough because my throat is literally on fire!!,” the person wrote. “This is my fourth time having Covid and I swear it feels like the worst time I’ve ever had it!!”

Others who escaped COVID for more than four years became infected this summer.

One person fell ill and tested positive for the first time after hosting a Father’s Day gathering with 12 people. She described “uncontrollable chills that caused me to lose most of my fingers.”

A 42-year-old nurse, who has had COVID four times before, said her latest illness was “intense, with fever, cough, pressure in the head and pain. It attacks my throat and my ability to swallow.”

Others, however, said it was easier to recover from each new COVID infection. One person infected for the first time wrote that she had “very mild symptoms (that) feel like a seasonal allergy flare.”

Some studies support the idea that subsequent COVID infections pose additional risks. A 2022 report in the journal Nature Medicine focused on veterans and found that “compared with uninfected individuals, the cumulative risks and burdens of repeat infection increased with the number of infections,” increasing the risk of medical problems, hospitalization, and death.

And while the prevalence of long COVID appears to be declining, doctors note that there is a risk of developing the syndrome with each infection. A report released by the U.S. Centers for Disease Control and Prevention last summer indicated that the prevalence of long COVID among U.S. adults was 7.5% in early June 2022, but had declined by mid-June 2023 to 6% — still a significant portion of the population.

There are a number of potential reasons why a new COVID illness could be worse than the first. Suppose a person who was vaccinated and last vaccinated in 2021 got infected in 2022 and then again in 2024. The relatively long time without exposure to infection or a booster shot “may have led (their body) to not have as much immune memory. And the variants have changed so much anyway, it’s like being exposed to something relatively different from the virus that the immune system had seen before,” Chin-Hong said.

Without staying up to date on COVID vaccinations, which “remind the immune system of what the most current variants look like,” a recent infection can cause the body to react relatively surprised to the FLiRT subvariants that are now dominant nationwide.

“It’s evolved so much, and the body is like, ‘Oh my God, what is this thing I’m seeing?’” Chin-Hong said.

The logic is much the same for annual flu vaccines, which are formulated each year in the hopes of preparing the immune system against the dominant circulating versions of that virus.

For the week ending Saturday, an estimated 70.5% of COVID samples nationwide were FLiRT subvariants — officially known as KP.3, KP.2 and KP.1.1 — up from 54.9% a month earlier. Another closely related subvariant, LB.1, is estimated to have made up 14.9% of samples, up from 10% a month earlier.

Immunity acquired from older vaccines can still do a decent job of protecting many people from severe disease. But without the booster that an updated vaccine provides, Chin-Hong said, the immune system “is unlikely to be able to stop the virus in its tracks, or neutralize it as soon as it comes along, because it looks very different, before activating memory immunity.”

“Meanwhile,” he added, “this virus is happily infecting cells, while the body tries to use its current memory to make new immune cells.”

It’s also worth noting that even for young adults considered up-to-date on their COVID vaccinations, it’s been nearly a year since their last vaccination, and vaccine effectiveness wanes over time.

A report released by the CDC in February found that receiving the updated 2023-24 COVID-19 vaccine provided about 54% increased protection against symptomatic disease compared to no vaccine. Vaccine effectiveness against symptomatic infection is highest in the first few months after receiving the updated vaccine.

Vaccines continued to provide good protection against hospitalization and death.

In Los Angeles County, COVID cases and hospitalizations continue to rise. For the week ending June 30, there were an average of 229 coronavirus cases reported per day, up from 106 a month earlier. And for the week ending June 29, there were an average of 197 people infected with the coronavirus in hospitals per day, up from 117 a month earlier. And while COVID-related hospitalizations are now higher than they were this time last year, they remain below the relatively mild peak seen in the summer of 2023.

Officially reported cases are an undercount because they only take into account tests done in medical facilities and do not account for at-home tests or those who do not get tested. In Los Angeles County, the COVID spike last summer peaked at 571 cases per day in late August, and reached a peak of 620 people infected with the coronavirus per day in hospitals in early September.

Viral levels in Los Angeles County wastewater have remained relatively stable. For the week ending June 22, the most recent available viral levels in wastewater were 17% of the peak in the winter of 2022-23, the same as the previous week. Last summer, the peak was in early September, when viral levels in wastewater were 38% of the peak in the previous winter.

The coronavirus test positivity rate continues to rise in California. For the week ending July 1, 10.6% of coronavirus tests statewide came back positive, up from 4.1% a month earlier. Last summer’s test positivity rate peaked at 13.1%, near the end of August.

The COVID-19 vaccination rate, which has been available since September, has been relatively low. Since then, 36.7% of California seniors aged 65 and older have received at least one dose of the updated vaccine, as have 18.5% of adults aged 50 to 64 and 10% of younger adults up to age 49.

For people who haven’t gotten an updated vaccine in the past year, “you should consider getting one, especially if you’re older and immunocompromised,” Chin-Hong said. Hundreds of COVID-19-related deaths continue to be reported each week nationwide, with older adults and those who are immunocompromised most at risk.

Even if you get the 2023-24 vaccine now, you can still get the updated COVID vaccine that is expected to be available this fall. The CDC will recommend that everyone 6 months and older get the updated 2024-25 vaccine.

October is the best time to get the 2024-25 COVID-19 vaccine, Chin-Hong says.

Chin-Hong said even health care workers need to be reminded of proper COVID infection control protocols, such as the importance of getting tested when feeling sick and reporting illness to your employer.

“Everyone seems to think that COVID-19 has become a normal disease,” Chin-Hong said. But taking sensible steps – like deciding not to go to work when you’re sick and getting tested when you have symptoms – can make a big difference in limiting the spread of COVID-19 to fewer people.

And with the rise of COVID, it’s also a reminder that it’s smart to keep a mask in your pocket to wear if you’re around someone who is sick, Chin-Hong said.

News Source : www.latimes.com
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