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Public health emergency extended. The U.S. Department of Health and Human Services has extended the COVID-19 public health emergency, which went into effect in January 2020 and has since been renewed every 90 days. The order has allowed for a number of flexibilities throughout the coronavirus pandemic, including expanded telehealth coverage and free at-home tests for Medicare beneficiaries. The extension comes as COVID-19 cases, hospitalizations and deaths are on the rise and a highly contagious version of the coronavirus is spreading throughout many areas of the U.S.
New coronavirus strain gains ground. The subvariant known as XBB.1.5 is spreading quickly in many regions in the U.S., including the Northeast, where it is responsible for about 70 percent of COVID-19 cases, according to the latest data from the Centers for Disease Control and Prevention (CDC). Nationwide, XBB.1.5 accounts for nearly 30 percent of COVID-19 cases — a jump from previous weeks. The CDC says it’s unclear whether the subvariant can cause more severe disease than its predecessors. “We’re closely watching this variant to see how well our vaccines [and] treatments are working against it,” the public health agency wrote Dec. 30 on Twitter.
Updated boosters cut risk of hospitalization, research shows. A study published by the CDC on Dec. 16 found that adults 65 and older who received an updated bivalent COVID-19 booster saw their risk of hospitalization reduced by 73 percent compared with peers who received the original COVID-19 vaccines only. A second study, also published by the CDC on Dec. 16, found that the new omicron-targeting boosters may reduce the risk of severe COVID-19 in all adults by 50 percent or more. Health officials encourage all people eligible for a bivalent booster to get one as soon as possible, in an effort to avoid a winter surge of severe illness. “With co-circulation of multiple respiratory viruses, including SARS-CoV-2 (COVID), influenza and respiratory syncytial virus (RSV), vaccination against respiratory diseases for which vaccines are available is especially important to prevent illnesses resulting in health care encounters and to reduce strain on the health care system,” the authors on one of the CDC reports wrote.
Four in 10 oldest adults boosted. Among adults 65 and older, 39 percent say they have gotten the new bivalent booster, and 16 percent say they intend to get the shot as soon as possible, according to a survey by the nonpartisan Kaiser Family Foundation. The bivalent booster targets both the original and omicron COVID-19 strains and has been available since September. Federal officials have urged Americans to get the latest shot as the number of COVID-19 cases has steadily increased. Among those Americans 65-plus who have been vaccinated but not gotten the latest booster, 36 percent say they don’t think they need it, and 36 percent say they don’t think the benefit of the updated booster is worth it. About 1 in 4 (23 percent) say they haven’t gotten the booster because they have been too busy or haven’t had the time.
Americans can order more free at-home COVID tests from the government. The Biden administration announced Dec. 15 that it restarted its free at-home testing program. Every U.S. household can order four free at-home COVID-19 tests at covidtests.gov; shipping is also free. The administration will distribute thousands of at-home tests to rural health clinics, long-term care facilities and community health centers. The move is part of the White House’s COVID-19 Winter Preparedness Plan amid a rise in COVID-19 cases, hospitalizations and deaths. Along with expanded testing, the plan includes a push to get more Americans vaccinated with the most recent bivalent booster, including residents in long-term care facilities, and to increase access to high-quality masks in communities throughout the country..
Bivalent vaccines now available for kids as young as 6 months. Children 6 months to 5 years old who are fully vaccinated with Moderna’s COVID-19 vaccine are eligible to receive an updated bivalent booster shot, the CDC said Dec. 9. Kids 6 months to 4 years old who were vaccinated with Pfizer and have not received their third dose in the primary series can receive a bivalent vaccine for their third shot. The bivalent vaccines target some of the more recently circulating strains of the coronavirus. These shots have been available to adults since September. About 42 million Americans have rolled up their sleeves for the new booster, which public health experts say is critical to combating a wave of severe illness this winter.
Repeat COVID infections can be dangerous. If you’ve had COVID-19, that doesn’t mean future coronavirus infections will be less severe, a study suggests. A team of researchers from Washington University School of Medicine in St. Louis and the Veterans Affairs St. Louis Healthcare System found that repeat coronavirus infections can come with consequences, and that health risks can increase with each subsequent infection. The study, published in Nature Medicine, compared the health outcomes of people who have avoided COVID-19 with people who tested positive one time and people who had two or more infections. Researchers found that people with repeat infections were 3.5 times more likely to develop lung problems, three times more likely to suffer heart conditions and 1.6 times more likely to experience brain conditions than patients who had been infected with the virus once. “During the past few months, there’s been an air of invincibility among people who have had COVID-19 or their vaccinations and boosters, and especially among people who have had an infection and also received vaccines; some people started referring to these individuals as having a sort of superimmunity to the virus,” said senior author Ziyad Al-Aly, M.D., a clinical epidemiologist at the Washington University School of Medicine. “Without ambiguity, our research showed that getting an infection a second, third or fourth time contributes to additional health risks in the acute phase, meaning the first 30 days after infection, and in the months beyond, meaning the long COVID phase.” The study’s authors encourage people to be aware of their risks and practice vigilance going into the winter season when cases could surge.
CDC authorizes Novavax booster for adults. CDC Director Rochelle Walensky approved the Novavax COVID-19 booster for adults 18 and older. In her decision memo, Walensky gives adults the option “to receive a Novavax monovalent booster instead of an updated (bivalent) Pfizer-BioNTech or Moderna booster if they have completed primary series vaccination but have not previously received a COVID-19 booster — and if they cannot or will not receive mRNA vaccines.” This authorization comes on the heels of Novavax’s two-shot COVID-19 vaccine series being approved for ages 12 to 17 as well as for ages 18 and older. The two doses of the Novavax vaccine are given three weeks apart. Novavax’s product uses a more traditional technology than the other COVID-19 vaccines. Instead of prompting the body to make its own version of the spike protein (a key part of the virus), the protein is made in a lab and delivered directly upon injection. “If you have been waiting for a COVID-19 vaccine built on a different technology than those previously available, now is the time to join the millions of Americans who have been vaccinated,” Walensky said when the vaccine was first authorized for adults in July. “With COVID-19 cases on the rise again across parts of the country, vaccination is critical to help protect against the complications of severe COVID-19 disease.”
Answers to the most frequently asked questions about COVID-19.
How can you catch COVID-19?
COVID-19 is the name of the disease caused by a coronavirus called SARS-CoV-2. It’s spread in three main ways, according to the CDC. You can catch COVID-19 by breathing in air if you are close to an infected person who is exhaling small droplets and particles that contain the virus. You can also get it if those small droplets and particles land in your eyes, nose or mouth (likely through coughs or sneezes) or if you have virus particles on your hands and touch your eyes, nose or mouth.
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Who is at risk for COVID-19?
Anyone can get COVID-19, but some people are more at risk for what experts call “severe disease,” at which time hospitalization or intensive care may be required. Older adults are more likely than younger, healthier people to experience serious illness from COVID-19. The vast majority of COVID-19 deaths in the U.S. have occurred among people 50 or older — and the risk increases with age.
Adults of any age with an underlying medical condition are at increased risk for complications from a coronavirus infection. Among the factors:
- Cancer
- Chronic kidney disease
- Chronic lung diseases, including COPD (chronic obstructive pulmonary disease), asthma (moderate to severe), interstitial lung disease, cystic fibrosis and pulmonary hypertension
- Dementia or other neurological conditions
- Diabetes (type 1 or type 2)
- Down syndrome
- Heart conditions (such as heart failure, coronary artery disease, cardiomyopathies or hypertension)
- HIV infection
- Immunocompromised state (weakened immune system)
- Liver disease
- Mental health conditions, including depression and schizophrenia spectrum disorders
- Overweight and obesity (defined as a body mass index of 25 or greater)
- Pregnancy
- Sickle cell disease or thalassemia
- Smoking (current or former)
- Solid organ or blood stem cell transplant (includes bone marrow transplants)
- Stroke or cerebrovascular disease, which affects blood flow to the brain
- Substance use disorders (such as alcohol, opioid or cocaine use disorder)
- Tuberculosis
What can you do to reduce your risk?
Get vaccinated and boosted. The FDA has officially approved two vaccines — a two-shot series from Pfizer-BioNTech and another two-shot series from Moderna. The FDA also issued an emergency use authorization (EUA) for a COVID-19 vaccine developed by Johnson & Johnson (J&J) and another developed by Novavax. All four vaccines are effective at preventing hospitalization and death from COVID-19. Health officials encourage everyone 6 months and older to get vaccinated, including people who have had COVID-19.
Once you are vaccinated, you should get boosted. Kids 5 and up — and some children as young as 6 months — are eligible for a booster at least two months after their last shot.
Other ways to lower the likelihood of getting sick from COVID-19: Wear a high-quality face mask in public indoor settings (see the CDC’s guidance on when one might be needed in your community), avoid crowds and poorly ventilated spaces and wash your hands often.
Do the vaccines have side effects?
It’s common to experience mild to moderate side effects after getting vaccinated, such as soreness in the arm, headache, fatigue, muscle and joint pain, nausea, fever or chills — but these are temporary “and normal signs that your body is building protection,” the CDC says. A small number of vaccine recipients have experienced adverse reactions to the shots. These serious events after COVID-19 vaccination “are rare but may occur,” the CDC says. Anaphylaxis, an allergic reaction, has occurred in 2 to 5 people per million vaccinated in the U.S. (nearly 600 million COVID-19 vaccine doses have been administered). This is why you may be asked to wait about 15 minutes after your shot or booster to monitor for symptoms. Vaccine providers are equipped with medicines to quickly treat the reaction.
Health officials are also monitoring reports of myocarditis or pericarditis in some adolescents and younger adults after vaccination with the Pfizer, Moderna and Novavax vaccines. Most of these patients who received care responded well to medicine and felt better quickly, the CDC says. Another uncommon event that has been linked to J&J’s vaccine is a rare but serious clotting disorder, called thrombosis with thrombocytopenia syndrome. There have been 60 cases as of March 2022 out of about 14 million doses administered; nine people have died from it. Women in their 30s and 40s are most at risk. After reviewing evidence of the adverse event, the CDC decided on Dec. 16, 2021, to recommend the Pfizer and Moderna vaccines over J&J’s product; the FDA has since limited its authorization. J&J’s vaccine, however, is still available to those who are “unable or unwilling” to get vaccinated with Pfizer or Moderna.
Can you get COVID-19 even if you’re fully vaccinated?
The COVID-19 vaccines can help prevent a coronavirus infection, but importantly, they are highly effective at preventing serious illness from COVID-19. Unvaccinated individuals 50 and older are 14 times more likely to die from COVID-19 than their vaccinated peers who are up to date on their COVID-19 vaccines, federal data from June 2022 shows. Hospitalization rates are also much higher among unvaccinated adults.
Despite these protections, the vaccines are not 100 percent effective at stopping the virus — and preliminary data shows that omicron is better at sneaking around the vaccines than previous variants — so it is possible for fully vaccinated individuals to get COVID-19. This is called a breakthrough infection.
Though people with breakthrough infections are less likely to develop serious illness from COVID-19 than unvaccinated people, they can still be contagious and spread the virus to others. Wearing a mask in indoor public settings can help prevent people with asymptomatic or mild illness from unknowingly spreading the virus to others.
What are the symptoms of COVID-19?
People with COVID-19 have reported a wide range of symptoms that typically appear two to 14 days after exposure to the virus, including:
- Fever or chills
- Cough
- Shortness of breath or difficulty breathing
- Fatigue
- Muscle or body aches
- Headache
- Loss of taste or smell
- Sore throat
- Congestion or runny nose
- Nausea or vomiting
- Diarrhea
This list is not exhaustive, and more unusual symptoms have been noted throughout the pandemic — from cognitive complications to skin rashes. A COVID-19 test can help you determine if you have an infection. Most people with COVID-19 can recover at home. However, if you develop emergency warning signs — pain or pressure in the chest; disorientation or confusion; pale, gray or blue-colored skin, lips or nail beds; difficulty breathing; or an inability to wake or stay awake — get medical attention immediately.
