Doctors are increasingly unable to differentiate COVID-19 from allergies or the common cold, as the illness’s symptoms, such as dry cough and loss of taste or smell, are becoming less common, with milder disease primarily affecting the upper respiratory tract.
“It isn’t the same typical symptoms that we were seeing before. It’s a lot of congestion, sometimes sneezing, usually a mild sore throat,” said Dr Erick Eiting, vice chair of operations for emergency medicine at Mount Sinai Downtown in New York City.
According to Eiting, the sore throat usually arrives first before congestion.
Additionally, the Zoe COVID Symptom Study which collects data on self-reported symptoms in the UK found that sore throats became more common after the dominant omicron variant in late 2021, while loss of smell became less widespread.
Hospital admissions declined compared to the summer and fall of 2021, and doctors now describe a clearer, more consistent pattern of symptoms.
“Just about everyone who I’ve seen has had really mild symptoms,” Eiting said of his urgent care patients, adding, “The only way that we knew that it was COVID was because we happened to be testing them.”
How COVID-19 develops
Three doctors revealed how COVID-19 symptoms commonly begin with a sore throat these days but each doctor gave differing descriptions of the severity of a sore throat.
Dr Grace McComsey, vice dean for clinical and translational research at Case Western University, said: “Some patients have described a burning sensation like they never had, even with strep in the past. Then, as soon as the congestion happens, it seems like the throat gets better.”
Coughing isn’t a prominent symptom, but some patients also report headache, weariness, muscle pains, fever, chills, or post-nasal drip along with congestion, according to experts.
McComsey reports that fatigue and muscle aches typically last a few days, while congestion can last a few weeks. She estimates that only 10-20% of COVID-19 patients lose their sense of taste or smell.
Meanwhile, Eiting said he’s not seeing a lot of diarrhoea lately, either — a more common symptom in the past.
For the most part, the doctors said, few patients require hospitalisation and many recover without needing the antiviral pill Paxlovid or other treatment, according to NBC.
Dr Michael Daignault, an emergency physician at Providence Saint Joseph Medical Center in Burbank, California, says that since July, younger individuals with upper respiratory symptoms, such as cough, runny nose, sore throat, fever, and chills, 99% of the time go home with supportive care.
Why does COVID-19 seem milder now?
Dr Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston, attributed the mild symptoms to immunity from vaccines and previous infections.
He stated that the severity of COVID-19 is lower now than a year and two years ago, due to higher immune responses.
Other doctors believe that omicron, a variant of the virus, may have altered the presentation of COVID-19 symptoms.
Early versions of omicron were less effective in infecting the lungs. Currently, EG.5 and FL.1.5.1 are the most prevalent subvariants, while BA.2.86, a variant with numerous mutations, is also causing an increase in COVID-19 infections.
Although BA.2.86 cases are increasing in the US, it is not among the top variants. Barouch said the new booster shots should be effective against those three strains and others.