New COVID Variants: What You Need to Know Now

The COVID-19 virus continues to generate variants and change considerably. The amount of overall risk to public health remains in a manageable place due to individuals who are immune due to vaccination, immunity due to infection, or reports of non-mastering signals. It is necessary to remain cognizant of the current variant and its symptoms for your and your community’s health. This post will inform you of the current variants visible, including JN.1, NB.1.8.1, LF.7, and XFG.  We will inform you of what symptoms to look for and what to do about them.

Understanding the Latest COVID Variants

The virus that causes COVID-19 continues to mutate, creating variant strains of the virus. Some variants may behave differently than previous iterations with respect to transmissibility or ability to escape immunity build-up. At present, different sub-variant strains of Omicron are being tracked globally. 

• JN.1: This has been a dominant strain in much of the world, including India. JN.1 is a subvariant of Omicron that is a descendent of the BA.2.86 variant. Mutations in the spike protein allow JN.1 to be very transmissible, and while the mutations in the spike protein do help the virus bind to and enter cells, the mutations may also allow the virus to evade some immune responses.
• NB.1.8.1 and LF.7: These are new offshoots that have been seen mostly in India over the past few months. These variants are classified as “Variants Under Monitoring” by the WHO which means that these are not yet considered a threat to global health, but they are being monitored. In fact, they are contributing to rising case counts in parts of Asia.
• XFG: This is another Omicron subvariant circulating in regions like Europe, the US, and India, also showing flu-like symptoms.

Symptoms of New COVID Variants

While many symptoms of these new variants overlap with earlier COVID-19 strains and even common colds or flu, some distinct patterns have been observed, particularly with JN.1.

Common Symptoms across variants (including JN.1, NB.1.8.1, LF.7, XFG):

• Fever or chills (often persistent and low-grade with JN.1)
• Cough (can be dry or produce phlegm)
• Sore throat
• Fatigue/tiredness (muscle fatigue and exhaustion are significantly higher with XFG and JN.1)
• Headache
• Runny or blocked nose/congestion
• Muscle aches/body pain

More Frequently Reported or Distinct Symptoms (especially with JN.1):

It’s important to note that the severity of illness with these newer variants, particularly JN.1, NB.1.8.1, LF.7, and XFG, generally appears to be mild, especially in vaccinated individuals. However, increased transmissibility means they can still lead to a higher number of infections in a shorter period.

Low-Grade Fever: In prior variants of COVID-19, high fever was a prominent symptom. JN.1 infections typically produce an ongoing low-grade fever (typically somewhere between 37.6C and 38.1C; or 99.6 and 100.5F). Once again, in contrast to previous variants, the lower-grade fever may only be noted because the patient describes “feeling a little off,” and they may not show rapid breathing or a warm to the touch. The ongoing low-grade fever is fundamentally easy to ignore in routine practice. 

Gastrointestinal Symptoms appears to be a consistent increased frequency of gastrointestinal symptoms with JN.1. Symptoms now commonly include: gastrointestinal upset, nausea, loss of appetite, stomach upset, diarrhea. These are also noted frequently in patients with JN.1. Gastrointestinal symptoms have previously been noted in association with prior variants, however in comparison, frequency and proportion of patients with JN.1 appear to be typically elevated and have even happened before or concurrently to respiratory symptoms. 

Loss of taste or smell: This was once a classic feature of COVID-19 infection, however; its frequency in newer variants is less common.

Once again, we think it is imperative to emphasize that the new variants, JN.1, NB.1.8.1, LF.7, and XFG are generally less problematic than prior variants.

Treatment and What to Do If You’re Unwell

For most mild cases of COVID-19 caused by these new variants, treatment focuses on supportive care:

• Rest: Get plenty of rest to allow your body to recover.
• Fluids: Stay well-hydrated by drinking ample fluids.
• Over-the-counter medications: Use medications like acetaminophen (paracetamol) or ibuprofen to manage fever, headache, and muscle aches.
• Steam inhalation and gargles: These can help alleviate respiratory symptoms like sore throat and cough.

When to Seek Medical Advice:

• If your symptoms worsen.
• If you experience difficulty breathing or chest pain.
• If your oxygen levels drop (below 94%).
• If you are in a high-risk group (e.g., elderly, immunocompromised, those with underlying health conditions, pregnant women).

Antiviral medications like Nirmatrelvir with Ritonavir (Paxlovid), Veklury (remdesivir), and Molnupiravir (Lagevrio) are available for individuals who are at higher risk of developing severe illness. These treatments are most effective when started within 5-7 days of symptom onset. Consult your healthcare provider as soon as possible if you fall into a high-risk category and develop symptoms.

Prevention Remains Key

Despite the emergence of new variants, the fundamental preventive measures remain your best defense:

• Vaccination and Boosters: Staying up-to-date with your COVID-19 vaccinations and recommended boosters significantly reduces your risk of severe illness, hospitalization, and death.
• Masking: Wear high-quality masks (like FFP2 or N95) in crowded or enclosed spaces, on public transport, and when visiting vulnerable individuals.
• Hand Hygiene: Practice good hand hygiene by washing hands frequently with soap and water or using an alcohol-based hand sanitizer.
• Avoid Close Contact: Avoid close contact with sick individuals.
• Test if Symptomatic: If you experience symptoms, get tested for COVID-19 to confirm the infection. Rapid antigen tests are widely available, but an RT-PCR test is more accurate.

The continuous emergence of COVID-19 variants highlights the importance of ongoing vigilance. While these new variants generally cause milder illness, understanding their symptoms and taking appropriate precautions can help protect yourself and the wider community. Stay informed, stay prepared, and prioritize your health.