Another year, another variant. As Covid-19 cases rise in New York City once again, many New Yorkers are left with questions. Reporter Andrea Pineda-Salgado spoke to Dr. Mark Horowitz who has partnered with us and our vaccine efforts about the new variant and what we can do to stay safe.
The following has been condensed and edited for clarity.
Epicenter-NYC: What is the new variant, what is it called and what do we know about it so far?
Dr. Horowitz: There is a new variant, called XBB1.5 that has been identified in the last couple of weeks and comes out of a new variant that came out a couple of months earlier called BQ1. These variants are essentially mutations of the original Omicron variant of Covid. What’s happening with this virus is that it is undergoing very rapid mutations. When I say mutations, I mean that it has had some changes in its genetic material. With each new variant we see the ability of the virus to infect people who’ve been previously vaccinated or previously infected, or both. The virus is becoming smarter, fortunately, it doesn’t seem to be becoming more dangerous — at least for people who are healthy or vaccinated and boosted.
Epicenter-NYC: What are some of the variant’s common symptoms?
Dr. Horowitz: The symptoms of Covid really haven’t changed over the last year. The majority of people who are infected with new variants have symptoms that the old variant did. These include flu-like symptoms of fever, nasal congestion, cough, sore throat. Some people still have loss of taste and smell. Although that seems to be a little less common than the original versions of Covid. If I had to emphasize one difference in the current variant from previous variants, it would be sore throat and hoarseness of the voice. I’ve seen people in the last two to three weeks who have tested positive for Covid who’s only presenting symptoms were hoarseness of the voice and sore throat. They haven’t necessarily had a fever, they haven’t had loss of taste or smell. It seems, at least to me anecdotally, that this current XBB1.5 variant seems to have an affinity for the throat and voice box.
Epicenter-NYC: If you get the variant, how long will it last?
Dr. Horowitz: The rate of the illness depends upon the immune status of the patient. If you’ve been vaccinated and boosted — 12 to 15 days. If you’ve been vaccinated and boosted and you’re fortunate enough to have a primary care doctor who prescribes the antiviral medication Paxlovid for you, you could be done with it as quickly as five days. In most cases, it’s over in 11 days or less. In some cases, particularly with the antiviral medication, it could last as little as six days.
Epicenter-NYC: How do you know if you have the variant?
Dr. Horowitz: Routine antigen tests that we do on our own on a regular basis, do not discriminate between various variants. It’s up to the Department of Health to inform what variants are prevalent. What they do is they examine 200 or 300 samples to determine what variant they are.This is how they discover when a variant is emerging and characterize what percentage of infections in the community are caused by this variant. In the last four weeks, approximately 75% of infections in the New York area have been caused by this XBB1.5. The tests that you do at home tell you if you have Covid or not, but don’t tell you what variant you have.
Epicenter-NYC: What are restrictions like now? If one of our family members has Covid do we still have to quarantine? Do we mask up? What do we do?
Dr. Horowitz: I think the best answer is it’s always better to be safer than sorry. These variants have a very high likelihood of being spread by human contact. If a family member, a coworker, a close friend, a roommate or someone else has Covid, the individual involved should monitor themselves for symptoms. The minute any symptoms develop: test and test more than once. In the meantime, to protect others around you, it’s imperative that you wear a mask. Let’s say you have dinner with someone and the next day they call you and say, ‘Hey, I just tested positive for Covid.’ What should you do? Number one is you should monitor yourself for symptoms, and the second you develop any symptoms you should test yourself. If your test is positive, you should call a healthcare professional and talk about antiviral therapy. If your test is negative, you should test the following day again and probably after that. In the meantime, even if your test is negative, if you’ve been exposed to someone with this new variant, you should certainly wear a mask when you’re in close proximity to other people.
Epicenter-NYC: Let’s say you are someone who got the booster when they were first made available about a year ago — will that be enough to protect against the variant?
Dr. Horowitz: Probably not. If you had three or more doses of the vaccine at least a year or more ago, the protection against the current variant is weak. It’s not zero, but it is weak. If you were exposed, you could get a mild illness, not a severe illness, unless you’re elderly or immunosuppressed. But the additional dose of the so-called Bivalent booster, which was available in September, will really strongly protect you against severe disease. I’ve had patients who have been infected in the last two to three weeks who’ve already received three or even four vaccines, including the Bivalent vaccine. And frankly, they’re bored to death during the five days they have Covid. I say that lightheartedly, but I say that honestly, they’re more bored than sick. They may have a day or two of sniffles and sore throat, but then while they’re waiting for their quarantine they feel mostly back to normal. The Bivalent booster really, really does help reduce the severity of illness.
Epicenter-NYC: So, would you recommend people to get boostered again?
Dr. Horowitz: Absolutely. If you have not had the Bivalent booster — if you haven’t gotten the booster since September, you should absolutely get the new Bivalent booster. However, if you’ve had Covid in the last six months, you probably can defer the booster because the natural infection with Covid caused the booster effect in your body. If someone has had Covid between August 2022 and now, they probably don’t need the Bivalent booster yet, they can probably wait until six months after their infection cleared to get it. But if you haven’t had Covid in the last six months and haven’t had a booster in six months, then you absolutely would be well advised to take the Bivalent booster.
Epicenter-NYC: What can we continue to do to protect ourselves and our loved ones?
Dr. Horowitz: The main thing again is if you’re in a crowded place, you’re in a public place: wear a mask. I know a minority of New Yorkers still wear masks, but really is the best protection there is.
Epicenter-NYC: Do you think cases are bound to rise again or are they set to die down soon?
Dr. Horowitz: I think Covid is here to stay. I don’t think in the foreseeable future Covid will be out of our lives, I think this virus will continue to mutate as other viruses do. When you think about the flu every year the virus is different and every year the vaccine is different — it’s the same thing with Covid. Every couple of months, this virus changes a little bit. Thankfully, the virus hasn’t changed to become more harmful. If anything, it’s become a little less harmful. But I think the virus is here to stay.
Epicenter-NYC: Is there anything else you’d like for us to know?
Dr. Horowitz: I would say that everybody is sort of tired of Covid. Everybody is. As a result, some people have let their guard down or some people have felt that they don’t really need to take another dose of the vaccine. I would encourage people to question themselves and their health care providers and consider getting the booster even if you feel like you have had enough of Covid and enough of the vaccine. The booster really helps prevent severe disease, and hopefully in the future you won’t need to get a booster every three or six months, but it’ll be every year or even less frequently. But at this point, the virus is changing so rapidly that you’re doing it yourself and the people around you. If you’re vaccinated and you’re protected, you’re going to spread the virus to fewer people around you and you never know who you are sitting next to on the subway — someone who might have a chronic disease, someone elderly or someone with immune disease. So if you are not doing it for yourself, do it for your fellow New Yorkers. Do it for the person sitting next to you.