309Write - Omicron symptoms: What we know about the illness caused by the new subvariants

Subvariants of omicron continue to be the dominant causes of Covid infections around the globe. The original version of omicron, now referred to as BA.1, was first detected in November 2021 and later went on to cause a massive surge in cases in the U.S. last winter.
Since then, new omicron subvariants have emerged and subsequently waned away. The BA.5 subvariant, which dominated through October, has given way to a slew of other subvariants, all of which are vying for control. These subvariants go by names such as BQ.1.1, BF.7 and BA.4.6.
But do they cause more severe illness?
Here's what experts have to say about the infection symptoms caused by the latest omicron subvariants.
What are the symptoms of omicron subvariants?
Anecdotally, doctors say, the symptoms of the latest omicron subvariants are mostly similar to those of the earlier version of omicron.
Dr. Roy Gulick, the chief of infectious diseases at Weill Cornell Medical Center and NewYork-Presbyterian, said typical symptoms of the omicron subvariants include:
  • Sore throat
  • Hoarse voice
  • Cough
  • Fatigue
  • Nasal congestion
  • Runny nose
  • Headache
  • Muscle aches 
Unlike earlier variants like delta that affected the lungs, omicron and its subvariants tend to cause more upper respiratory symptoms, said Dr. Armando Meza, chief of infectious disease at Texas Tech University Health Sciences Center in El Paso. Those symptoms can include congestion, sore throat and changes in taste and smell.
Dr. Joseph Khabbaza, a pulmonary and critical care physician at the Cleveland Clinic, said symptoms can be vague, similar to what is seen with any kind of flu-like virus.
Still, it is virtually impossible for people to rely on symptoms to self-diagnose an illness. Doctors urge people who have any cold symptoms or flu-like symptoms to get tested.
Meza noted that when people are tested for Covid, the tests don’t look for which variant the person has.
“We assume that the most prevalent variant in the community is the one that they got infected with,” he said. “There really shouldn’t be a big difference in terms [of symptoms] that you can tell one from the other. It’s really more of a subtle difference that you find out after the fact.”
Do the omicron subvariants cause less severe illness?
Omicron and its subvariants have, for the most part, caused less fatal infections than previous variants, Meza said, especially compared to what was seen with the delta variant and the original strain of the virus. 
Part of the decrease in severity may be because the virus tends not to burrow deeply into the lungs as much as previous variants, but remains higher up in the respiratory tract, experts say.
In that way, the illness may act more like bronchitis than pneumonia, said Dr. Hugh Cassiere, the director of critical care services for Sandra Atlas Bass Heart Hospital at North Shore University Hospital on Long Island, New York.
“Usually patients with acute bronchitis tend not to be short of breath. They tend to cough and produce sputum,” Cassiere said. “Patients with pneumonia tend to be short of breath and feel more fatigued than bronchitis in general.”
Khabbaza said that recently, Covid cases he’s seen in the ICU have had a lesser degree of severity than earlier in the pandemic: Patients haven’t needed to be on oxygen for as long and have stayed in the hospital for shorter periods of time.
Another possible factor in decreased severity is increased prior immunity. “People are also getting less sick because their immune system has seen it already,” Khabbaza said.
Does the vaccine or booster protect against the omicron subvariants?
In August, the Food and Drug Administration authorized a new version of the Covid booster that targets the spike protein of both the BA.4 and BA.5 subvariants. This booster also targets the original strain of the virus that was first detected in Wuhan, China, in late 2019.
During the first omicron wave, the variant caused a milder illness in people who were up to date on their Covid vaccinations.
Drugmakers Pfizer and Moderna have yet to release data on how effective their updated boosters are against infection, severe illness and death, though Pfizer has said that its new booster generates a stronger immune response against BA.4 and BA.5 than the original vaccine.

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