As fall settles in across the United States, a familiar yet evolving threat is making headlines once again: new COVID-19 variants driving a noticeable uptick in cases.
Dubbed Nimbus (NB.1.8.1) and Stratus (XFG), these Omicron subvariants are not only spreading rapidly but are also linked to some peculiar symptoms that are catching both patients and doctors off guard. With wastewater surveillance signaling moderate to very high levels in several states, health experts are urging vigilance without veering into alarm.
The variants have gained significant ground in recent months. Stratus, first detected in Southeast Asia back in January and arriving in the US shortly after, now dominates the landscape.
By early September, it accounted for a staggering 80% of sequenced COVID cases nationwide, up from a mere 3% in May. Nimbus, another swift-moving Omicron descendant, is contributing to this momentum, particularly in the Northeast where infection rates are climbing.
According to the Centers for Disease Control and Prevention (CDC), national wastewater levels -- a key indicator of community transmission -- peaked in mid-September before beginning a slight decline.
However, the picture is patchier on the ground: four states, including Nevada, Utah, Delaware, and Connecticut, are reporting "very high" levels, with the Northeast showing the most concerning rises. This regional hotspot echoes patterns from previous waves, but experts emphasize that these strains aren't packing a deadlier punch than their predecessors.
"It's clear that COVID activity is on the rise again," says Dr. Tyler Evans, an infectious diseases expert and former New York City chief medical officer during the pandemic's early days.
"While we're in a much better place than in 2020, rising transmission still poses a risk to those with underlying conditions or limited access to care. Concern should lead to preparedness, but not panic."
What sets Nimbus and Stratus apart isn't just their transmissibility -- it's the way they're making people feel. Traditional COVID signs like headaches, coughs, fatigue, and nasal congestion persist, but reports of more distinctive woes are flooding clinics.
Patients are describing a throat pain so intense it's likened to "razor blades," alongside a raspy, croaky voice that lingers like a bad case of laryngitis.
Dr. Aaron Glatt, an infectious disease specialist at Mount Sinai Hospital in New York, has fielded numerous complaints of this caliber. "Patients were complaining of 'severe pain, as if their throat is covered with razor blades'," he shared.
"While not specific to [COVID-19], this expression has been used to describe sore throat symptoms in some patients with the most recent COVID-19 variant."
These symptoms, while uncomfortable, don't signal greater severity overall. "The dominant strain in the US right now is an Omicron subvariant called Nimbus (NB.1.8.1). It spreads quickly but is not more severe than earlier forms," Dr. Evans adds.
"It can still be dangerous for older adults, people with chronic conditions, and those with weakened immune systems." The variants' genetic tweaks appear geared toward evasion and efficiency in spreading, rather than ramping up virulence -- a silver lining in an otherwise unwelcome resurgence.
Even as cases rise, the specter of long COVID looms large. Mild infections aren't a free pass; they can still leave lasting marks.
Dr. Laura Malone, director of the Pediatric Post-COVID-19 Rehabilitation Clinic at Kennedy Krieger Institute in Baltimore, warns against complacency: "Just because you got through your first infection and didn't develop long COVID, it's not that you are completely out of the woods."
Vaccination remains the strongest shield, yet uptake is faltering amid eligibility confusion. A recent CDC advisory panel opted against broad recommendations for boosters, favoring "individual decision-making" instead -- a move that could inadvertently curb access and fuel further spread.
In the UK, where cases are also ticking up (positivity rates jumped from 7.6% to 8.4% in a week, with hospital admissions rising), targeted boosters are rolling out for those over 75, immunocompromised individuals, and care home residents.