The New EG.5 and BA.2.86 COVID Symptoms You Should Know About
COVID-19 has been a presence for years now, so you probably have at least some idea of what signs of the virus to look for. But the virus has changed over time—and so have COVID symptoms.
The EG.5 variant (dubbed “Eris”) now makes up more than 20% of new COVID cases in the U.S., and BA.2.86, nicknamed “Pirola,” is another new variant making headlines. As coronavirus cases continue to grow, it’s understandable to have questions about what new COVID variant symptoms look like in 2023.
At the same time, COVID hasn’t been on many people’s radar for a few months. What should you do if you test positive these days? Doctors break it all down.
What is the EG.5, a.k.a. “Eris,” variant?
Nicknamed “Eris,” EG.5 is a descendent of the Omicron variant of COVID-19, explains William Schaffner, M.D., an infectious disease specialist and professor at the Vanderbilt University School of Medicine. “Think of Omicron as the ‘grandfather’ of ‘Eris,’” he says. “‘Eris’ is highly contagious, as was Omicron, but it is not causing more severe disease. That’s very, very good.”
The World Health Organization (WHO) has spoken about the rise of “Eris,” noting in an initial risk evaluation that “the public health risk posed by EG.5 is evaluated as low at the global level.”
What is the BA.2.86 variant, nicknamed “Pirola?”
BA.2.86, a.k.a. Pirola, is another new subvariant of Omicron that’s been detected in specific locations around the globe. According to the WHO, it was first sequenced on July 24, and so far only seven cases have been reported.
Pirola is a descendent of BA.2, according to an analysis from the Bloom lab, which studies the evolution of viruses and proteins. One aspect of the variant that is of concern is that there are 34 mutations in the spike protein of BA.2.86—which the virus uses to infect a person’s cells—from BA.2, Bloom lab says.
What are COVID symptoms in 2023?
So far, EG.5 “seems to be the same in terms of symptoms,” says Thomas Russo, M.D., a professor and the chief of infectious diseases at the University at Buffalo in New York. The same goes for “Pirola,” infectious disease expert Amesh A. Adalja, M.D., senior scholar at the Johns Hopkins Center for Health Security, previously told Prevention. Those can include, per the Centers for Disease Control and Prevention (CDC):
Fever or chills
Cough
Shortness of breath or difficulty breathing
Fatigue
Muscle or body aches
Headache
New loss of taste or smell
Sore throat
Congestion or runny nose
Nausea or vomiting
Diarrhea
“Most people will have an upper respiratory tract infection, but some people will develop more serious disease, which will be a lower respiratory tract infection,” Dr. Russo says. “Some people develop non-respiratory tract symptoms, like diarrhea.”
Conjunctivitis, a.k.a. pink eye, may also be a symptom, Dr. Schaffner says.
Overall, Dr. Russo says that “Eris,” or EG.5, “is behaving like other Omicron variants in terms of symptoms.” One thing that’s less likely with “Eris,” though, is loss of taste and smell, Dr. Russo says.
Will you need a new booster vaccine?
Back in June, the U.S. Food and Drug Administration (FDA) announced that it would ask COVID vaccine makers to focus on using a single component in their vaccines that is targeted at the XBB.1.5 variant, which is a descendent of Omicron.
“The new booster is going to be a good match for ‘Eris,’” Dr. Russo says. “It’s only two amino acids difference in the spike protein.”
There is a COVID-19 booster currently available based on previous formulations. But, if you don’t fall into a high-risk category for severe complications from COVID-19, Dr. Russo recommends waiting until September, when the new vaccine is expected to roll out.
If you’re considered high risk for severe complications from COVID-19, Dr. Russo says there are a few options to consider. “If you’re going to be really careful and aren’t going to any functions where you can’t wear a mask, I would hold off and get the new booster when it’s available,” he says. “However, if you are high risk but there’s an event coming up where you know you won’t wear a mask, I would go ahead and get the old hybrid booster. It’s better to protect yourself with the waning immunity if you’re high risk.”
There aren’t currently recommendations on who should get the new booster (and when), but they should be issued soon-ish, Dr. Schaffner says. His advice: “Listen to the recommendations. I would certainly enthusiastically support getting it.”
While Dr. Schaffner acknowledges that “Eris” is causing mild illness, he stresses that “mild” means something different to the medical community than it does for everyone else. “‘Mild’ means that you don’t need to be hospitalized,” he says. “If you get ‘Eris,’ you can feel miserable for two to three days, at least. Not everyone who gets ‘Eris’ will say, ‘Gee, that was mild.’ It can put you out of sorts and make you feel miserable.”
Unfortunately, vaccines protecting against BA.2.86 are more up in the air right now. “The mutations that it possesses would likely pose problems for the current and future formulations of the vaccines,” Dr. Adalja previously told Prevention. “However, it is unclear—at this time—if this is going to actually spread in a manner that will be significant.”
However, experts agree that any form of protection is better than none. Dr. Schaffner points out that the new booster won’t just offer protection through the fall. “It will help protect against serious disease going through the winter,” he says. “That’s where we expect a notable increase in COVID.”
What to do if you test positive for COVID
If you test positive for COVID, Dr. Russo recommends contacting your primary care physician, if you have one. Antiviral treatments like Paxlovid could help shorten how long you’re sick and lower your risk of developing serious complications from COVID, including long COVID, he says. Note: Anti-viral medications work best when they’re taken as soon as possible, so it’s important to test yourself and call your doctor ASAP if you have symptoms.
The CDC also recommends that you isolate for at least five days from when you first developed symptoms of the virus. If you need to be around others, the CDC recommends wearing a high-quality mask. Isolation can end after day five or when you’re fever-free without the use of medication.
Dr. Schaffner acknowledges that “not everyone is doing that” when it comes to following isolation guidelines. “They are reverting to their usual way of doing things, which I don’t endorse,” he says. If you test positive for COVID-19, he says it’s really best to stay home—both for your health and to help keep others from getting sick.
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