COVID-19 Cases Rising As New ‘Stratus’ XFG Variant Emerges: What to Know

• A recent uptick in COVID-19 cases has been linked to a new Omicron subvariant XFG known colloquially as “Stratus.”
• New CDC data indicate that “Stratus” has become the predominant variant in the United States.
• As of August 5, CDC data shows that COVID-19 cases are rising in 45 states.
• In light of recent changes to COVID-19 vaccine recommendations,understanding how symptoms of the disease present can help minimize transmission.

Forecasting projections from the Centers for Disease Control and Prevention (CDC) indicate that COVID-19 infection rates are rising.

This late-summer rise in infections is likely driven by a fresh Omicron subvariant, XFG, commonly referred to as the “Stratus” variant.

First identified in January in parts of Southeast Asia, the XFG subvariant began to spread internationally. By June, XFG had been reported in 38 countries and made up about 22% of COVID-19 cases. The World Health Organization (WHO) subsequently labeled it a “variant under monitoring.”

Recent CDC figures also show COVID-19 test positivity rates have climbed by 8.6%, though hospital admissions for the respiratory illness remain relatively low.

Waves in SARS-CoV-2 case counts are usually driven by more transmissible mutations combined with waning immunity from prior infection or vaccination.

“We are settling into COVID being a more seasonal respiratory virus,” said Rishi Khakhkhar, MD, Chief Medical Officer at Counsel Health and an emergency physician at Mount Sinai.

“This pattern will bring periodic increases in infections and, regrettably, some hospitalizations, though severe illness is far less frequent than during the early pandemic waves because most Americans have had COVID at least once by now,” Khakhkhar told Healthline.

Access to COVID-19 shots may be restricted

Although existing COVID-19 vaccines may still provide protection against the new subvariant, recent policy shifts around vaccination could reduce availability.

For example, Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. recently withdrew $500 million in funding for mRNA vaccine research programs.

The Health Secretary also announced earlier this spring that the CDC will no longer recommend COVID-19 vaccines for pregnant people and young children. Similarly, the Food and Drug Administration (FDA) will not approve updated COVID-19 vaccines for those under 65.

As noted in a paper published in the New England Journal of Medicine, exceptions will be allowed for children and adults with at least one medical condition that increases their risk of severe COVID-19.

“High-risk and immunocompromised individuals in particular should make sure to stay current on the latest COVID vaccination,” Khakhkhar advised.

Symptoms of ‘Stratus’ and other Omicron subvariants

COVID-19 symptoms frequently resemble those of other respiratory infections such as the flu, but they can also be wide-ranging.

Monica Gandhi, MD, MPH, a medicine professor at the University of California, San Francisco, noted that the symptom profile of evolving Omicron subvariants resembles that of prior SARS-CoV-2 strains.

“There is no evidence that the symptoms caused by [new variants] differ from the symptoms caused by other Omicron subvariants,” Gandhi said. “The symptoms seem to be the same as with other recent subvariants of Omicron.”

A 2020 study suggested that common COVID-19 symptoms may appear in a particular sequence, but as the virus has changed, symptom patterns have become more diverse.

Generally, COVID-19 symptoms may include upper respiratory signs such as:

• fever
• cough
• sneezing
• runny nose

Other frequent symptoms include headache and muscle or body aches. In some instances, COVID-19 can lead to gastrointestinal issues, including nausea, vomiting, or diarrhea.

If you experience any of the symptoms above and test positive for COVID-19, you may have contracted one of the recent subvariants. It’s prudent to inform people you’ve recently been in close contact with.

Most COVID-19 symptoms resolve without medical care. Ways to ease symptom discomfort include:

• rest
• staying well-hydrated
• over-the-counter pain relievers and fever reducers

If symptoms continue, consult a healthcare provider for treatment. They may prescribe the antiviral Paxlovid if you are still within five days of symptom onset.

In severe cases of COVID-19, hospitalization may be necessary.

Gandhi added that immunocompromised people, older adults, and those lacking immunity may be at risk of more serious lower respiratory tract illness such as pneumonia. If you are immunocompromised, test positive, and develop symptoms, seek medical evaluation.

Should you worry about new COVID subvariants?

People who have been vaccinated against COVID-19 are likely protected from severe disease caused by Omicron subvariants, including the “Stratus” variant.

The updated COVID-19 shots are aimed at protecting immunocompromised individuals, people with multiple medical conditions, and adults 65 and older.

“I am not very concerned about the new variant because COVID-19 is not an eradicable virus, so we will always see new subvariants,” Gandhi said.

“However, we currently have high levels of population immunity in the United States. Memory B cells — whether from vaccination or from a prior infection — have been shown to recognize the virus, including its variants. Specifically, when memory B cells encounter a variant, they can produce antibodies tailored to that variant or subvariant,” she explained.

Gandhi also pointed out that both vaccines and natural infection stimulate T cell production.

“B cells act as memory reserves to make antibodies when required, and T cells both assist B cells in antibody production and recruit cells to attack the pathogen directly. T cell immunity from vaccines remains protective across variants, ‘from alpha to Omicron.’ Our T cell response, even against a mutated spike protein, is robust enough that we have not observed a failure of cellular immunity to counter severe disease from the mutated virus,” Gandhi concluded.