‘Mild’ COVID Doesn't Mean What You Think It Does

Omicron is often described as a milder illness, but that doesn't always capture what it means to have the virus.
Dalibor Despotovic via Getty Images

As omicron cases explode in the United States, health officials have offered stark warnings about our collective future. The variant is so contagious, “most people are going to get COVID,” Janet Woodcock, the acting head of the Food and Drug Administration, recently said. Two years into the pandemic, that’s not the news anyone wanted. So, many people are taking solace in emerging evidence suggesting omicron really does cause milder symptoms than previous variants. There’s a lot of talk about just getting omicron — and getting it over with.

But that’s misguided for many reasons, not the least because there is still so much experts don’t know about this variant and how it works. It’s also problematic because many people’s sense of what it means to have a “mild” case of COVID-19 is really ... off.

Here’s what you need to know about what mild actually means — and what it doesn’t.

First, the definition of mild isn’t set in stone.

For health care providers and laypeople, the term tends to conjure up pretty different things.

You or I might hear “mild” and imagine spending a few days with a cough or sniffle. And we might hear “moderate” and think of being knocked out in bed with a fever for a week. But doctors tend to have a higher bar for when someone is considered really sick.

Just look at the National Institutes of Health’s definitions. According to the agency, you can have a “mild” COVID-19 case that includes any combination of fever, cough, sore throat, malaise or profound fatigue, a headache, muscle pain, nausea, vomiting, diarrhea, or a loss of taste and smell.

You’re considered moderately ill if the disease has spread into your lower respiratory system, or your oxygen saturation levels have dipped past a certain point.

To complicate matters further, not every health group or health care provider uses exactly the same terms. Some refer to “severe” versus “non-severe” disease. All of that is important to keep in mind as you read news reports about mild COVID-19 and think about what a case might mean for you or your family.

So you could have a ‘mild’ case of COVID and not be able to get out of bed.

Some of the terminology around the severity of COVID-19 is fluid, but one thing that is clear is that having mild COVID-19 is not the same thing as having an asymptomatic case. Asymptomatic COVID-19 means you do not develop any symptoms during the course of your infection.

Preliminary data suggests that asymptomatic infections are quite common with omicron, though again it’s still too soon to say with any certainty — and monitoring asymptomatic transmission depends heavily on regular testing.

Mild infections, on the other hand, exist on a spectrum. You might experience a few days of feeling off, like you’ve got a cold. Or you could feel really terrible, like you’ve got a bad case of the flu.

“The big question is whether or not you’re able to recuperate at home,” Carl Lambert Jr., a Chicago-based family physician, told HuffPost. If you can — even if that means you’re really not able to do anything, and you need days or even weeks of rest, fluids and medication — you’ve still got a “mild” case.

“When I talk to patients, I explain that moderate or severe means that you had to go to the hospital and they had to keep you to watch you,” he explained.

Mild (and even asymptomatic) illness has led to long-term complications.

Another reason to take COVID-19 seriously is the clear evidence that even people with no symptoms during their infection have developed long-haul COVID-19. Studies from last summer suggested that about a quarter of patients with mild or asymptomatic cases went on to experience long-term symptoms, like brain fog, migraine and fatigue.

Researchers are still exploring the connection between mild illness from omicron and long-haul COVID-19. Even if studies don’t ultimately show that is the case, there’s recent anecdotal evidence of people grappling with “mild” infections that have at least made them miserable for a month or longer.

Vaccines protect you against getting really sick.

So yes, a mild case of COVID-19 might knock you out for a week or two. That’s no fun and it can be a significant logistical challenge. Getting vaccinated helps ensure your illness does not develop into something more serious. There’s also evidence that getting vaccinated helps lower your risk of developing long-haul COVID-19.

Hospitalizations are soaring right now, and there is early evidence from places hit hard by omicron at the beginning of the current surge that deaths might begin to spike too.

But the risk is simply much higher if you haven’t been immunized. Recent estimates suggest that you’re 17 times more likely to go to the hospital if you’re not vaccinated against COVID-19. If, on the other hand, you’re vaccinated and boosted, you’re much more likely to experience mild symptoms or no symptoms at all.

“The patients who are having mild symptoms usually are patients who are vaccinated and boosted,” Lambert said.

Experts are still learning about COVID-19. The information in this story is what was known or available as of publication, but guidance can change as scientists discover more about the virus. Please check the Centers for Disease Control and Prevention for the most updated recommendations.

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