New COVID Variant HV.1: What To Know About Symptoms – TODAY

As the United States enters respiratory virus season and health officials roll out updated COVID-19 vaccines, a new COVID variant HV.1 has emerged and is currently sweeping the country.

The new omicron subvariant has rapidly overtaken other strains, including EG.5 aka Eris, to become the dominant variant in the U.S. As of late October, HV.1 is responsible for more than a quarter of all COVID-19 cases, and health officials are monitoring the new variant amid concerns of a winter COVID-19 surge.

HV.1 accounted for an estimated 25.2% of new COVID-19 cases during the two-week period ending Oct. 28, according to the latest data from theU.S. Centers for Disease Control and Prevention.

After HV.1, the next most common variant in the U.S. was EG.5, which made up 22% of cases, followed by FL.1.5.1 or Fornax, and XBB.1.16 orArcturus. (Globally, EG.5 is still the dominant strain, according to the World Health Organization.)

All of the most prevalent COVID-19 strains in the U.S. are offshoots of omicron, which first emerged in November 2021.

Although COVID-19 cases and hospitalizations have been trending downward after a late summer surge, HV.1 is continuing to pick up speed around the country.

Cases are expected to increase again this winter as was the case the past three years, Dr. William Schaffner, professor of infectious diseases at Vanderbilt University Medical Center, tells TODAY.com.

As HV.1 spreads, many are curious if the new subvariant is more contagious or severe, whether it could cause different symptoms, and if the new COVID-19 vaccines will provide protection. Heres what we know about HV.1 so far.

HV.1 is part of the omicron family. You can almost think of HV.1 as a grandchild of omicron, says Schaffner. HV.1 is a sublineage of omicron XBB.1.9.2 and a direct descendent of EG.5, according to the CDC's SARS-CoV-2 lineage tree.

The COVID family of viruses likes to mutate. Weve all learned that by now," says Schaffner. While HV.1 is mutated, it's still very close to the existing omicron subvariants, Schaffner explains.

For the most part, scientists are not concerned about new variants like HV.1, which look very similar to strains we've already seen before, NBC News reported.

However, there are a few highly mutated strains which have set off alarm bells. These include BA.2.86 or Pirola, which has an extra 36 mutations that differentiate it from XBB.1.5., and a newer variant called JN.1, which has one more mutation than Pirola.

Fortunately, neither BA.2.86 nor JN.1 are common in the U.S. right now, according to the CDC JN.1 is so rare that it makes up fewer than 0.1% of SARS-CoV-2 cases.

As for HV.1, it rapidly gained steam after it was first detected this past summer. In late July, HV.1 accounted for just 0.5% of COVID-19 cases in the U.S., CDC data show.By Sept. 30, HV.1 made up 12.5% of cases, and by November, it was the dominant strain.

One of the characteristics of this entire omicron family is that they are highly transmissible," says Schaffner. Sometimes, mutations can enable a new variant to spread more effectively or quickly, per the CDC.

Right now, it appears that HV.1 could be slightly better at spreading from person to person than previous strains, NBC News reported. The increased transmissibility of HV.1 likely explains how it became dominant so quickly in the U.S., Schaffner notes.

It appears that HV.1 could also be slightly better at escaping prior immunity to COVID-19, but not enough to cause alarm, Dr. Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston, told NBC News.

Although it is more transmissible, HV.1 does not appear to produce more severe disease or lead to more hospitalizations, Schaffer says.

The symptoms caused by infection with HV.1 are similar to those caused by recent variants, says Schaffner, which include:

Congestion, sore throat and dry cough seem to be the three most prominent symptoms right now, says Schaffner.

Increasingly, doctors report that COVID-19 symptoms appear to follow a pattern of being concentrated in the upper respiratory tract, starting with a sore throat and followed by congestion or a runny nose, NBC news reported.

Coughing isn't typically a primary symptom, but it can persist. "The virus seems to produce a kind of a chronic bronchitis, so that you can have a cough syndrome that lasts beyond the period where youve recovered from other symptoms," says Schaffner.

Another trend is that COVID-19 seems to be causing milder infections, likely because people have some prior immunity. By milder, we mean it doesnt require hospitalization even though you can feel quite miserable for several days, says Schaffner.

All COVID-19 tests including PCR tests performed by a health care provider and rapid at-home antigen tests will detect HV.1, says Schaffner.

Testing is a crucial tool to protect yourself and others from COVID-19. The symptoms of HV.1 and other COVID-19 variants can look very similar to other viruses, including respiratory syncytial virus (RSV), influenza and rhinovirus, which usually causes the common cold.

"The only way to distinguish (COVID-19) from RSV and flu, both of which are now gaining steam, is by testing," says Schaffner.

Experts encourage anyone who has symptoms to get tested, especially those in high-risk groups people over the age of 65, who are immunocompromised or who have underlying health conditions.

We have treatments that can prevent more serious disease," says Schaffner, but early detection is key. COVID-19 antivirals such as Paxlovid are effective against HV.1 and other variants, but they work best when within five days of symptom onset, TODAY.com previously reported.

Testing has significantly diminished in the U.S. in the last year, which is concerning, says Schaffner.

When the U.S. federal public health emergency for COVID-19 ended in May, so did the guarantee of free testing for many people.

However, every American can still get COVID-19 tests for free or low-cost right now. One way is to order four free at-home COVID-19 tests from the government, which will be delivered by mail via the U.S. Postal Service. To order your free tests, go toCOVIDTests.gov.

In addition, all health insurance plans are required to reimburse eight at-home COVID-19 tests per month, according tothe Centers for Medicare & Medicaid Services. State Medicaid programs are also required to cover at-home tests, and Medicare beneficiaries and uninsured individuals can access free tests provided by Health & Human Services at thousands of community health centers, clinics and pharmacies.

If you still have a stockpile of tests sitting around, remember to check the expiration date and whether it's been extended bythe U.S. Food and Drug Administration.

The updated COVID-19 vaccine is recommended by the CDC for everyone ages 6 months and older. It is now widely available at pharmacies, doctor's offices and other locations around the U.S., says Schaffner.

The new boosters have been reformulated to target omicron XBB.1.5, which was the dominant COVID variant for most of 2023. While XBB.1.5 has since been overtaken by HV.1, Eris, Fornax and Arcturus, it is still closely related to these newer strains.

The updated vaccines seem to be well-matched to the variants currently circulating and making people sick, Andrew Pekosz, Ph.D., virologist at Johns Hopkins University, previously told TODAY.com.

Laboratory studies indicate that the updated booster will protect against serious disease caused by HV.1, says Schaffner. Vaccination also significantly lowers the risk of becoming hospitalized or dying, per the CDC.

However, only 23 million Americans or 4.5% of the population had received the updated shots by Oct. 27, Reuters reported.

The first phase of the new booster rollout hit several speed bumps, including supply delays, high demand, cancelled appointments and insurance obstacles. Some parents have been unable to get theirkids vaccinatedas some pharmacies and pediatrician's offices have struggled to secure enough child-size doses.

Although many of these initial issues have been resolved, says Schaffner, uptake is still slow. "We've underutilized this updated vaccine, and we anticipate that COVID will once again increase even more during the winter season," says Schaffner.

It's not too late to take advantage of the new booster, Schaffner adds, and people should get the shot as soon as they can.

The FDA has authorized three vaccine options for 2023-2024:one mRNA shot each from Moderna and Pfizer, and a protein-based non-mRNA shot from Novavax.

Insurance plans should cover the updated booster, says Schaffner, and those without insurance should still be able to get the shot for free, according to the CDC.

Were in a good place because for a considerable time now, we have not had a new variant that causes more severe disease or evades the protection of currently available vaccines, says Schaffner.

As the winter and holiday season approaches, it's important to take steps to protect yourself from COVID-19 and prevent transmission to others, especially the most vulnerable. These include:

Caroline Kee is a health reporter at TODAY based in New York City.

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New COVID Variant HV.1: What To Know About Symptoms - TODAY