What Are the Symptoms of Omicron BA.4 and BA.5?

The new Omicron subvariants are now responsible for the majority of COVID-19 cases in the U.S.

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Fact-checked on July 14, 2022, by Marley Hall, a writer and fact checker specializing in medical and health information.

With every new COVID-19 variant, the conversation inevitably shifts to how the symptoms from this new mutation might affect our health—the BA.4 and BA.5 Omicron subvariants are no different.

These two new subvariants are now dominant in the U.S., making up over 80% of COVID cases, according to new data from the Centers for Disease Control and Prevention (CDC). BA.5 alone is responsible for 65% of cases.

And while the transmissibility of BA.4 and BA.5 certainly set them apart from other Omicron subvariants—CDC Director Rochelle Walensky, MD, in a Tuesday White House press briefing called it "more transmissible and more immune evading" than other Omicron variants—experts believe the symptoms of these strains aren't all that different.

Here's what we know so far about what a BA.4 or BA.5 infection might look like, and whether those symptoms are any more severe than other COVID-19 strains.

What are the Symptoms of BA.4 and BA.5 Variants?

Like the other Omicron subvariants that have been dominant in the U.S. since December 2021, experts say BA.4 and BA.5 mainly cause respiratory or cold-like symptoms—the Centers for Disease Control and Prevention (CDC) names cough, runny nose, congestion, and fatigue as the most common ailments people experience when they're infected with Omicron.

"COVID tends to present similarly and the presentation may vary from person to person, but the most common stuff we're seeing are fevers, congestion, [and] sore throat," Katie Passaretti, MD, vice president and enterprise chief epidemiologist with Atrium Health, told Health. "Often the sore throat is the kind of initiating symptom and then the rest kind of come on."

Once a hallmark of COVID-19 infection, losing your sense of taste or smell seems to be less common among patients getting sick now, Dr. Passaretti noted, and she's heard that with BA.5 or with Omicron more generally, people may experience worse fevers and sore throats.

Non-respiratory symptoms may also be associated with the newer subvariants, George Rutherford, MD, a professor of epidemiology at the University of California, San Francisco, told Health. Diarrhea, which was a common symptom for earlier variants, may turn up more, as well as other common COVID-19 symptoms like headache and muscle pain.

But because these subvariants have only been infecting large numbers of people for a short while, it may take some time to confirm these slight variations in symptoms beyond just what doctors are hearing anecdotally.

It's also important to remember that COVID-19 affects everyone differently. "I've heard people say, you know, [there are] adults who have had fevers of almost 40 degrees Centigrade [104 degrees Fahrenheit]," Dr. Rutherford told Health. "People said, 'It's the worst sore throat I've ever had.' Others say it's trivial."

Until there are many more people who have been sick with the BA.4 and BA.5 subvariants for a longer period of time, Dr. Rutherford said, it will be hard to pinpoint the specifics of these symptoms. But for the most part, he said, "it's all predominantly respiratory."

Milder disease may also be adding to the increased transmissibility of BA.5. The body's usually mild response to a BA.4 or BA.5 infection means a person may not realize they're spreading COVID-19. The actual number of cases, Dr. Rutherford estimates, might be more than twice as high as what's being reported.

"Mild disease [is] harder to detect because people are like, 'I just have allergies. I'm going to work,'" Dr. Passaretti said. "And then you get other people infected."

Are Symptoms of BA.4 and BA.5 Variants More Severe than Other COVID Strains?

Not only are the symptoms from a BA.4 and BA.5 infection similar to other Omicron variants, but they seem to have a similar severity, Dr. Passaretti and Dr. Rutherford said.

At Atrium Health hospitals, where Dr. Passarettti works, hospitalizations due to the BA.5 variant have spiked in recent weeks, as is the case in the rest of the country. But the greater number of hospitalizations due to COVID-19 is caused by the high number of infections, rather than the subvariants being more severe. Though more people are in the hospital, the number of deaths nationwide has plateaued since April.

"We aren't seeing at this point in time—although we continue to monitor closely—a steep increase in our number of ICU stays or deaths from COVID," Dr. Passaretti said. "But we are certainly seeing an increase in cases in the community, and that's spilling over to more patients admitted with COVID."

The milder symptoms—cough, sore throat, runny nose—can be easily dealt with at home. But if a person's oxygen levels drop and they start to feel dizzy or short of breath, they'll need to be treated for COVID-19 at a hospital. Avoiding deaths from the BA.4 and BA.5 variants should be approached like any other strain— "rapid diagnosis, early diagnosis, and treatment is the way to go," Dr. Rutherford said.

As is the case with the symptoms themselves, it may be too early to tell just how severely they might present in patients. In a Tuesday White House press briefing, Dr. Walensky noted that it's still too early to tell whether or not these symptoms are more or less severe than other variants, but that we still need to be vigilant in staying up to date on COVID-19 vaccines and boosters.

"We know that vaccine effectiveness against severe disease and death remains high for other omicron sublineages and likely also for BA4 and 5," she said. "So staying up to date on your COVID-19 vaccines provides the best protection against severe outcomes."

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