COVID-19 still matters, but not in the same way it did in 2020 or 2021. It no longer overwhelms hospitals or causes mass lockdowns. For most healthy people, a single infection is comparable to a bad flu. But the virus still kills, still causes lasting damage in some people, and still poses serious risks to older and immunocompromised adults. The honest answer is: it matters less than it used to, and more than most people think.
How Dangerous Is COVID Now?
By the 2023 to 2024 season, the short-term severity of COVID had converged with seasonal flu. The 30-day hospitalization risk for people who caught COVID was 16.2%, compared to 16.3% for influenza and 14.3% for RSV. The 30-day death rate was also similar across all three viruses that season, a meaningful change from earlier years when COVID was clearly deadlier.
The gap shows up further out. At 180 days after infection, COVID still carried a higher mortality risk than both flu and RSV. That difference points to something important: COVID’s damage doesn’t always happen right away. It can set off a chain of complications that play out over weeks and months, particularly in the cardiovascular system.
The Cardiovascular Risk Lingers
One of the clearest ways COVID continues to matter is its effect on the heart and blood vessels. Research from the National Heart, Lung, and Blood Institute found that people who caught COVID had double the risk of heart attack, stroke, and cardiovascular death compared to people who were never infected. For those who had severe cases requiring hospitalization, the risk was nearly four times higher.
What makes this finding striking is the timeline. The elevated risk persisted for up to three years after infection. Within each follow-up year, the increased chance of a major cardiovascular event remained significant, in some cases comparable to the risk posed by having type 2 diabetes. This was true even after accounting for people who already had heart disease before their infection. A study of excess mortality across 16 European countries noted that these findings are consistent with ongoing premature cardiovascular deaths among working-age adults, particularly men.
Long COVID Is Still Widespread
In 2023, 6.4% of U.S. adults reported experiencing Long COVID symptoms at the time they were surveyed. That translates to roughly 16 million people dealing with persistent fatigue, brain fog, shortness of breath, or other symptoms weeks or months after their initial infection.
The relationship between reinfection and Long COVID is more nuanced than early fears suggested. A large study of healthcare workers found that the cumulative risk of Long COVID among those who’d been infected was 17%. However, reinfections during the Omicron era carried about 40% lower risk of triggering Long COVID compared to first infections with earlier variants, and nonsevere infections carried 72% lower risk compared to severe ones. In other words, the combination of prior immunity and milder variants has reduced the per-infection risk, but with the virus circulating year-round, infections keep accumulating, and so does the overall burden.
Who Is Still at Serious Risk?
COVID’s remaining danger is concentrated heavily among older adults and people with weakened immune systems. Among nearly 1,900 hospitalized COVID patients studied during the 2024 to 2025 season, 57% needed supplemental oxygen, 19% experienced acute respiratory failure, and nearly 18% were admitted to the ICU. These are not mild outcomes.
The updated vaccines still help, but they don’t offer the same level of protection to everyone. For immunocompetent adults, the 2024 to 2025 vaccine reduced the risk of hospitalization by about 40% and cut the risk of ending up on a ventilator or dying by 79%. For immunocompromised adults over 65, the protection against hospitalization dropped to 36%. That’s meaningful but far from bulletproof, which is why antiviral treatment remains an important backstop for high-risk groups.
Treatments Work, If You Use Them
The oral antiviral most commonly prescribed for COVID reduced hospitalization risk by 68% overall in a large real-world study. For adults 65 and older with at least one additional risk factor, the reduction was 74%. That’s a substantial benefit, but it depends on starting treatment within the first few days of symptoms. Most people who could benefit from early treatment don’t seek it, either because they assume COVID is no longer serious or because they don’t test.
The Economic Footprint
COVID’s impact on the workforce hasn’t disappeared. An analysis for the Brookings Institution estimated that Long COVID reduced U.S. labor force participation by about 0.3 percentage points, representing roughly 700,000 people either out of work entirely or working fewer hours. A federal review confirmed that people with Long COVID are less likely to be employed and, if employed, work fewer hours than those without it. In a survey sample, 42% of people with Long COVID reported not having worked in the prior seven days. For an illness that many consider “over,” it still exerts a measurable drag on the economy.
The Virus Keeps Changing
SARS-CoV-2 accumulates mutations at a rate of about 0.44 substitutions per week across its genome, which is roughly consistent with other coronaviruses. That steady pace of evolution is why new variant lineages keep emerging and why vaccine formulas need regular updates. The virus isn’t becoming dramatically more dangerous with each new variant, but it’s changing enough to partially dodge immunity from previous infections and vaccinations. This is the new normal: a virus that circulates continuously, evolves steadily, and periodically produces lineages different enough to cause fresh waves of infection.
What “Mattering” Looks Like Now
COVID no longer matters in the way that demands emergency public health measures or daily case counts on the news. For a healthy person under 50 with some immune history from vaccines or prior infection, a single bout of COVID is unlikely to be a crisis. That’s real, meaningful progress.
But the virus still kills tens of thousands of Americans each year, still sends hundreds of thousands to the hospital, still leaves millions with lingering symptoms, and still doubles cardiovascular risk for years after infection. It matters the way heart disease and diabetes matter: as a persistent health threat that rewards basic preventive steps. Staying current on vaccines if you’re over 65 or immunocompromised, testing when you’re sick so you can access treatment early, and recognizing that each infection carries some nonzero risk of long-term consequences are all reasonable responses to a virus that has become endemic but not harmless.