COVID-19 is still circulating but is far less dangerous for most people than it was during the pandemic peaks of 2020 through 2022. National wastewater surveillance, one of the most reliable ways to track viral spread, currently shows COVID-19 activity at “very low” levels across the United States. The virus still causes significant illness and death each year, but for the average vaccinated person, it now behaves more like a severe seasonal respiratory illness than the emergency it once was.
Where Things Stand Right Now
The CDC’s wastewater monitoring system, which detects the virus in sewage before people even show up at doctors’ offices, rates current national COVID-19 activity at 1.10 on its scale, firmly in the “very low” category (anything under 2). That puts it on par with influenza and RSV right now. Activity levels fluctuate seasonally, typically rising in winter months and after holidays, so this number will change.
Even so, COVID-19 remains a significant cause of hospitalization and death on a yearly basis. Projections published in JAMA Network Open estimated roughly 814,000 hospitalizations and 54,000 deaths in the U.S. between April 2024 and April 2025, similar in scale to the year before. For context, a bad flu season kills around 50,000 Americans. So COVID’s annual toll has settled into a range that’s comparable to, though often slightly worse than, seasonal flu.
How It Compares to the Flu Now
A CDC study comparing hospital outcomes found that for most age groups, the risk of dying in the hospital from COVID-19 (specifically the Omicron BA.5 wave) was statistically similar to the risk from influenza. The major exception was adults aged 18 to 49, who still faced higher in-hospital death rates from COVID than from flu. ICU admission rates and the need for breathing support were also comparable between the two diseases for hospitalized patients.
That’s a dramatic shift from 2020 and 2021, when COVID was many times deadlier than flu across all age groups. The combination of widespread immunity from prior infections, vaccination, and the evolution of the virus toward less lethal (but more transmissible) variants has narrowed the gap considerably.
Who Is Still at Serious Risk
The burden of severe COVID-19 falls overwhelmingly on older adults. More than 81% of COVID deaths occur in people over 65, and the death rate in that group is 97 times higher than among adults aged 18 to 29. Age remains the single strongest predictor of a bad outcome.
Beyond age, several conditions raise your risk substantially. Obesity is a major one: risk of severe illness climbs sharply with higher BMI, starting at a BMI of 25 and increasing further above 30 and 40. Having multiple underlying conditions compounds the danger. People who are immunocompromised, whether from a medical condition or medications that suppress the immune system, face a particular challenge because vaccines may not protect them as well, even if they’re fully up to date.
Racial and ethnic minority groups and people with disabilities also experience higher rates of severe illness, largely driven by disparities in healthcare access, housing, and working conditions rather than biological differences.
What Symptoms Look Like Now
Current COVID symptoms overlap heavily with cold and flu. The most common include fever or chills, cough, sore throat, congestion or runny nose, fatigue, muscle aches, and headache. Loss of taste or smell, once considered a hallmark of COVID, still appears on the CDC’s symptom list but is reported less frequently with newer variants. Some people also experience nausea, vomiting, or diarrhea. Symptoms typically appear 2 to 14 days after exposure.
For most vaccinated, otherwise healthy adults, the illness resolves within a week or two. The experience is often described as a moderate to bad cold or a mild flu. Severe cases involving pneumonia, difficulty breathing, or organ complications still occur but are concentrated in high-risk groups.
Long COVID Remains a Concern
Perhaps the most important reason COVID isn’t “just a cold” is long COVID. A large meta-analysis published in 2024 estimated the global prevalence of long COVID at 36% of people with a confirmed infection, with a U.S.-specific estimate of 29%. That means roughly one in three people who get COVID develop symptoms lasting weeks or months, ranging from persistent fatigue and brain fog to heart palpitations and shortness of breath.
Vaccination cuts the risk significantly. Unvaccinated people are about twice as likely to develop long COVID compared to those with any vaccination. The prevalence has dropped only marginally over time (from 36% overall to 34% in studies published in 2024), suggesting that newer variants haven’t dramatically reduced this risk on their own. Long COVID can affect people of any age, including those whose initial infection was mild.
Vaccines and Treatment Still Work
Updated COVID vaccines are reformulated each year to target the dominant circulating strains, similar to the annual flu shot. The 2024-2025 vaccines were expected to work well against the variants in circulation. You can still get infected after vaccination, but the vaccines continue to prevent severe disease, hospitalization, and death, which has been their primary purpose since the initial rollout.
Antiviral treatment also remains effective. Paxlovid reduces the risk of hospitalization by roughly 40% to 60% depending on age group, and it works against Omicron-lineage variants. Treatment can cut your overall risk of hospitalization by more than half and reduce the risk of death. You’re eligible if you’re 50 or older or have conditions that put you at higher risk. The key is starting treatment early, so testing promptly when symptoms appear still matters, especially for people in higher-risk categories.
The Virus Keeps Changing
SARS-CoV-2 continues to mutate and produce new variants. As of early 2026, the dominant variant in the U.S. is XFG.1.1, accounting for about 32% of sequenced cases. New variants will keep emerging, and some will replace others. This is expected and normal for a respiratory virus that has settled into an endemic pattern. Each new variant can shift transmissibility and immune evasion slightly, which is why vaccine formulations are updated and why wastewater surveillance continues to be a valuable early warning system.
For most people, the practical takeaway is that COVID is no longer the crisis it was, but it’s not gone. It causes a level of annual illness and death roughly comparable to a severe flu season, with the added risk of long-term symptoms that flu rarely produces. Staying current on vaccination, testing when symptomatic, and seeking treatment early if you’re in a higher-risk group remain the most effective ways to keep your personal risk low.