COVID-19 cases have declined across Alabama and hospitalizations are down from months past, Dr. Wes Stubblefield, district medical officer for the Alabama Department of Public Health’s northern third of the state.

But don’t be tempted to think it’s gone. Stubblefield said it is important to remember that COVID is still circulating in Alabama, it still is infecting  people and it still is killing people.

Since early March, Alabama’s COVID-19 hospitalization numbers have hovered around 200. As of Friday, statewide there were 136 adults and seven children hospitalized with it, far below the highs of 3,000 patients seen periodically in previous years.

Stubblefield said most of the current COVID infections are due to the XBB.1.5 Omicron subvariant.

But, he said, “There is another subvariant out there, and we are starting to see it, but it has not increased the number of hospitalizations or the death rates in the state.”

The new variant, XBB.1.16, has been reported in several states, according to Dr. Rajendram Rajnarayanan of the New York Institute of Technology.

The new variant has contributed to a spike in the number of cases in Southeast Asia in recent weeks, but the World Health Organization reports that the death count for the area has decreased by 6% over the past four weeks.

XBB.1.16 is similar to the XBB1.5 subvariant, but it has one additional mutation that makes it more infectious and potentially more pathogenic, according to a WHO official.

The basic goal of a virus is to replicate itself, Stubblefield said.

“If it kills its host or the host’s immune system destroys it, it will disappear. But over time this virus has mutated causing it to become more contagious and to evade the body’s immune system response. But it is less deadly.”

It can be difficult to accurately compare COVID cases now to earlier times because most people who think they might have it now test themselves at home with drug store tests, and many never seek a doctor’s care and so are never recorded.

Still a Pandemic

The disease is still considered a worldwide pandemic, a designation assigned by WHO.

Stubblefield said he does not know when it will be downgraded, but some health officials have started calling the situation post-pandemic or endemic. The debate is ongoing.

While some areas of the world are seeing declining cases, such as in WHO’s Americas Region, cases in other areas, such as the Eastern Mediterranean Region and the South-East Asia Region, more than doubled in the last four weeks, according to WHO’s most recent regional update.

In the future, Stubblefield said, the COVID virus likely will be treated more like other common respiratory viruses, such as the flu, although data continues to show the infection is still potentially more serious than the flu.

The Federal Drug Administration’s advisory committee has presented data based on circulating variants for developing a yearly COVID booster vaccination. But neither the FDA nor the Centers for Disease Control and Prevention has yet made official recommendations.

Each fall, people at high risk, such as those who are over age 65 or immune compromised, might be recommended to have this updated COVID-19 booster similar to yearly flu shots. It is still possible that high-risk individuals will be recommended to have an additional dose of the currently available bivalent booster this spring or summer.

“They should also stay current on their COVID shots and discuss potential life-saving treatments that are still available through their health care provider,” Stubblefield said.

According to the CDC, symptoms of XBB1.16 include fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting and diarrhea.