Nurse Judy's approach: Covid in 2026/ What does it look like now

Covid 19 versus covid 2026

Back in 2019 when covid first showed up it was terrifying enough that it shut the world down for several years.

The virus was completely new to humans, no one had natural immunity and there were no vaccines to protect us. Millions of people died. Just being exposed was down-right terrifying.

The picture changed as immunity from vaccination and past infections grew, treatments arrived, and the virus continued to evolve. COVID is still contagious and can still be serious, but most healthy people who get it these days now recover at home. Of course, it is not the least bit pleasant, but the diagnosis, generally no longer fills people with the same type of utter dread.

We are in the midst of a wave right now. You probably know someone who has COVID or just got over it. So we figured it was time to review all the things you need to know.

What does COVID look like these days?

Sore throat (occasionally a REALLY intense one)
Congestion and runny nose
Cough (dry or productive)
Fatigue and exhaustion
Headache
brain fog
Fever or chills
Muscle and body aches
Loss of taste or smell is still possible, but it’s not the hallmark it once was. (Loss of smell or taste can still happen, but it is less dependable as a clue than it was early in the pandemic.)

COVID can also cause nausea, vomiting, or diarrhea. Keep in mind that other viruses can be behind the GI symptoms. Unlucky households can have two infections at once.

Is it COVID, flu, or another virus?

Flu tends to arrive abruptly with fever and body aches. In other words it hits you like a mack truck! COVID generally comes on slower.

Both can make a patient feel miserable, and both can occasionally cause serious illness. A test is more useful than trying to identify the virus by the exact flavor of symptoms.

When to test?

If you have suspicious symptoms or have been exposed, a home antigen test is a good place to start. It is especially important if the patient has a risk factor that might make treatment relevant. If you have someone vulnerable in the household, that is another reason to be extra careful. Perhaps you have a birthday party next week or upcoming travel. Sometimes it is important to know! Fortunately it is pretty easy to test. We have come a long way from the pandemic days.
Be aware that negative test on day one does not rule COVID out. Repeat it 48 hours later if symptoms continue. Testing can also distinguish COVID from flu when a treatment decision is on the table. There are over the counter tests available now that can detect Covid, flu & RSV all with one nasal swab.
If the patient looks significantly ill, we don’t care what the test says, check in with your doctor.

Symptomatic treatment

For most people, this looks a lot like caring for any other respiratory virus:

Hydration is essential. Sometimes a dose of Tylenol or Advil can ease throat discomfort and make it easier to drink.

Honey is great for the throat and or cough. Remember no honey for anyone under a year.

Humidifiers can also be useful

See below for more useful links.

Who needs treatment?

Technically speaking, most healthy children do not need an antiviral for COVID or flu. Supportive care is enough. That being said, Dr. Ted finds it very useful to start Tamiflu early for his patients that test positive for flu. It is low risk and it shortens the symptoms. There are no age restrictions.

On the other hand, he does not jump into offering Paxlovid quite as quickly, especially for a normal, healthy child. For one thing, Paxlovid only becomes an option for eligible patients aged 12 and older who weigh at least 88 pounds.

If you decide to treat, it must be started within five days of symptom onset. Another thing to pay attention to is that along with the side effect of a very nasty taste in your mouth, it has many medication interactions.

“Do we really need the COVID shot?”

Dr. Ted gets this question all the time. Here’s how he answers it:

For a generally healthy older child, I don’t feel strongly about whether a family chooses this season’s COVID vaccine. It can lower the chance of getting COVID for a while, although that protection fades. I feel more strongly about vaccinating babies and toddlers, children at higher risk of serious illness, and children who live with someone vulnerable.

I feel differently about the flu shot. I recommend it every year for children who are old enough to receive it. In my experience, flu can hit otherwise healthy kids hard, and vaccination makes a meaningful difference.

Officially, for the 2026–27 season, the American Academy of Pediatrics recommends an updated COVID vaccine for

all children 6 through 23 months old. Just like the flu shot, as soon as babies turn 6 months, they should get 2 injections separated by 4 weeks. After the first season, only one shot is required.
Any child who has never been vaccinated
children and teens 2 through 18 years old who are at increased risk of severe COVID,
people with certain medical conditions
Anyone who lives with someone at high risk.

People not on that list can still receive it after a discussion with their clinician. In other words, you can just ask for it. Insurance usually covers an annual vaccine.

The vaccine’s strongest benefit is protection against serious illness; it is not a promise that you or your child will never catch COVID.

When can my child return to school or daycare?

The CDC advises staying home until symptoms have been improving overall for at least 24 hours AND any fever has been gone for 24 hours without meds.

For the next five days, take extra care around others: consider air filters, a mask if your child can wear one, and avoid close contact with people at higher risk.

A lingering cough alone does not necessarily mean a child must miss weeks of school. Check your school or daycare policy, which may have its own rules, and keep a child home if they are too ill to participate in activities.

It is annoyingly common for a cough to linger easily for 21 days. This happens with any virus.

When you get past the 21 day mark, it is reasonable to check in with your doctor if that cough is persistent.

How does COVID spread, and how can we protect others at home?

COVID spreads mainly through the air we share, especially indoors. Opening windows, improving ventilation, and wearing a well-fitting mask when practical can reduce exposure. Having a good Hepa filter can make a huge difference.

If someone at home has COVID, try to give them their own space and avoid close face-to-face time with an infant, an older adult, or anyone at higher risk. Don’t bother trying to turn your home into a sterile operating room; clean air and less close contact do more to prevent the spread than wiping every doorknob.

Reality check: We know that it is challenging to keep siblings apart and a parent with covid, might love to say “peace-out” and go hide in their room, but it isn’t usually a valid option. Do the best you can.

What about long COVID?

Long COVID means symptoms that persist or emerge after the initial infection, such as fatigue, trouble concentrating, headaches, or exercise intolerance. It remains a nightmare for those dealing with it.

It can happen in children, although estimates vary and most children who get COVID do not develop it. If your child is still not back to their usual self 12 weeks later, tell your doctor.

Frequently asked questions

Can you COVID again and again?

Yep. Just like the flu, prior infection offers some protection, but it does not make anyone immune to future infections. (sorry)

Does a positive test mean the patient is infectious

Not necessarily. The return-to-activity guidance is based primarily on symptoms, not a required negative test.

In conclusion:

Most healthy people recover well with fluids, rest, and time. We still take COVID seriously when a patient is struggling to breathe, cannot stay hydrated, or has a condition that makes severe illness more likely.