For millions of people, COVID-19 has become something associated with the past. Lockdowns have ended, travel restrictions have disappeared, and the virus that once dominated daily life is now often treated as another respiratory infection.
Yet the latest figures from the World Health Organization tell a more complicated story.
During the 28-day period ending October 4, 2026, 607 new COVID-19 deaths were reported to the WHO by 32 countries. In the same period, 2,901 hospitalisations were reported by 27 countries, although these numbers represent only a fraction of global surveillance because many countries no longer report infections and deaths as extensively as they did during the pandemic.
An even more revealing statistic concerns the people who are dying. Among deaths reported with age information in September 2026, 78% occurred in adults aged 65 and older.
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According to the WHO's latest COVID-19 surveillance dashboard, the virus continues to circulate on every inhabited continent. Although the overwhelming majority of infections no longer result in life-threatening illness, COVID-19 remains a substantial concern for older adults, people with certain medical conditions and individuals with weakened immune systems.
The disease also carries another risk that is not reflected in the death toll. Some patients develop long COVID, experiencing persistent fatigue, breathing difficulties, cognitive problems and other symptoms for months or years after the initial infection.
What exactly is COVID-19, and where did it originate?
COVID-19 is an infectious disease caused by SARS-CoV-2, a coronavirus that primarily infects the respiratory system but can also affect other organs. The disease was first identified following an outbreak of unexplained pneumonia in Wuhan, China, in December 2019.
The virus belongs to a broader family of coronaviruses, some of which cause relatively mild respiratory infections, while others have been responsible for more severe diseases, including severe acute respiratory syndrome, or SARS, and Middle East respiratory syndrome, known as MERS.
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By March 2020, the rapid international spread of SARS-CoV-2 had prompted the WHO to characterise COVID-19 as a pandemic. Governments introduced emergency measures as hospitals struggled with rapidly increasing numbers of patients, while scientists began developing vaccines and treatments against the previously unknown virus.
On May 5, 2023, the WHO announced that COVID-19 no longer constituted a public health emergency of international concern. This marked the end of the organisation's highest-level global health alert, but it did not mean that the virus had disappeared or could no longer cause serious illness.
In its global risk assessment published on August 6, 2026, the WHO continued to classify the global public health risk from COVID-19 as moderate, reflecting ongoing transmission, severe disease among vulnerable populations and uncertainty surrounding its long-term consequences.
How do people become infected with COVID-19?
COVID-19 spreads primarily through the air when an infected person releases respiratory particles containing SARS-CoV-2. These particles are produced during ordinary activities such as breathing, speaking, laughing, singing, coughing and sneezing.
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Some particles are relatively large and settle quickly, while smaller particles can remain suspended in the air, particularly in enclosed spaces with inadequate ventilation. This means that infection can occur not only during direct face-to-face contact but also when people share indoor air with someone who is infectious.
According to the WHO's explanation of COVID-19 transmission, crowded indoor environments represent particularly favourable conditions for transmission. Offices, classrooms, public transport, hospitals and residential care facilities can all experience outbreaks when infectious people share enclosed spaces with others.
The virus can also spread through contact with contaminated surfaces followed by touching the eyes, nose or mouth, although this is not considered a principal route of transmission. Airborne exposure remains the most important consideration when evaluating infection risks.
Unlike Ebola, which requires direct contact with infectious bodily fluids in ordinary transmission settings, COVID-19 can spread between people who never physically touch one another.
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Can you spread COVID-19 without feeling sick?
One of the characteristics that made COVID-19 exceptionally difficult to control was its ability to spread before infected people realised they were ill.
Symptoms generally appear several days after exposure, often within three to six days, although the incubation period can vary. During part of this period, infected individuals may already be capable of transmitting the virus to others.
Some people never develop noticeable symptoms yet can still transmit SARS-CoV-2. Others feel completely healthy until a day or two before symptoms emerge, meaning they may continue attending work, school or social gatherings while infectious.
The CDC's guidance on COVID-19 symptoms notes that illness can appear between two and 14 days after exposure. The duration of infectiousness depends on the individual, the severity of the infection and immune function, with people experiencing severe illness or substantial immune suppression sometimes remaining infectious longer.
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This helps explain why COVID-19 can continue circulating even when few people appear seriously ill. A person with a mild sore throat or no symptoms at all may unknowingly expose someone who faces a much higher risk of complications.
What are the first symptoms of COVID-19?
COVID-19 can produce a wide range of symptoms, from almost imperceptible illness to severe respiratory disease. Many infections now resemble a common cold or influenza-like illness, particularly in people who have developed immunity through vaccination, previous infections or both.
The most frequently reported symptoms include fever, chills, sore throat, coughing, nasal congestion, headache, tiredness and muscle aches. Some patients also experience nausea, vomiting, diarrhoea, chest discomfort or shortness of breath.
Loss of taste or smell became one of the most recognisable symptoms during the early pandemic. Although it can still occur, it is not present in every infection and is not required for a diagnosis.
According to the WHO's updated COVID-19 factsheet, most people recover without requiring specific medical treatment. However, symptoms alone cannot reliably distinguish COVID-19 from influenza or other respiratory infections, and clinical deterioration remains possible.
Warning signs requiring urgent medical assessment include difficulty breathing, persistent chest pain, new confusion, severe drowsiness, an inability to remain awake and pale or bluish skin caused by inadequate oxygenation. Such symptoms may indicate a medical emergency rather than an ordinary viral illness.
What happens inside the body during a severe infection?
After entering the body, SARS-CoV-2 attaches to susceptible cells and begins reproducing. The upper respiratory tract is commonly affected first, but the infection can extend into the lungs and, in some patients, trigger inflammatory responses affecting several organ systems.
In severe cases, inflammation and damage within the lungs interfere with the transfer of oxygen into the bloodstream. Patients may develop pneumonia and acute respiratory distress syndrome, a dangerous condition in which the lungs cannot supply enough oxygen to the body.
COVID-19 can also affect the cardiovascular and circulatory systems. Certain patients develop abnormal blood clotting, increasing the risk of complications such as pulmonary embolism, stroke or other vascular problems. The kidneys, heart and nervous system may also be affected during severe illness.
According to the CDC's February 2026 clinical management overview, critically ill patients may experience respiratory failure, severe inflammatory responses, sepsis, shock and complications involving multiple organs.
These complications are far less common than mild respiratory symptoms, particularly among people with substantial existing immunity. Nevertheless, they explain why COVID-19 remains potentially fatal despite the major improvements in treatment and population protection achieved since 2020.
Who is most likely to catch COVID-19?
Anyone can become infected with SARS-CoV-2, including children, young adults, healthy athletes and people who have previously recovered from COVID-19. The likelihood of infection depends primarily on exposure to the virus, existing immunity and the circumstances in which contact occurs.
People who spend extended periods in crowded indoor environments have more opportunities for exposure. Healthcare professionals, care-home workers, teachers and employees working in close contact with large numbers of people may encounter the virus more frequently than individuals with fewer social contacts.
Household transmission is another important factor. When someone becomes infected, other people living in the same home may experience prolonged exposure, particularly when ventilation is limited or household members continue sharing rooms during the infectious period.
However, greater exposure does not necessarily mean a greater risk of dying. A young, healthy healthcare worker may have numerous opportunities to encounter SARS-CoV-2 while still facing a considerably lower risk of severe disease than an older adult with significant underlying medical conditions.
This distinction between the probability of becoming infected and the probability of developing serious illness is essential to understanding the continuing impact of COVID-19.
Which groups are most likely to die from COVID-19?
Age remains the single most important established risk factor for severe COVID-19. Although younger adults and children can become critically ill, the likelihood of hospitalisation and death increases substantially with advancing age, particularly beyond 65 and 75 years.
The WHO's September 2026 surveillance data illustrates this difference. Among reported COVID-19 deaths for which age information was available, 78% involved people aged 65 or older. This does not mean that 78% of everyone who dies from COVID-19 worldwide belongs to that age group, because reporting remains incomplete, but it highlights the continuing concentration of severe outcomes among older adults.
According to the CDC's October 2026 assessment of underlying medical conditions, people with diabetes, obesity, cardiovascular disease, chronic kidney disease, chronic lung disease and certain neurological conditions face increased risks of serious complications.
Cancer patients, organ transplant recipients and individuals receiving immune-suppressing medication are also particularly vulnerable. Some may generate weaker immune responses to vaccination or struggle to clear the virus once infected.
The number of underlying conditions matters as well. Someone living with several serious health problems may face a substantially greater risk than a person of similar age without those conditions.
Socioeconomic circumstances can influence outcomes by affecting access to vaccination, testing, early treatment and hospital care. Consequently, COVID-19 mortality reflects not only biological vulnerability but also differences in healthcare access and living conditions.
Are pregnant women and children at risk?
Pregnancy can increase the risk of severe COVID-19 compared with being non-pregnant at a similar age. Changes affecting the immune system, lungs and circulation can make certain respiratory infections more complicated during pregnancy, particularly when additional conditions such as obesity or diabetes are present.
Severe COVID-19 during pregnancy has been associated with an increased risk of certain adverse pregnancy outcomes, including premature birth. However, most pregnant women who become infected do not develop critical illness, and individual risk depends on vaccination history, underlying health and the severity of infection.
Children generally have a lower risk of severe COVID-19 than older adults, although infants and children with certain medical conditions can become seriously ill. Rarely, children develop a severe inflammatory condition known as multisystem inflammatory syndrome in children, or MIS-C, which can emerge several weeks after a SARS-CoV-2 infection.
The WHO's clinical guidance emphasises that assessment and treatment should consider the specific circumstances of pregnant patients, children and people with underlying health conditions rather than treating every infection as equally dangerous.
Which countries are still affected by COVID-19 in 2026?
Unlike dengue or Ebola, COVID-19 is not concentrated primarily in a limited collection of countries. SARS-CoV-2 has become established worldwide, with infections occurring across North and South America, Europe, Asia, Africa and Oceania.
Countries including the United States, Brazil, India, the United Kingdom, Germany, France and Japan have experienced substantial COVID-19 waves since the beginning of the pandemic. However, historical case totals cannot be used to produce a reliable ranking of current infection risk because countries differ greatly in population size, testing practices and reporting systems.
The WHO recorded 69,783 newly reported cases from 61 countries during the 28 days ending October 4, 2026, down from 88,531 reported during the preceding 28-day period. Those figures do not represent all infections worldwide, because many countries now rely on limited surveillance testing rather than attempting to record every case.
The same WHO report identified elevated viral activity or increasing transmission in parts of Central America, the Caribbean, tropical South America, northern and eastern Europe, Africa and several Asian subregions. Global activity was nevertheless assessed as generally low and stable during the latest reported surveillance week.
In Europe, the European Centre for Disease Prevention and Control's October 16, 2026 update described SARS-CoV-2 circulation across the EU and European Economic Area as low overall, although two countries were recording higher rates.
The situation demonstrates that COVID-19 has not disappeared but that transmission and disease severity fluctuate geographically. Local surveillance, hospital admissions and wastewater monitoring often provide more meaningful information about current conditions than cumulative case totals.
Which COVID-19 variants are circulating now?
SARS-CoV-2 continues to evolve as mutations accumulate in its genetic material. Some mutations can influence how efficiently the virus spreads or how effectively it avoids existing immune responses, which is why public health authorities continue monitoring new variants.
The emergence of Omicron in late 2021 fundamentally changed the pandemic's trajectory, and the variants circulating in 2026 are largely descendants of the Omicron family. Different branches have gained prominence at different times, often replacing earlier variants without necessarily causing more severe disease.
According to the WHO's September 2026 variant surveillance, XFG accounted for approximately 46% of globally submitted viral sequences in the week ending September 20. JN.1 represented approximately 19%, while NB.1.8.1 accounted for around 13%.
WHO was also monitoring other variants, including PQ.16.1.1 and BA.3.2. At that time, available evidence did not indicate that these monitored variants presented additional public health risks compared with other circulating SARS-CoV-2 variants.
The figures should be interpreted with caution because genetic sequencing is not performed equally across countries. They describe the distribution of submitted samples rather than establishing the exact proportion of infections caused by each variant worldwide.
Why can people catch COVID-19 more than once?
A previous COVID-19 infection generally produces an immune response, but it does not guarantee permanent protection against future infections. Immunity against infection can decline over time, while new variants may partially evade antibodies generated by earlier exposure.
Vaccinated people can also become infected, particularly when considerable time has passed since their most recent dose. However, protection against severe illness and death generally lasts longer than protection against any detectable infection.
Repeated infections are therefore possible, sometimes within relatively short intervals. The consequences vary: many reinfections are mild, but individuals with significant medical vulnerabilities can still become seriously ill, and each new infection carries some possibility of longer-term complications.
The WHO's August 2026 global risk assessment identified the potential long-term health consequences of repeated infections as an area of continuing scientific uncertainty.
Researchers are still investigating whether repeated infections can contribute to cumulative health problems in particular populations, and the extent to which vaccination or existing immunity changes those risks. Current evidence does not justify assuming that every subsequent infection will be harmless or that repeated infections inevitably cause permanent damage.
What is long COVID, and how many people develop it?
For some people, the most difficult period begins after the acute infection has ended. Long COVID, also called post-COVID-19 condition, describes a range of health problems that persist or emerge following SARS-CoV-2 infection and cannot be better explained by another diagnosis.
Symptoms can include severe fatigue, shortness of breath, muscle and joint pain, disrupted sleep, headaches, dizziness and difficulties with memory or concentration. Some patients describe problems with thinking clearly as "brain fog", while others experience changes in heart rate, particularly when standing.
According to the WHO's post-COVID condition factsheet, approximately six in every 100 people who develop COVID-19 experience post-COVID-19 condition. Estimates vary according to the population studied, the definition used, vaccination status and the period of the pandemic being examined.
Long COVID does not exclusively affect people who were hospitalised. Individuals who experienced mild infections can also develop persistent symptoms, sometimes affecting their ability to work, exercise, study or complete ordinary household activities.
The condition is generally identified when symptoms continue or appear approximately three months after the original infection and persist for an extended period. Some patients recover gradually, while others experience relapses or symptoms lasting considerably longer.
Scientists have proposed several possible mechanisms, including persistent immune-system disturbances, changes affecting blood vessels, tissue damage and possible ongoing viral activity in certain parts of the body. However, long COVID is not a single uniform illness, and researchers have not established one explanation that accounts for every patient's symptoms.
Is there a treatment for long COVID?
Unlike acute COVID-19, which can sometimes be treated with antiviral medication, long COVID does not currently have one proven treatment capable of curing every form of the condition.
Management depends on the patient's symptoms and underlying problems. Healthcare professionals may recommend targeted rehabilitation, treatment for pain or sleep disturbances, support for breathing difficulties, or specialist assessment of neurological and cardiovascular symptoms.
According to the CDC's March 2026 clinical guidance for long COVID, treatment should be tailored to the individual, with attention to how symptoms affect daily life and functional ability. Normal results on routine laboratory tests do not automatically exclude the condition.
An important consideration is post-exertional malaise, a worsening of symptoms following physical or mental activity. Patients who experience this problem may need carefully managed activity levels and pacing rather than programmes that encourage them to push through worsening symptoms.
Because long COVID can involve several body systems, successful care may require cooperation between primary care clinicians, rehabilitation professionals and medical specialists. Research into more targeted treatments is continuing.
How do doctors diagnose COVID-19?
COVID-19 is generally diagnosed using tests that detect SARS-CoV-2 or components of the virus. The most commonly used approaches are rapid antigen tests and molecular tests, including PCR.
Rapid antigen tests usually provide results within 15 to 30 minutes and are useful for identifying many active infections. However, they are less sensitive than molecular tests, particularly when the amount of virus present is still relatively low.
The CDC's guidance on COVID-19 testing notes that a single negative antigen test cannot reliably exclude infection. For symptomatic people, repeat antigen testing 48 hours after an initial negative result can improve detection, while molecular testing provides another option.
A positive result should be interpreted alongside symptoms, recent exposures and medical history. In patients at increased risk of severe disease, testing can be particularly important because antiviral medications work best when started early.
People with severe breathing difficulties, chest pain or other emergency warning signs should seek urgent medical attention regardless of whether an initial home test is positive or negative.
What treatments are available for COVID-19?
Most people with mild COVID-19 recover without specialised medication. Treatment generally involves rest, sufficient fluid intake and appropriate medicines to relieve discomfort, fever or headaches. Antibiotics are not effective against the virus itself and are not routinely recommended unless a bacterial infection is suspected or confirmed.
For patients at increased risk of serious illness, antiviral medicines can substantially reduce the likelihood of hospitalisation and death when prescribed early in the course of infection.
One of the principal treatments is Paxlovid, which combines nirmatrelvir and ritonavir. Nirmatrelvir interferes with an enzyme needed for viral replication, while ritonavir helps maintain effective drug concentrations in the body. Treatment is typically taken for five days and should begin within five days of symptom onset.
Another option is remdesivir, administered intravenously. A three-day outpatient course can be used in eligible high-risk patients when started within seven days of symptom onset. Molnupiravir may be considered when preferred alternatives are unsuitable or unavailable, although it is generally less favoured and is not recommended during pregnancy.
According to the CDC's treatment recommendations updated on October 8, 2026, clinicians should assess patients' age, underlying conditions, kidney and liver function, and possible medication interactions before selecting an antiviral treatment.
For critically ill patients, hospital treatment may include supplemental oxygen, respiratory support, medications to prevent or manage blood clots and treatments intended to control harmful inflammatory responses.
Corticosteroids such as dexamethasone can improve survival in patients with severe or critical COVID-19, but they are not recommended as routine treatment for mild cases because suppressing immune activity too early can be harmful.
The WHO's guidance on corticosteroid treatment emphasises that these medicines should be reserved for appropriately selected patients with severe or critical disease.
How effective are COVID-19 vaccines in 2026?
COVID-19 vaccines remain an important tool for reducing severe illness, hospitalisation and death. Their principal value is not that they prevent every infection, but that they help the immune system respond more effectively when an infection occurs.
Vaccination can generate immune protection against serious disease, although the strength of that protection changes over time. Updated vaccines have been developed to improve protection against more recently circulating variants, particularly those belonging to the Omicron family.
In its July 2026 position paper on COVID-19 vaccination, the WHO updated its recommendations to reflect widespread population immunity, continued viral circulation and the availability of variant-adapted vaccines.
The WHO advises countries to prioritise routine vaccination for people facing the greatest risk of severe COVID-19. These include the oldest adults, older people with significant underlying conditions, residents of long-term care facilities and individuals with moderate or severe immune suppression.
For these highest-risk groups, WHO recommends at least one vaccine dose annually, preferably two doses approximately six months apart, subject to national implementation policies and individual circumstances.
Countries may also recommend routine vaccination for additional groups, including pregnant women, healthcare workers and people with certain medical conditions. Exact eligibility, timing and vaccine products differ internationally.
Vaccines can cause temporary side effects such as fatigue, fever and soreness at the injection site. Serious adverse events are rare, but they are monitored through national and international vaccine safety systems. The balance of benefits and risks should be considered according to a person's age, health and risk of severe COVID-19.
How deadly is COVID-19 compared with earlier in the pandemic?
COVID-19 is substantially less likely to cause severe illness in many previously exposed populations than it was during the first years of the pandemic. Vaccination, immunity following infection, antiviral treatments and improvements in clinical care have all contributed to this change.
However, it is misleading to describe COVID-19 using one universal fatality percentage. The probability of death varies considerably according to age, medical history, immune protection, virus characteristics and access to treatment.
The WHO's public cumulative figures, last updated on September 6, 2026, recorded approximately 779.4 million confirmed COVID-19 cases and 7.12 million reported deaths worldwide. Dividing the reported deaths by the reported cases produces a crude historical ratio of about 0.9%.
That calculation should not be interpreted as the risk of death from an infection in 2026. It includes the earliest, most dangerous years of the pandemic, omits vast numbers of unrecorded infections and is affected by differences in testing and reporting practices.
The current risk is much lower for many healthy, previously vaccinated adults than it was in 2020. But the risk remains substantially higher for frail older adults, people with serious underlying conditions and individuals whose immune systems cannot mount effective protection.
WHO surveillance covering September 2026 illustrates this continuing imbalance: approximately 78% of reported COVID-19 deaths with available age information occurred among people aged 65 and older.
Did COVID-19 kill more people than official figures suggest?
The officially recorded COVID-19 death toll does not capture the entire mortality burden associated with the pandemic. Many infections were never confirmed, and some deaths occurred in settings where testing and death registration were limited.
One way researchers assess the broader consequences is through excess mortality, which compares the number of deaths that occurred during a particular period with the number expected under ordinary circumstances.
According to a WHO analysis published in May 2022, an estimated 14.9 million excess deaths occurred globally during 2020 and 2021 in association with the pandemic, with an uncertainty range of 13.3 million to 16.6 million.
That estimate includes people who died directly because of COVID-19 and those whose deaths were indirectly associated with the pandemic, including disruptions to essential healthcare services. It therefore cannot be treated as the number of laboratory-confirmed COVID-19 deaths.
The findings also revealed substantial geographical differences. Most estimated excess deaths occurred in South-East Asia, Europe and the Americas, while middle-income countries accounted for the majority of the total.
These figures help explain why official case and death counts, although useful for surveillance, cannot fully describe the scale of the pandemic's consequences.
How can people protect themselves against COVID-19?
Prevention remains particularly important for people at high risk of severe illness and those who live or work with vulnerable individuals. Although no measure eliminates every possibility of infection, combining several approaches can substantially reduce exposure.
Good indoor ventilation is especially valuable because SARS-CoV-2 spreads primarily through infectious airborne particles. Introducing fresh outdoor air, improving filtration and avoiding prolonged crowding in poorly ventilated rooms can reduce the concentration of infectious particles.
Properly fitted protective masks, particularly high-filtration respirators, can provide additional protection in crowded environments or when someone must spend time near people who may be infectious.
Vaccination according to applicable national guidance reduces the risk of severe disease, while testing and early medical treatment can be particularly valuable for people with underlying vulnerabilities.
People experiencing respiratory symptoms should avoid close contact with others when possible, particularly older adults and immunocompromised individuals. Hand hygiene and covering coughs and sneezes also remain useful measures, although they do not replace the importance of reducing airborne transmission.
According to the WHO's ventilation guidance, improving indoor air quality can reduce the risk of COVID-19 transmission, especially in crowded spaces where infectious aerosols may otherwise accumulate.
Why COVID-19 still matters long after the global emergency ended
COVID-19 in 2026 is not the same public health crisis the world experienced in 2020. Population immunity is considerably greater, doctors have access to effective treatments, and the proportion of infections leading to serious illness has declined substantially in many settings.
Nevertheless, the virus continues to circulate, mutate and cause preventable complications. Older adults and people with significant health vulnerabilities account for a disproportionate share of severe outcomes, while long COVID remains an important concern for people who survive their initial infection.
The latest WHO figures underline the need to distinguish between a declining global emergency and a disease that has ceased to exist. COVID-19 no longer dominates everyday life, but its consequences remain visible in hospitals, mortality statistics and the lives of people experiencing persistent symptoms.
For most otherwise healthy people, an infection will resolve without serious complications. For those at higher risk, however, recognising symptoms promptly, maintaining appropriate vaccine protection and obtaining early medical treatment can still make a potentially lifesaving difference.
This article is made and published by Aksel Kryhlmand, who may have used AI in the preparation.