New variants of COVID‐19 (XBB.1.5 and XBB.1.16, the "Arcturus"): A review of highly questioned concerns, a brief comparison between different peaks in the COVID‐19 pandemic, with a focused systematic review on expert recommendations for prevention, vaccination, and treatment measures in the general population and at‐risk groups

Introduction: The COVID‐19 pandemic has taken many forms and continues to evolve, now around the Omicron wave, raising concerns over the globe. With COVID‐19 being declared no longer a "public health emergency of international concern (PHEIC)," the COVID pandemic is still far from over, as new Omicron subvariants of interest and concern have risen since January of 2023. Mainly with the XBB.1.5 and XBB.1.16 subvariants, the pandemic is still very much "alive" and "breathing." Methods: This review consists of five highly concerning questions about the current state of the COVID Omicron peak. We searched four main online databases to answer the first four questions. For the last one, we performed a systematic review of the literature, with keywords "Omicron," "Guidelines," and "Recommendations." Results: A total of 31 articles were included. The main symptoms of the current Omicron wave include a characteristically high fever, coughing, conjunctivitis (with itching eyes), sore throat, runny nose, congestion, fatigue, body ache, and headache. The median incubation period of the symptoms is shorter than the previous peaks. Vaccination against COVID can still be considered effective for the new subvariants. Conclusion: Guidelines recommend continuation of personal protective measures, third and fourth dose boosters, along with administration of bivalent messenger RNA vaccine boosters. The consensus antiviral treatment is combination therapy using Nirmatrelvir and Ritonavir, and the consensus for pre‐exposure prophylaxis is Tixagevimab and Cilgavimab combination. We hope the present paper raises awareness for the continuing presence of COVID and ways to lower the risks, especially for at‐risk groups. Key points: The COVID pandemic is far from over, with new variants of interest and concern rising since January of 2023 (mainly XBB.1.5 and XBB.1.16 subvariants).The main symptoms of the current Omicron wave include a high fever, coughing, conjunctivitis (with itching of the eyes), sore throat, runny nose and congestion, fatigue, body ache, and headache.The median incubation period for the current peak was calculated to be 3.8 days which is shorter than the incubation period calculated for most of the previous peaks; and the median duration of the symptoms was calculated to be 5 days for the current peak which is shorter than the duration calculated for the previous peaks by 3–5 days.A cumulative 64.42% of the population worldwide are fully vaccinated against COVID‐19 as of June 16, 2023. Vaccination against COVID can still be considered mostly effective against new symptoms, severe disease, long COVID, and death for the new subvariants.Guidelines recommend continuation of personal protective measures, third and fourth dose boosters, particularly in individuals above 60, immunocompromised patients, and healthcare personnel, along with administration of bivalent messenger RNA vaccine boosters.The consensus option for antiviral treatment is combination therapy using Nirmatrelvir and Ritonavir, and the consensus for pre‐exposure prophylaxis is Tixagevimab and Cilgavimab combination. [ABSTRACT FROM AUTHOR]