A stuffy nose. A sore throat. A cough. Is it allergies? The flu? Or could it be COVID-19? With allergy season in effect, flu season ramping up, and COVID-19 still very prevalent, it can be difficult to tell the difference. Here, Atrium Health experts weigh in on how to figure out what your symptoms might mean, and how to prevent and treat them.
Allergies vs. COVID-19
Among all of the symptoms, some of the key differences between allergies and COVID-19 is the fact that there’s not usually a fever or loss of taste or smell associated with allergies.
“When it comes to allergies, the nose and eyes are the parts of the body that are most commonly affected,” says Alekh Gupta, MD, an allergy and immunology specialist with Atrium Health. “That can result in symptoms such as a runny nose, itchy eyes, watery eyes, congestion, postnasal drainage, hoarseness in the voice, or a feeling of fullness in the ears. In patients with asthma, there can be some coughing and wheezing as well.”
At this time of year, people may experience outdoor allergens to trees, grass, weeds and molds (which can be found in piles of leaves) or indoor allergens to pet dander and dust mites.
There are plenty of over-the-counter medications that are effective in treating many symptoms, including antihistamines, nasal sprays, and eye drops that can help relieve congestion and itchiness.
Dr. Gupta also notes that nasal sprays and eye drops can be more effective since they are targeted therapies to specific parts of the body, while antihistamine pills treat the body systemically.
“The key with nasal sprays is to use them consistently,” advises Dr. Gupta. “They’re not as effective when they’re only used intermittently.” For some indoor allergies, air purifiers can also be helpful in reducing symptoms. If your allergy symptoms are more severe or change over time, your doctor can perform allergy testing or prescribe a stronger medication than over-the-counter allergy medicine. Allergy shots can also be useful in desensitizing people to many allergens.
If you think you have allergies but aren’t sure what you’re allergic to, testing can give you definitive answers.
“In our office, we do skin testing where we scratch the skin with allergens that we suspect the person is sensitive to,” says Dr. Gupta. “Then, we’ll watch for a reaction on the skin, and that'll tell us exactly what the patient is allergic to.”
Distinguishing the flu from COVID-19
While COVID-19 is still a concern, the flu (influenza) isn’t going away this winter. People will still need to prepare themselves to prevent and, if necessary, treat it. COVID-19 and the flu do share certain symptoms, which can make it difficult to know what you might have if you aren’t feeling well.
“There are some symptoms, like loss of taste or smell, which may be more common with COVID-19 compared to seasonal flu. But those symptoms don’t always occur with COVID-19, so it can be difficult to differentiate between the flu and COVID-19 without a test,” says Anupama Neelakanta, MD, an infectious disease physician and epidemiologist with Atrium Health.
Both flu and COVID-19 symptoms may include fever, chills, headaches, sore throat, congestion, cough, difficulty breathing, and some gastrointestinal (GI) symptoms (stomach upset). GI symptoms may be somewhat more common in COVID-19 patients but can also occur in children with flu.
People with the flu or COVID-19 may exhibit mild symptoms or even be asymptomatic at first. “There are some differences between the incubation period between the two viruses. For the flu, usually it is one to three days after exposure to someone with flu when you tend to get symptoms. For COVID-19, the incubation period is usually two to 14 days, and most commonly it is around four to seven days,” says Dr. Neelakanta. She also says it’s important to remember that for both flu and COVID-19, you can be contagious for one or two days before you show symptoms.
COVID-19 symptoms may not peak until two weeks after the person becomes infected. “Some people, during the second week, can experience severe symptoms, like shortness of breath and hypoxia (lack of sufficient oxygen),” says Dr. Neelakanta, “With the flu, symptoms might peak in the first five to seven days after symptom onset.”
What should you do if you experience any of the symptoms of flu or COVID-19? “First of all, stay home. Don't go to work and don't go to places with large groups of people, to prevent further exposure to other people,” advises Dr. Neelakanta.
If your symptoms are mild, a video visit with a doctor might be sufficient to help you make the right decision about your health. Many people can recover from the flu at home, and for some people with mild versions of COVID-19, at-home care could be a good option for recovery. But if you have more severe symptoms, whether you think you have the flu or COVID-19, don’t hesitate to see your doctor as soon as possible. “If you experience something like shortness of breath or difficulty breathing, or if you’re in a vulnerable group like senior citizens or young children, it becomes more important to see a doctor and get tested,” says Dr. Neelakanta. Doctors can prescribe medications (like Tamiflu) to lessen the effects of flu, and more severe cases of COVID-19 may require hospitalization for proper monitoring and treatment.
Preventing the spread of flu and COVID-19
“The flu vaccine is very effective in preventing seasonal flu,” says Dr. Neelakanta. “The efficacy is different depending on the year, because it depends on the strains of flu in the community. Depending on which vaccine you take the vaccine typically contains three or four strains of flu against which you are protected. And even if you do get the flu once you've taken the vaccine, often the symptoms of the flu will be much milder.”
She advises everyone to get a flu vaccine this year – especially those who may be more vulnerable to its effects such as the elderly, children, and pregnant women. “We don’t know what the effects will be on patients who contract both the flu and COVID-19 at the same time,” points out Dr. Neelakanta. Hopefully, she says, we’ll have a milder flu season this year because of practices like wearing masks and social distancing.
In addition to getting a flu shot, Dr. Neelakanta advises everyone to continue to practice proper hand hygiene, maintain social distancing (staying six feet apart when indoors), and wear masks anytime you’re in a group setting or around anyone who’s not part of your immediate household.
“Make sure you have your mask placed appropriately, which means that it is over the nose and covering the mouth,” she says, and adds, “Practice good respiratory etiquette and make sure that you're sneezing into your elbow, so that you're not spreading particles and exposing those around you.”
“When in doubt, if you continue to have worsening symptoms, or if you feel that anything is different than usual, please be cautious, stay home, seek help as needed and get tested for flu and COVID-19 if indicated,” says Dr. Neelakanta.
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