Cold, Flu or COVID-19? Here’s How to Tell the Difference

October 21, 2020 1:28 PM

An expert offers advice for those worried sick about their symptoms.

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Illustation by Michigan Medicine

You wake up one morning feeling under the weather. While in previous years you may have chalked up a sore throat or body aches to a run-of-the-mill cold or flu, this year’s COVID-19 pandemic adds a new element of concern to getting sick.

“There is significant overlap between symptoms of influenza and COVID,” says Laraine Washer, medical director of infection prevention and epidemiology at Michigan Medicine. “Both can present with fevers, chills, cough, muscle/body aches, fatigue and headache.”

Here, Washer offers advice to follow during this unique cold and flu season.

Is it a cold, the flu or COVID?

Cold symptoms are mild and the common cold tends not to be associated with fever or headache. 

Congestion/runny nose is common for the common cold and would be uncommon to be the only symptom for influenza. Congestion/runny nose can be a symptom of a COVID infection and might be the only symptom in mild cases.

SEE ALSO: Seeking Medical Care During COVID-19

Flu symptoms are often of rapid onset. COVID symptoms can be of rapid or more gradual onset. 

Says Washer, one symptom that is more unique to a COVID infection is the loss of taste or smell. 

Should I get a test?

Washer says that in many settings, the only way to tell the difference between COVID and influenza is by testing. “The differentiation can be very important as there are isolation requirements to prevent transmission of COVID and antivirals that can be used for influenza,” she explains.

If you have fever/chills, new cough or new shortness of breath, you should stay home and arrange to be tested for COVID.

If you have two or more of the following symptoms: 

  • headache,

  • new muscle aches,

  • new upper respiratory symptoms (congestions, runny nose, sore throat),

  • new loss of taste or smell, new nausea/vomiting/diarrhea,

  • or new rash,

you should consider COVID testing.  If you have had a known close contact exposure to someone with COVID, you should be tested even if you have one mild symptom.  If you are a Michigan Medicine patient, you can call the COVID hotline (734-763-6336). There is a low threshold for COVID testing given risk of transmission to others.  Once influenza season begins, your doctor may also wish to test you for flu.

Should I call the doctor?

If you have any chronic medical conditions or are over the age of 65, you are at higher risk of getting a severe COVID infection and should call your doctor. Call your doctor for a fever that does not go down with fever reducing medicine (do not use aspirin as it is contraindicated in influenza) or any severe symptoms or symptoms that get worse over time.

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Should I go to the emergency room?

Go the emergency department if you have chest pain or pressure, confusion, difficulty breathing or blue discoloration to your lips or face.

Some good news is that social distancing and wearing masks may mean a milder flu season. “Flu and other respiratory illnesses were reduced in the Southern Hemisphere, whose flu season typically stretches from May to November,” says Washer.

Getting a flu shot this year is particularly important to reduce the potential for a twin pandemic of influenza and COVID, which could further overwhelm the healthcare system.

Adds Dr. Washer, “Continue to social distance, avoid large gatherings and wear your mask! And get and use a thermometer.”

SEE ALSO: Keeping Our Patients Safe During COVID-19