How do you recognize the difference between a cold, COVID and flu

We’re entering the annual cold season, but there’s also the flu, fall allergies, and of course COVID-19 to think about. All of these illnesses can cause symptoms such as fatigue and congestion – but without knowing what makes you feel sick, it can be difficult to take care of yourself.

“Sometimes COVID can be quite severe and more like the flu where you have a high fever, severe fatigue and shortness of breath,” Dr. Bernard Camins, medical director for infection prevention at Mount Sinai Health System, TODAY. “But when it’s a mild case of COVID, it’s really hard to tell the difference (between COVID-19 and the common cold).”

Both mild COVID-19 and the common cold often cause symptoms such as runny nose, sore throat, headache and body aches, Camins said. “If you just get a sore throat or a runny nose, it’s very hard to tell the difference,” he said, adding that he’s seen many people with COVID-19 who only report having those milder symptoms.

Because of the potential for confusion, don’t hesitate to take a COVID test at home if you start feeling symptoms, Dr. John Torres, NBC News senior medical correspondent, TODAY.

“If you start to get sick, you essentially have to assume it’s COVID unless proven otherwise,” he explained. “And by that I mean, make sure you self-isolate (and) get tested to make sure it’s not COVID.”

Related: COVID-19 booster side effects: what to expect and how to deal with them

Common symptoms of COVID-19

When it comes to COVID-19, the BA.5 omicron subvariant still causes the vast majority (almost 80%) of cases in the US, according to estimates from the Centers for Disease Control and Prevention.

Other variants including BA.4.6, BF.7 and BA.2.75 are also starting to gain steam. That’s why it’s important to get the new updated COVID-19 booster, which protects against the BA.4 and BA.5 variants in addition to the original coronavirus strain.

The signs of omicron and its subvariants are usually similar to previous strains of COVID-19, and they can include mild cold symptoms. But there are some minor differences. And people haven’t reported a loss of taste or smell with omicron subvariants as often as with the earlier variants, Torres said.

These are possible symptoms of COVID-19, according to the CDC:

  • Cough
  • Fatigue
  • Headache
  • Sore throat
  • A fever
  • Pain in the body
  • Runny nose and congestion
  • shortness of breath
  • Nausea or vomiting
  • Diarrhea
  • Loss of taste or smell

Symptoms of a cold

With a cold, symptoms tend to build up over the course of a few days. Torres said to watch out for the following:

  • Runny or stuffy nose
  • Sore throat
  • Cough
  • Accumulation

Common flu symptoms

After a few years of surprisingly mild flu seasons, early signs suggest that this fall and winter could bring flu numbers back to normal. To get the most protection, aim to get your flu shot in late October, experts say.

Unlike the common cold or COVID-19, flu symptoms often come on suddenly and can feel severe. “The flu hits you right away,” Torres explained. “If you’ve ever had the flu, you know you get to a point where you can’t get out of bed.”

Here’s what to watch out for:

  • A fever
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Pain in the body
  • Headache

Symptoms of Common Seasonal Allergies

Many people who regularly get seasonal allergies know their usual symptoms and have their own strategies for managing them. But we’re still in a pandemic, so if you start feeling symptoms, it’s worth trying a rapid test for COVID-19 just to be sure, Torres said.

He also noted that while there is some overlap with COVID-19 symptoms, allergies do not cause a fever. And the fatigue is usually milder with allergies than with a coronavirus infection.

  • Itchy or watery eyes
  • Itchy throat
  • Itchy ear canals
  • Stuffy or runny nose
  • Fatigue or tiredness

Quiz: Is It a Cold or COVID-19?

Do you have a high fever?

“The most common cause of the common cold is the rhinovirus,” Camins explained. And rhinoviruses can cause fever, but that’s rare.

So while you can get a fever with COVID-19 or a cold, you’re more likely to get a fever with COVID-19, Camins said. And a high fever is a sign you may have a more serious COVID-19, he said.

Do you have severe fatigue?

While fatigue is a common symptom of both the common cold and COVID-19, Camins explains, the fatigue is often more severe with the coronavirus.

Do you have shortness of breath?

A cold can cause a cough, but it usually doesn’t lead to shortness of breath, Camins said. So if you notice shortness of breath, that’s a sign you may have COVID-19. If you’re having trouble breathing, you should seek medical attention, the CDC says.

Do you have body aches or headaches?

As with fatigue, body aches and headaches can occur with the common cold and COVID-19. But with COVID-19, people tend to experience these symptoms more often and more intensely, Camins said.

Do you suffer from nausea, vomiting or diarrhea?

Gastrointestinal symptoms like these generally don’t occur with the common cold, the Mayo Clinic says. On the other hand, people do report stomach problems, as well as nausea and vomiting with COVID-19, the CDC explains.

Have you lost your sense of taste or smell?

It’s possible, but generally rare, to lose your senses of taste and smell from a cold, the Mayo Clinic says. And while it’s less common now with COVID-19 than it used to be, it should be a sign that your symptoms are more likely due to COVID-19.

Have you recently had close contact with someone who tested positive for COVID-19?

If you have been in close contact with someone who later tested positive for COVID-19, you may have been exposed to the virus. So you need to take precautions including wearing a mask and getting tested for COVID-19 five days later. If you develop COVID-like symptoms within that time, self-isolate and get tested immediately, the CDC says.

Don’t hesitate to test – and take precautions

“One of the biggest things is you want to avoid self-diagnosing. That means if you’re showing symptoms, you want to go ahead and get tested,” Torres said.

Camins agreed: “If you have cold symptoms and it could be COVID, number one: get tested,” he said.

If you have access to rapid home tests, you can, Camins said. And if you test negative on the first one, you’ll need to take another one 24 to 48 hours later to confirm your results. If your rapid test is still negative and you have noticeable symptoms or you know you’ve been exposed to someone with COVID-19, you can take a third test 48 hours later, the Food and Drug Administration says.

Alternatively, you can get a PCR test at any point in that process instead of continuing to use home antigen tests, Camins said.

If you get a PCR test, depending on your symptoms and what your COVID-19 test results are, you may also be tested for flu or strep throat. You may also get more than one illness at a time (such as “flurona”), or you may develop allergies in addition to COVID-19 or another condition.

In addition, if you have symptoms that could be due to COVID-19, you should wear a mask when interacting with other people, Camins said. “Even if you just have a cold and don’t have COVID, it’s still worth wearing a mask, washing your hands regularly and trying not to spread it to other people,” he added.

Best home remedies for cold, flu, allergy and COVID-19

The best home treatments for each of these illnesses depend on the exact symptoms you are experiencing. Torres shared some advice on about-the-products that can help, but you should always check with your health care provider first.

  • Fever and body aches: Use pain and fever reducers such as acetaminophen and ibuprofen.
  • Accumulation: For nasal congestion, use an over-the-counter medication such as guaifenesin (Mucinex). If your congestion is due to allergies, try a steroid nasal spray or a non-sedating antihistamine.
  • Fatigue: Make sure you stay hydrated, get enough electrolytes and rest. “Sleep is one of your greatest resources you can use right now to help your body recuperate and regenerate itself so it can protect you and keep your immune system strong,” Torres said.
  • Breathing problems: If you experience difficulty breathing or shortness of breath or if your symptoms get worse instead of improving, see a doctor, Torres said.

It’s not too late to get vaccinated

When it comes to COVID-19, know that it’s not too late to get vaccinated. And if you haven’t already, you can now get your updated bivalent COVID-19 booster and this year’s flu shot. You can even get them both on the same appointment.

COVID-19 vaccines take a few weeks to build an immune response and provide the most protection. So if you haven’t gotten those vaccines yet, now is the best way to be protected in the future.

Children as young as 6 months old are now eligible for vaccination in the United States, and anyone age 5 and older who has had their first round of vaccinations is eligible for the first booster shot. Adults 50 years and older and people 12 years and older who are moderately or severely immunocompromised are eligible for a second booster shot.


How do you recognize the difference between a cold, COVID and flu

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