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Coronavirus or the Flu: Is There a Difference Between Symptoms?

Cold, flu and COVID-19 symptoms all look similar, so it's ill-advised to self-diagnose. But experts agree that it's probably a good idea to isolate yourself from others while you wait for test results.

By Leslie Nemo
Aug 26, 2020 9:28 PMNov 3, 2020 4:47 PM
flu or covid-19 fever - shutterstock
(Credit: Prostock-studio/Shutterstock)


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A potentially dicey phase of the pandemic is almost here: flu season. The yearly influx of infections will soon coincide with SARS-CoV-2 in the Northern Hemisphere. Normally, healthcare practitioners that see patients with flu-like symptoms in late fall, winter and early spring assume the individual has influenza and treat them accordingly. This year is different.

“Going into respiratory virus season, we’re going to have a much harder time knowing what is the cause of a person’s symptoms,” says Lisa Maragakis, the senior director of infection prevention at the Johns Hopkins Health System.

Even with the potential for uncertainty, there are still some practices that physicians recommend everyone follows as the double-whammy draws near — especially if you start to develop symptoms.

Take Precautions

For starters, get your flu shot, says Maragakis. These vaccines aren’t perfect — according to the CDC, each yearly flu vaccine bounces between about 20 and 60 percent efficacy. Even though the injections don’t guarantee protection for everyone, they will work for some and can help rule out the possibility that any sniffles or body aches you develop stem from the flu.

Speaking of those all-too-familiar aches and pains: If you develop any respiratory symptoms, a fever, headaches or gastrointestinal issues that are out of the ordinary, isolate yourself. Stay home from work, skip social gatherings, and if there are any high-risk people in your home — individuals with diabetes, for example — keep to yourself if possible, says Sankar Swaminathan, chief of the infectious diseases division at University of Utah Health.

“It would be hard for me, with most people, to get at whether they have the flu or COVID-19 because the symptoms overlap to such a degree,” he adds. For the most part, only a test can parse whether or not you have the flu, a cold or COVID-19. So until you’re able to talk to a medical professional or get results back from the lab, it’s best to take precautions and behave as if you have a COVID-19 diagnosis. 

Remember that symptoms that look like a cold might actually be COVID-19 related. Colds will still be circulating among people during the fall and winter, and already Maragakis has heard from patients who chalked their runny nose and sore throat up as a typical cold. To combat those kinds of assumptions, “we’re asking people to have a high index of suspicion,” she says.

Since the best way to diagnose someone is to examine which (if any) virus is living in their body, SARS-CoV-2 testing needs to be widespread, accessible and fast. Right now, however, a majority of states fall short of daily testing goals. Recent surveys suggest that about 63 percent of people tested wait longer than one to two days for results, even though that is the ideal turnaround window for contact tracing.

The shortfall may stem from national coordination issues. "As far as I have seen, it's not a lack of willingness to provide more tests — it comes down to ability," says Maragakis. Faltering supply chains mean the essential tools needed to test and test fast are in short supply. "In my opinion, we need a much more coordinated national response to testing in order to solve those problems."

What A Test Can Do

SARS-CoV-2 tests do more than deliver peace of mind if, say, you feel congested and learn that it’s a regular cold. The results inform public health officials about the spread and containment of COVID-19 and help determine what kind of care you get.

For example, many people getting a SARS-CoV-2 test will also get an influenza test (possibly with a new two-in-one technology). If someone has the regular flu, there are approved medications to fight off the infection they can take. In past flu seasons, healthcare practitioners administered influenza tests but often treated the individual as if they had the infection before getting results, Swaminathan says. The odds of their illness being the flu are high enough to make that a reasonable choice. With much more uncertainty this year about what someone might have and what treatments could help them, the prescribe-before-results habit will likely be much less common.

The prospects of not knowing what kind of illness you might have, or waiting a long time for official lab results, might sound gloomy. But there is a bright side. It's possible that our COVID-19 mitigation tactics, like wearing masks, social distancing and avoiding large gatherings, could reduce influenza spread as well. This scenario likely played out in the Southern Hemisphere earlier this year. That half of the globe sees an influenza season during the Northern Hemisphere's spring and summer, and many countries reported very low non-COVID diagnoses.

To keep influenza and COVID-19 cases low — and to keep you from playing the symptomatic guessing game with yourself — stick with those preventative health measures for the foreseeable future. "It’s not going to last forever," says Swaminathan, "but we have to be patient and we have to be vigilant."

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