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Seasonal Allergies, the Flu, Or COVID-19?

Medically reviewed by Chhavi Gandhi, MD, Susan Kerrigan, MD and Marianne Madsen on January 14, 2023

The weather is warm and outdoor activities are legion, yet all you want to do is curl up in bed with some hot tea.  If you’re feeling ill, you likely have a host of symptoms. Unfortunately, a year’s worth of dire medical news can turn the most hardy person into a hypochondriac. You don’t want to overreact. Still, it’s normal to worry that your cough means you have COVID-19. The good news is that in many places your risk of contracting the virus is the lowest it has been in months. So take a step back, think about what’s ailing you, and determine if you have seasonal allergies, the flu, or COVID-19.

 

The Summer Sniffles

 

Unlike COVID-19, the flu, or even the common cold, seasonal allergies are not caused by a virus. Instead they are an immune system response triggered by allergens. For many of us, that’s pollen. In the spring and summer, hay fever can be pretty terrible. Yet despite the name, a fever is not a symptom of hay fever! People with seasonal allergies (or allergic rhinitis and allergic conjunctivitis can) suffer through them every year. The common symptoms include runny nose, stuffy nose, post nasal drip, sneezing and itching of the nose and eyes. They aren’t accompanied by chills or muscle aches. While most viruses resolve in days to weeks, allergy symptoms can persist for the entire triggering season. Symptoms can be worse during certain times of the day. The right allergy avoidance and medication usually clears up symptoms. When it clears up, they not only feel decent, they often feel better than ever (having suddenly clear sinuses can do that). 

 

It can help to keep your windows closed and the AC running during days with high pollen counts. Sunglasses can help you keep pollen out of your eyes when you’re outdoors. Allergy sufferers often find that an antihistamine works wonders––although it might lead to a midday nap.  A few people with seasonal allergies also have asthma. When it’s triggered, they experience  shortness of breath usually with coughing and/or wheezing. These symptoms can be difficult to distinguish from symptoms of COVID-19 but usually temporarily improve with emergency asthma medications and can be completely controlled with the right combination of medications. If you or a loved one are having a serious asthma attack and don’t have access to treatments, medical attention may be necessary.

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Allergic Rhinitis & Conjunctivitis - Treatment

Allergic Rhinitis & Conjunctivitis - Treatment

The Common Cold

 

Along with seasonal allergies, the flu, or COVID-19, some unlucky people regularly get summer colds. While everyone else is enjoying the beach, they’re likely stuck at home. Common colds are caused by a class of virus called rhinoviruses (COVID-19 is caused by the SARS-CoV-2 virus). However, some colds are caused by other coronaviruses including 229E, NL63, OC43, and HKU1. Like COVID-19, they strike the respiratory system with symptoms including a fever or a cough. Although the coronavirus was named for its shape, the rhinovirus was named for its favorite place to visit––your nose (which is at a cold-preferring temp of 33–35 °C). There is no cure for the cold, although there are a host of over-the-counter treatments that can help you feel better. The range of symptoms is varied––fever, body aches, coughing, runny nose, and sneezing are common. Sneezing, however, is very rare in COVID-19 patients––perhaps one in 20 who were hospitalized with the virus had this symptom. Colds can also bring on shortness of breath in patients with underlying respiratory diseases such as COPD or asthma. Colds tend to go away in a few days, although for an unlucky few they hang on for weeks––like that jobless summer house guest. 

 

The Flu and Flu-like Symptoms

 

Perhaps the illness hardest to distinguish from COVID-19 is the flu. Both are caused by viruses, with variants of influenza A or B responsible for thousands of deaths each year. During the 2017-2018 flu season, over 60,000 people died in the United States alone. A significant percentage were under 65 and otherwise healthy, even athletic, whereas over 80% of those suffering from severe COVID-19 symptoms are over 65 or suffering from severe health problems. 

 

The challenge is that many of COVID-19’s symptoms like muscle pain, fevers, and chills are also common with the flu. It can be very difficult to tell one from the other. The one distinct symptom with severe COVID-19 is shortness of breath, even in those without an underlying respiratory condition. It often doesn’t occur until several days after the onset of other symptoms. It’s important that this life-threatening symptom be monitored closely. Low levels of oxygen in the blood are one of the main reasons for hospitalizations and death. Unlike the flu, COVID-19 has been linked to a huge number of other symptoms including brain fog, hallucinations, and skin irritation.

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COVID-19 Symptoms

COVID-19 Symptoms

Anything that affects your sinus cavities, including seasonal allergies, the flu, or COVID-19, will impact your ability to smell or taste. However, some teenagers who later tested positive for COVID-19 reported loss of smell and/or taste as their only symptoms. In other words, despite being able to breathe through their nose, they still didn’t have a sense of smell or taste. It’s important that those with this symptom get tested.

 

Finally, although the 2020-2021 flu season was far less severe than most predecessors, the subsequent seasons have been more severe. Experts believe the social distancing and mask wearing done to reduce the spread of COVID-19, along with more people getting flu vaccines, was the main reason for the decline in 2021-2021. If you have a contagious illness, staying home in bed is actually a good idea. If the pandemic taught us anything, it’s that no matter how important your job may seem no one should ever go into their workplace with a communicable illness.

 

Written by John Bankston

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