Montefiore in the News
Is it a Cold, the Flu, or COVID-19?
- October 12, 2020
October 12, 2020
About 80 percent of people who get COVID-19 develop mild symptoms that resemble those of a cold.Aleksei Morozov/iStock
Before the pandemic, a scratchy throat and stuffy nose were nothing to get alarmed about. Most of us experiencing these symptoms could assume we had a cold and power through.
This is clearly no longer a great strategy. “There’s a tremendous amount of overlap between symptoms of a cold, the flu, and COVID-19,” says Jeffrey Loria, MD, an internist in New York City. “It’s not that you have to panic. If you get a simple runny nose or scratchy throat without a fever or other significant respiratory symptoms, it’s likely that you’ve just got a cold.”
But that’s not always the case now that the novel coronavirus has entered our lives. “COVID can present as a common cold, with a runny nose, congestion, and a headache,” says Natasha Chida, MD, an infectious diseases physician at The Johns Hopkins Hospital in Baltimore. “In fact, 80 percent of people who get COVID-19 develop mild symptoms that resemble those of a cold.”
COVID-19 symptoms can also mimic signs of the flu, which is especially concerning as flu season approaches and distinguishing between the two illnesses becomes vital. “The flu usually hits with a fever, muscle aches, and a feeling of being rundown, all of which can be present in COVID-19,” Dr. Chida says.
If you begin to feel unwell and don’t know why, the most important thing you can do — in addition to staying home and isolating yourself — is calling your healthcare provider to describe your symptoms. “Talking to your physician about your symptoms and whether to get tested is the best first step,” says Chida.
Top Cold Symptoms
“We’ve all had colds, so we tend to know what the symptoms are — and they are typically less severe than those of COVID-19 or the flu,” says Dr. Loria.
Cold symptoms can include:
- A runny nose
- Mild cough
- Sore throat
- Body aches
Top Cold Symptoms
“Flu symptoms are apt to come on very abruptly, versus symptoms of COVID-19 or a cold,” says Loria.
These symptoms can include:
- A high fever lasting several days — “One of the hallmarks of the flu is a higher fever than you’d get with COVID-19, which generally tends to be in the 100.5 [degrees F] range,” Loria says.
- Malaise, fatigue, and weakness
- Muscle aches
- Dry cough — “Often with the flu you get a dry ‘barking’ cough, which is not something you see with a cold, though you may see it with COVID-19,” says Loria.
Unlike COVID-19, the flu is seasonal, mainly occurring in fall and winter. ”We know it’s coming every year,” says Priya Nori, MD, an infectious diseases specialist at Montefiore Health System in New York City. As for COVID-19, she says. “You can get it in warm weather or cold, in spring, summer, winter, and fall.”
Top COVID-19 Symptoms
COVID-19 can bring on the same symptoms as a cold (congestion, headache, body aches, sore throat) and the flu (fever, cough, overall malaise, and muscles aches). “But there are also outside-the-box symptoms that you may not see with the common cold or flu,” says Dr. Nori.
COVID-19 symptoms include:
- A lack of ability to smell or taste, particularly at the onset, when there are no other symptoms present
- “We generally don’t think of diarrhea and other gastrointestinal symptoms as something that occurs with influenza in adults,” says Nori. “But with COVID, diarrhea can occasionally be the only symptom, along with profound fatigue.”
- Nausea or vomiting
- Shortness of breath, difficulty breathing, or chest tightness
- Severe inflammation — “In more advanced cases, especially, COVID can affect blood vessels and damage big and small arteries and veins throughout the body, leading to a severe inflammatory state,” says Nori.
- “Young children with COVID may get a rash on their fingers and toes,” says Nori. “And, rarely, we’ve seen something called multisystem inflammatory disorder in children [multisystem inflammatory syndrome in children, or MIS-C], which is similar to Kawasaki disease, and is not something we see with the flu.”
- Chest pain or heaviness in the chest
Getting a Diagnosis
The overlap in symptoms between the cold, the flu, and COVID-19 means that the only way to diagnose the illness is testing. “If we don’t test people, we’re merely guessing at things,” Loria says. “If someone reaches out with fever or any respiratory symptoms, I’d make sure to get them tested for both the flu and COVID.”
Loria adds, “Last year, if a patient had flu-like symptoms, I’d be likely to give them Tamiflu [a flu medication] without testing. But this year, those symptoms could be COVID. That’s why trying to get people tested, for both COVID-19 and the flu, is our No. 1 recommendation.”
The benefit to testing for COVID-19 is obvious by now: If you are found to be infected with the novel coronavirus, “the sooner you take yourself out of circulation and isolate yourself, the sooner you’ll be on the path to doing the right thing for the people around you,” says Nori.
There are also more treatments available for COVID-19 than in the beginning of the pandemic, she adds. “If you are in the small but real percentage of people with COVID who end up requiring hospitalization, remdesivir, if given early enough, can act to block the virus from entering immune cells and the respiratory tract, and shorten the time to recovery.”
A Flu Shot Is Vital
It has always been important to get a yearly flu vaccine, “but it’s absolutely critical to get a flu shot this season,” emphasizes Chida. Aim to do it by the end of October, though experts agree that the best time to do it is whenever is practical for you. Though the vaccine isn’t 100 percent effective, it is very safe and reliable. And if you get the vaccine and do get the flu, you will likely end up with a much milder case.
There are reasons beyond your own health to get a flu shot ASAP. “You’ll be protecting your community,” says Chida. “If COVID cases go up this winter, we don’t want the health system to be overwhelmed with both COVID and the flu.” Plus, you want to avoid getting the flu and COVID-19 at the same time. “Whenever you get a viral infection, it weakens your immune system, so it’s best to take steps so that doesn’t happen,” says Chida.
COVID-19 Safety Measures Can Prevent Cold and Flu Too
Tactics meant to prevent the spread of COVID-19 can also block the spread of colds and the flu. “Masks work amazingly well,” says Nori. “They’re a low-budget, low-stakes intervention with a high-stakes reward.”
Social distancing, staying home if you feel ill, and hand washing are also key — and doctors say they are already seeing the benefits of these measures, both in terms of fewer COVID-19 cases and fewer patients coming into the office with cold symptoms.
“If people get vaccinated for the flu, plus do everything else we’ve already been doing to prevent COVID, I anticipate we will see fewer colds, less flu, and less COVID this coming season,” says Loria.