“It can be confusing, and it’s important to differentiate. If it’s viral, every time you cough, you’re spreading droplets within a six-feet radius” that can infect others, said Sally Joo Bailey, an allergist at Allergy Associates of Northern Virginia in Arlington and the past president of the Greater Washington Asthma, Allergy and Clinical Immunology Society. Allergies, on the other hand, are not contagious.
Because of warmer temperatures, allergy season started in February this year instead of March, Bailey said, so Washington-area residents are already exhibiting symptoms. Data show that some people infected with the coronavirus experience similar symptoms, such as coughing, nasal congestion, runny nose and sore throat.
But there are key differences between the virus and allergies that should help allay unnecessary panic. Allergies, which are an overreaction of the immune system to foreign particles, should not trigger chills, body aches or fevers, Bailey said. Those are the classic signs of a viral infection, such as covid-19. In addition, while patients with coronavirus can have nasal congestion, it is not common. The World Health Organization found that only about 5 percent of the coronavirus patients in China had nasal congestion. About 14 percent had a sore throat.
Unfortunately, we are still in cold and flu season, which can go on until as late as May, and it is less easy to differentiate between covid-19 and those illnesses. Both cold and the flu, or influenza, are, like covid-19, viral infections transmitted through person-to-person contact. Flu is accompanied by fever, and a cold can cause fever, too. Both the flu and the coronavirus can cause a dry cough. A cold can be accompanied by a wet or dry cough.
The flu vaccine provides no protection against the coronavirus and does not guarantee you will not get the flu, so people who have been vaccinated against flu but are experiencing flu-like symptoms should take them seriously.
“In Virginia and Maryland, flu activity is still high,” said Jesse L. Goodman, an infectious disease specialist at Georgetown University. “Even an experienced clinician can’t always tell the difference between viral infections without testing.”
When in doubt, it is best to consult a doctor, Goodman said. “They’ll probably ask about general health and medications to assess your risk group.” Patients with high fever and difficulty breathing will be asked to come in but as cases of covid-19 rise, patients exhibiting mild symptoms may be asked to stay home rather than come in for testing since there is no medication for the disease, only supportive care. “We have a desire to test for flu because we have a treatment that helps with that,” Goodman said, referring to the antiviral medication used to treat some flu patients.
Here are some suggestions from experts about how to handle this confluence of seasonal allergies, the common cold, influenza and the coronavirus.
● Experienced seasonal allergy sufferers should pay close attention to allergy symptoms they are familiar with and treat them as they normally would. That includes showering and washing your hair as soon as you get home to remove pollen and taking the antihistamine that works best for you. Some antihistamines, such as Benadryl, have sedative effects and work quickly but must be retaken every four to six hours. Others such as Allegra, Claritin and Zyrtec are long-lasting and non-sedating but can require up to several hours to take effect. Antihistamines should provide some relief. If they do not, consult a primary care physician or an allergist.
● Anyone not feeling well should watch for a fever. Coronavirus can cause high fever, severe cough and shortness of breath. High fever usually means around 103 degrees, Goodman said, but anyone running a fever at all (above 100.4) who is also having difficulty breathing should seek medical help immediately, because that should not occur with simple allergies.
● While is important that healthcare professionals have the space and resources to help those who really need it, feel free to call your doctor’s office with concerns. A nurse can ask questions that will help determine whether you need to be examined immediately. “We don’t want to flood the system, especially the emergency rooms right now,” said Elizabeth Douglass, an infectious diseases specialist at Dell Medical School at the University of Texas at Austin.
● Get a flu shot, if you have not. Flu activity in Maryland and Virginia has been decreasing for the third week in a row but it is still high. The CDC reports that this season’s flu vaccine decreases chances of catching the flu by 45 percent. People who have not gotten the flu vaccine still can and should.
● Find out whether you are a candidate for the pneumonia vaccine. Both the flu and coronavirus can result in pneumonia, which can be life-threatening. Adults over the age of 65 or others with certain chronic medical conditions may benefit from the vaccine, which provides protection from the most common pneumonia in adults.
● Wash your hands. This helps prevent the spread of all viral infections, including cold, influenza and the coronavirus. Use soap and warm water, and scrub well.
● Don’t panic. There is no need to purchase face masks or wear them unless you have a contagious viral infection or you are caring for someone who is.
“No one can say right now that this is not significant virus,” Goodman said of the coronavirus. “But I think it is really important that people realize this is not Ebola,” which has an average case fatality rate of 50 percent, compared with the World Health Organization’s current estimate of between 3 and 4 percent for COVID-19. “It does appear that the great majority of people have a mild illness and get better.”
He emphasized that as we enter allergy season and exit cold and flu season, it is important that the public does not rush to the emergency room with seasonal allergies and minor illnesses, or purchase masks and hand sanitizer unnecessarily.
“Sometimes fear can be more dangerous than a virus,” he said. “People may put themselves and other people in danger.”
Sindya Bhanoo is a health and science reporter living in Austin, Texas.