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How to identify the different symptoms of influenza and Covid-19

As flu season approaches, some Americans, and particularly parents, are concerned that if they or their children get sick, it may not be easy to know which disease they have: the flu or Covid-19.

They are right. Most of the symptoms of the two diseases are so similar that unless you have one test – or two or three tests – you won’t be able to know for sure. But there are some clues. (And it’s possible to have both infections at the same time; some patients in China have experienced both this year.)

It is still unclear whether the US will have a flu season this year. Flu activity in the southern hemisphere, which is often predictive of activity in the United States, was 99% lower than normal during its winter. Epidemiologists believe this is due to Australians, New Zealanders, South Africans, Chileans and other residents of the southern half of the globe wearing masks, staying several meters away and washing their hands to prevent coronavirus transmission. Those same precautions also prevent the transmission of the flu.

Since there are very few flights between the Southern Hemisphere and the United States at this time, there may be no chance for the usual four strains of seasonal flu to “re-seed” among Americans. If they do, the masks and social distances should limit their spread.

However, experts urge all Americans to get vaccinated against the flu. Before it ended abruptly during the lockdown, last year’s flu season was well on its way to being one of the worst in recent memory. The number of child deaths was the same as in the 2017-18 season, the worst since the Centers for Disease Control and Prevention began monitoring deaths from the flu season in 1976.

If you get the flu, experts say, having the injection made it much less likely that you will be hospitalized or die.

Due to fears of a “twindemia”, influenza vaccines have been carried out in large numbers this year and distributed to pharmacies and doctors’ offices starting in August, which is early. Late last month, some doctors reported difficulties ordering as many as they want, but pharmacy chains say they are receiving constant supplies. To find a flu shot, try vaccinefinder.org or one of the pharmacy chain websites, such as CVS.com/immunizations/flu.

There are at least 100 viruses that can cause the common cold, but only four that cause seasonal flu. Many people who catch colds assume they have the flu, but experts constantly say the same thing about how to tell the difference: “The flu makes you feel like you’ve been hit by a truck.” The fever, aches, and headaches of a bad case of the flu are generally worse than a case of respiratory syncytial virus, rhinovirus, or other common cold virus.

Everyone knows the symptoms of the flu: fever, headache, muscle aches, sore throat, runny nose, stuffed breasts, cough and sneezing, and, for newborns, ear infections. Some victims, especially children, also suffer from diarrhea or vomiting.

In severe cases, the most common complication is pneumonia. Typical signs of flu pneumonia are shortness of breath, especially when exercising, and unusually rapid breathing – doctors typically look for in children – and sometimes chest or back pain.

Knowing if you have Covid-19 is much more complicated because there are so many different ones – and sometimes quite extravagant – symptoms, many of which echo those of the flu.

The most common symptoms are high fever, sometimes with chills, dry cough and fatigue.

The only sign that really distinguishes the two infections is that many Covid-19 victims suddenly lose their sense of smell, not because they have a stuffy nose, but because they don’t register even strong smells like onions or coffee. Not all virus victims get anosmia, the formal name for loss of smell, but one study found that 87 percent did.

Less common symptoms include sore throat, congestion, runny nose, vomiting, diarrhea, stomach pain, and feeling short of breath during exertion. Some victims have red or itchy eyes and others have redness or blisters on their fingers or toes, so-called Covid fingers, which resemble chilblains.

More dangerous symptoms – which means you should get immediate medical attention – include severe breathing difficulties; chest pain or pressure; blue lips or blue face; confusion or inconsistent responses to simple questions; and collapse or lose consciousness.

In addition to the frightening nature of the disease, it can cause blood clots that lead to damage to the heart, brain and lungs. And even some cases that appear mild or asymptomatic create signs of what doctors believe may be long-lasting heart damage.

Another unusual aspect of Covid is that people sometimes develop pneumonia without realizing how sick they are. Doctors aren’t sure why; one theory is that the air pockets in the lungs are damaged in a way that does not cause carbon dioxide to build up, which creates that feeling of “despair of air”.

However, as with diseases like measles, you can start spreading the virus two days before you start feeling sick. So, if you think you have been exposed, it is very important to warn others and isolate yourself from them as soon as possible, especially if they are older or medically frail.

It is a general practice axiom that when a disease is passing through an area and a patient has its symptoms, it is usually safe to assume that it is what the patient has and start treating it, rather than waiting for the test results. So, unless both the flu and the coronavirus start circulating heavily at the same time in your city, don’t be surprised if your doctor doesn’t recommend a test.

And getting tested for coronavirus can be tricky, especially with so many delays in testing. The type of PCR is more accurate than 15-minute “rapid antigen tests”, but it can take hours or even days to return results, depending on whether it needs to be sent to a central laboratory.

A positive test probably means you are infected, but a negative test should not be trusted; too many things can go wrong. Two negative PCR tests taken at least 24 hours apart are a better indication of whether or not you are infection free.

If your insurance company is only going to pay for one test, you might consider paying the second yourself for peace of mind.

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