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As flu season approaches, some Americans, and especially parents, are concerned that if they or their children get sick, it may not be easy to know which illness they have: the flu or COVID-19.
They are right. Most of the symptoms of the two diseases are so similar that unless one test, or two or three tests, is done, it will not be possible to know for sure. But there are some clues. (And it is possible to have both infections at the same time – some patients in China this year were found to have both.)
But first: get a flu shot
It is not yet clear whether the United States will have a flu season this year. Flu activity in the southern hemisphere, which often predicts activity in the US, was 99% below normal during the winter. Epidemiologists believe it is because Australians, New Zealanders, South Africans, Chileans and other residents of the southern half of the world wore masks, stood several feet away, and washed their hands to prevent transmission of the coronavirus. Those same precautions also prevent the spread of the flu.
Because there are so few flights between the southern hemisphere and the US At this time, there may not be a chance for the four common strains of seasonal flu to “reboot” among Americans. If they do, masks and social distancing should limit their spread.
Still, experts urge all Americans to get vaccinated against the flu. Before it ended abruptly during the lockdown, last year’s flu season was on track to be one of the worst in recent memory. The number of children who died was equal to that of the 2017-18 season, which was the worst since the Centers for Disease Control and Prevention began tracking deaths during the 1976 flu season.
If you do get the flu, experts say, having the vaccine makes it much less likely that you will be hospitalized or die.
Due to fears of a “twin,” large quantities of flu vaccines were made this year and distributed to pharmacies and doctors’ offices beginning in early August. Late last month, some doctors reported they were having a hard time ordering as many as they wanted, but pharmacy chains say they are getting constant supplies. To find a flu vaccine, try vacunarfinder.org or one of the chain pharmacy websites, such as CVS.com/immunizations/flu.
Assess the difference between a cold and the flu
There are at least 100 viruses that can cause the common cold, but only four that cause the seasonal flu. Many people who catch colds assume they have the flu, but experts consistently say the same thing about differentiating: “The flu makes you feel like you’ve been hit by a truck.” The fever, aches, and headaches from a severe case of influenza are generally worse than a case of respiratory syncytial virus, rhinovirus, or other common cold viruses.
Everyone knows the symptoms of the flu: fever, headaches, body aches, sore throat, runny nose, sinus congestion, coughing and sneezing and, in the case of babies, 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 straining, and unusually rapid breathing (doctors often look for that in children), and sometimes chest or back pain.
Identify COVID-19 by its flu-like and “quirky” symptoms.
Knowing if you have COVID-19 is much more complicated because there are many different, and sometimes quite outrageous symptoms, many of which resemble those of the flu.
The most common symptoms are high fever, sometimes with chills, a 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 even register strong odors like onions or coffee. Not all victims of the virus suffer from anosmia, the formal name for loss of smell, but one study found that 87% do.
Less common symptoms include a sore throat, congestion, runny nose, vomiting, diarrhea, stomach pain, and feeling somewhat breathless when straining. Some victims have red or itchy eyes, and some have redness or blisters on their fingers or toes, so-called COVID fingers, that look like chilblains.
The most dangerous symptoms, meaning you should get immediate medical attention, include severe shortness of breath; chest pain or pressure; blue lips or blue face; confusion or inconsistent answers to simple questions; and collapse or loss of consciousness.
Adding to the fearsome nature of the disease is the fact that it can cause blood clots that lead to heart, brain, and lung damage. And even some cases that seem mild or asymptomatic create signs of what doctors believe may be lasting heart damage.
Another unusual aspect of COVID is that people sometimes develop pneumonia without realizing how sick they are. Doctors are not sure why; One theory is that the air sacs in the lungs are damaged in a way that doesn’t cause carbon dioxide build-up, creating that “desperate for air” feeling.
Many doctors recommend purchasing a pulse oximeter, a fingertip device that measures oxygen levels in the blood. Multiple readings below 92% should prompt a call to a physician. The earlier pneumonia is detected, the better the outcome.
Understand that the symptoms of COVID-19 in children are similar to those in adults.
Children generally outgrow COVID-19 with little trouble; for younger ages, it is believed to be less dangerous than the flu.
Children have the same constellation of symptoms as adults, although parents are more likely to notice it when their children have a runny nose, red eyes, and exhausted irritability that comes from simply feeling terrible.
Dangerous symptoms include shortness of breath, bluish lips, confusion or inability to wake up, and severe abdominal pain or inability to retain fluids. If there are signs of these, it is important to get the child to a doctor or hospital quickly.
In very rare cases, children can develop multisystem inflammatory syndrome, which is believed to be caused by an overactive immune response and can cause shock and organ failure.
But doctors emphasize that it is rare and that parents must realize that their sick child is highly unlikely to have it.
Expect potential difficulties with testing
For COVID-19, symptoms can begin two to 14 days after exposure, but most begin five to seven days later.
However, as with illnesses like measles, you can start spreading the virus two days before you start to feel unwell. Therefore, if you think you may 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 fragile.
It is an axiom of general medicine that when a disease spreads through an area and a patient has its symptoms, it is generally safe to assume that is what the patient has and begin treating it, rather than waiting for the test results. So unless both flu and coronavirus start to circulate strongly at the same time in your city, don’t be surprised if your doctor doesn’t recommend a test.
And getting tested for the coronavirus can be tricky, especially with so many testing delays. The PCR type is more accurate than the 15-minute “rapid antigen tests,” but it can take hours or even days to get the 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 relied upon; Many things can go wrong. Two negative PCR tests taken at least 24 hours apart are a better indication of whether you are free of infection.
If your insurance company will only pay for one test, you might consider paying for the second one yourself for peace of mind.
