Cold, flu, hay fever, or COVID - Which one do I have?

Maybe you’ve developed a mild cough, sore throat and a runny nose, and you are panicking. That’s understandable, especially now, with COVID-19 still causing illness. It’s important to remember that as concerning as COVID-19 is, most people recover from the disease without needing special treatment. Some people never even have symptoms.

In fact, many of the most common COVID-19 symptoms are commonly seen in other illnesses, like the flu, the common cold or seasonal allergies such as hay fever (see Table 1).

Cough and cold, flu and allergy seasons often all occur at the same time which can make working out your symptoms even more challenging. You may end up with mixed symptoms (such as allergy and COVID-19 symptoms), so it can get complicated.

Comparing the most common features of COVID-19 with other viruses and allergies that circulate throughout the year might be a helpful start.

The initial COVID-19 symptoms tended to appear within the first 2 to 14 days, usually around day 5 to 6, but may be sooner with the more recent variants. The most common ones -- fever, cough and shortness of breath -- are well-known and expected features.

With the newer variants, a sore throat and nasal congestion, occurring more in the upper respiratory tract system, also seem to be common. Symptoms may appear more quickly than previous variants, around day 2 to 3 after exposure.

Omicron variants seem to cause less severe illness than earlier types of COVID-19. The variants circulating as of September 2023 are all of Omicron lineage.

Symptoms of COVID-19 are usually mild and start gradually. Although fever, cough, shortness of breath and fatigue are frequent symptoms, not everyone exhibits the same side effects. Some features, like diarrhea and headache, may occur less frequently. Children may exhibit a different set of symptoms or no symptoms at all.

The CDC states that anyone with can spread the virus to others, even if they are vaccinated or don’t have symptoms.

Table 1: Symptoms of COVID-19, the Flu, a Cold and Allergies

Does everyone show COVID-19 symptoms if they have this virus?

No, you can still be infected with COVID-19 and may not know it. While most people today usually get at least mild cold- or flu-like symptoms, you may not have any symptoms at all.

Staying at home, social distancing, using a good face mask, and frequent and thorough hand washing are so important if you are infected.

When to seek emergency care

It’s important to know your symptoms and seek advice when needed. If you develop emergency warning signs for COVID-19, contact emergency care immediately. Severe cases can lead to pneumonia and acute respiratory distress syndrome and can be fatal. Emergency warning signs include:

• Trouble breathing
• Persistent pain or pressure in the chest
• New confusion
• Inability to wake or stay awake
• Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone

If someone is showing any of these signs, call 911 or call ahead to your local emergency facility. Notify the operator that you are seeking care for someone who has or may have COVID-19.

Call your doctor

If you think you have been exposed to COVID-19, or test positive, and develop a fever and symptoms like a cough or difficulty breathing, call your health care provider for medical advice. Antiviral treatments like Paxlovid are now available but need to be started within 5 days of symptom onset.

If you have symptoms consistent with COVID-19 and you are aged 50 years or older OR are at high risk of getting very sick, you may be eligible for treatment. Treatment can reduce your risk of hospitalization by over 50% and reduce the risk of death.

Learn more: When should I test for COVID?

Who is at high risk for COVID-19 complications?

Older adults (age over 50) and people who have severe underlying medical conditions are especially vulnerable and should take special precautions to avoid contact with the virus. According to the CDC, more than 81% of COVID-19 deaths occur in people over age 65.

Higher risk groups for severe illness with COVID-19, as noted by the CDC, include:

• Heart diseases (heart failure, coronary artery disease, cardiomyopathies, and possibly high blood pressure (hypertension)
• Kidney and / or liver disease
• Overweight and obesity
• HIV infection
• Sickle cell disease or thalassemia
• Lung diseases such as asthma or chronic obstructive pulmonary disease (COPD)
• Type 1 or type 2 diabetes
• Cystic fibrosis
• Substance use disorders
• Certain types of disabilities (i.e., birth defects, Down syndrome, ADHD, cerebral palsy)
• Pregnancy
• Stroke
• Tuberculosis
• Organ or blood stem cell transplant
• Smoking (current or former)
• Weakened immune system (immunocompromised)
• Dementia or other neurological disorders
• Mental health disorders (mood disorders, including depression, and schizophrenia)
• Little or no physical activity

It is important that you talk with your healthcare provider about your risk for severe disease or death if you should contract COVID-19. Understand what kind of action plan you initiate if you have symptoms or test positive for COVID-19. Learn if you are eligible for antiviral treatment.

This is not all the information you need to know about COVID-19 treatment for safe and effective use and does not take the place of your doctor’s directions. Review any treatment information and discuss this information and any questions you have with your doctor or other health care provider.