Is it the flu or COVID-19? How to tell the difference

The flu and the coronavirus share several common symptoms. Here’s a look at how to know which of the two viruses you might have.

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USA Today

Due to overlapping symptoms between influenza and COVID-19, physicians and health experts are urging everyone six months and older to get vaccinated for the flu this year. One infection can make you more susceptible to others by weakening your immune system.

The flu vaccine reduces the severity and risk of serious complications, according to the Mayo Clinic. But it will not protect you from COVID-19.

Many of the steps recommended to prevent the spread of COVID-19 – such as mask-wearing, hand-washing, and physical distancing – also help prevent the spread of seasonal flu. The Centers for Disease Control and Prevention reported that positive test results for flu dropped from more than 20% during the pandemic.

The flu and COVID-19 share several common symptoms. Here’s how to tell the two viruses apart:


How are they transmitted?

According to World Health Organization, COVID-19 and influenza viruses can occur through direct, indirect or close contact with infected people through secretions such as saliva and respiratory droplets which are expelled when a person coughs, sneezes or talks.

Droplets from a sick person can transmit the virus to other people nearby. The smallest particles can linger in the air, and another person can inhale them and become infected.

What symptoms do COVID-19, flu share?

According to the CDC, the flu has killed an average of 37,000 Americans a year since 2010. Dr. Robert Redfield, the agency’s director, has said he’s especially worried about the impact that an early peak of the flu season would have on the coronavirus crisis. The flu season typically gets going in late October, gathers steam over the next two months and crests in January and February.


How flu and coronavirus symptoms typically develop

A study led by researchers from the University of Southern California determined the order of COVID-19 symptom progression, potentially making it easier to recognize an infection. The first symptom of the flu was most likely to be a cough while for COVID-19 it was fever. COVID-19 can also be distinguished by the loss of taste and smell.

But symptoms vary from person to person. In 40% to 45% of COVID-19 cases, there may not be any symptoms at all. Fewer than 20% of infected who show up at a hospital report having had a sore throat or runny nose. Patients experience muscle weakness, inflammation, arrhythmia, and in some cases, heart attacks.

How long does it take for symptoms to appear?

When a person is exposed to COVID-19, it can take up to two weeks before symptoms show up. It takes even more time for additional people to become ill after being exposed to that person. So several cycles of infection can occur before public health officials notice signals in data used to track the pandemic. 

Experts are concerned about a second wave of COVID-19. Both the 1918 flu pandemic and the 2009 H1N1 flu epidemic began with a mild wave of infections in the spring, followed by another surge of cases in the fall.


Studies show that dual waves of coronavirus and influenza threaten to overburden the health care system. The highest rates of mortality from COVID-19 are usually in the areas where the pandemic has hit hardest, overwhelming hospital resources and staff. The overall hospitalization rate in the U.S. for flu 2019 - 2020 flu season was about 69 hospitalizations per 100,000 people, according to the CDC. For COVID-19, it’s 175 per 100,000. The mortality rate for COVID-19 is thought to be substantially higher (possibly more than 10 times) than the rate for most strains of influenza.

“From a health care capacity standpoint, we’re concerned about having both of these serious viruses circulating at the same time,” said Lisa Maragakis, senior director of infection prevention at Johns Hopkins. ”The hospitals and health system may become even more overwhelmed.”

It’s also possible to have flu and COVID-19 at the same time. An analysis by Public Health England found that people with the two viruses were more at risk of severe illness. Overall, 43% of people with co-infection died compared to 27% of those who had COVID-19 alone. Most cases of co-infection were in older people, and more than half of them died. People with preexisting conditions are also more vulnerable.

For people with a mild case of COVID-19, the recovery time can be between 1 to 2 weeks. Some cases become much worse at around the 10 to 14-day mark, these individuals often need to go to the hospital. In severe cases, the recovery time may take up to six weeks or more and there may be lasting damage to the heart kidneys, lungs and brain. Nearly 3% of those in the U.S. who contract COVID-19 die from the disease, the fatality rate is around 1% worldwide.

According to the CDC, uncomplicated flu symptoms typically are resolved after 3-7 days for most people. Although a cough and overall weakness can persist for two weeks, especially in elderly people and those that have chronic lung disease.

Young children are also at risk of severe influenza. However, the National Poll on Children’s Health reported that 1 in 3 parents don’t plan to get their children vaccinated for the flu this year. An outbreak of flu or other preventable disease in children could make it harder for doctors and hospitals to care for all patients. 

The study recently published in the Journal of General Internal Medicine showed that fewer than half of U.S. adults and just two-thirds of children received the flu vaccine during the 2017–2018 season.

If you are worried about getting sick with COVID-19 while getting a flu shot, Maragakis recommends calling your provider and asking about safety measures they have in place. 

“In my experience, every clinic and health care system facility as well as the drugstores and other places that are administering the vaccine are doing a very good job to try to keep everyone safe while they get their vaccine,” Maragakis said. ”It shouldn’t be a risk for people to go and get their flu shots. Make sure that you wear your mask and wash your hands and practice social distancing while you do it.”

Preparing for a second COVID wave

Maragakis says that the U.S. is still in the first wave of COVID-19. However, different regions might be in different stages.

“Some of the Northern and Midwestern states appear to be having some of the highest case counts and are probably in the height of their first wave,” Maragakis said. ”But I think the most concerning thing is that we’re seeing some regions such as in the Northeast, that had obtained very good control of the virus, that are beginning to see increases.”

Experts expect a second wave of COVID-19 with the cases increasing in the fall. With the disease now widespread, it can be harder to detect and control transmission. There are a couple of things you can do to stay prepared. Make sure to maintain a two weeks’ supply of food, medicines, and supplies in case you’ll have to quarantine. Continue practicing COVID-19 precautions, such as maintaining physical distance, washing hands often, and wearing a mask.

In the end, it all comes down to abiding by public health measures. The more people practice the measures, the lower is the viral transmission.

Read more at USA Today.

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