You’ve just coughed or sneezed. Now what? With COVID-19 on everyone’s minds, it’s easy to become suspicious of any illness, even if it’s probably benign. When the symptoms of the common cold, the flu, and COVID-19 overlap, how can you tell which you have? Learn the differences between human coronavirus and other viruses, and how to prevent infection.
What causes colds, the flu, and COVID-19?
“All three are caused by viruses,” says Dr. Georgine Nanos, expert in epidemiology and CEO of Kind Health Group in Encinitas, California. “The common cold is usually caused by a virus called rhinovirus. COVID-19 is caused by coronavirus. The flu is caused by the influenza virus.”
Within those types of viruses, there are variations. Influenza virus falls into two categories labeled A and B. While we call COVID-19 “coronavirus” colloquially, it is really just one type of coronavirus.
“Coronaviruses are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV),” says Dr. Andrea Limpuangthip, medical director of quality of patient safety at Baltimore’s Mercy Medical Center. “COVID-19 is a new strain of coronavirus, which has been labeled as SARS-CoV-2 and the disease is called coronavirus disease 2019 (COVID-19).”
What are the symptoms of colds, the flu, and COVID-19?
Symptoms of a cold are usually fairly mild and include a runny or stuffy nose, coughing, sneezing, sore throat, and generally feeling unwell.
The flu has the same symptoms as a cold, but infected individuals may also have a fever or chills, muscle or body aches, headaches, fatigue, and occasionally vomiting and diarrhea (especially in children).
Coronavirus symptoms are fever, cough, and shortness of breath.
“Common colds usually show upper respiratory symptoms; influenza and COVID 19 show both upper and lower respiratory issues with systemic involvement,” says Dr. Hamid S. Syed, acute care and primary care physician at Reagan Medical Center in Atlanta.
How serious are these illnesses?
A cold is rarely serious and very unlikely to be fatal.
The flu and COVID-19 affect people with varying degrees of severity. For some, the symptoms are mild and there are no complications. For others, particularly those in high-risk categories, these viruses can cause severe complications and even death.
“Worldwide, annual flu epidemics are estimated to result in about 3 to 5 million cases of severe illness, and about 290,000 to 650,000 respiratory deaths,” says Dr. Limpuangthip. “As of Mar. 7, 2020, COVID-19 has killed more than 3,400 people and infected more than 100,000 since it was first identified in Wuhan, China, in December 2019.”
Right now, the death rate for COVID-19 is slightly higher than that of the flu; however, this virus is new and still being studied. We don’t currently know how widespread it will become or what the death rate will be.
Those most at risk for serious symptoms or complications from the flu are:
- Adults over 65
- People who are pregnant
- People who are immunocompromised
- People with other health conditions such as diabetes, heart disease, and asthma or COPD
For COVID-19, those most seriously affected are:
- Older adults
- People who are immunocompromised
- People with other health conditions like heart disease, lung disease, or diabetes
People of any age can catch COVID-19, and while not considered high risk at the moment, children and pregnant people are considered special populations because of their increased risk of severe illness from other infectious diseases.
What are the treatments for these illnesses?
There is no treatment for the common cold except for symptom management. Rest, fluids, and if needed, over-the-counter symptom relief medicine such as Vicks Vaporub.
For the flu, an antiviral medication called Tamiflu can lessen the severity of the symptoms and length of the illness, but is only effective if given within the first 24 to 48 hours after symptoms develop. Rest and fluids are important for recovery, and symptoms can be managed with medications such as Advil or Tylenol for fever and muscle pain. The flu can cause secondary infections like pneumonia or other complications, which may require further medical treatment.
There is currently no treatment for COVID-19. Antivirals like Tamiflu are not effective against COVID-19. Rest, fluids, and symptom-management as well as monitoring for secondary infections or complications is the recommended treatment plan as of right now. There are currently case studies utilizing high dose IV Vitamin C, as well as other case studies utilizing some other antiviral medications to treat those hospitalized with COVID-19.
Due to emerging data coming out of China and Italy, it is now recommended that ibuprofen, as well as other NSAIDs, be avoided if you think you may have symptoms of COVID-19, as these types of medications have been shown to cause worsening of symptoms. It is recommended that if you have a fever, or body aches/pains, that you instead take acetaminophen (but make sure to follow appropriate dosing guidelines and do not exceed the maximum recommended daily dose), or if you have a low grade fever, let the fever run its course.
How do colds, the flu, and COVID-19 spread?
“The common cold and flu are usually transmitted via [having contact with] small or large droplets from coughing, sneezing or close contact with an infected person,” says Dr. Syed. “COVID-19 likely has similar modes of transmission, but definitive information is currently incomplete.”
“Close contact” means within six feet of an infected person, where it is possible to breathe in droplets being expelled into the air, or to have droplets land onto another person. It’s also possible to contract the infection by touching surfaces contaminated with droplets containing the virus, and then touching the face (particularly the eyes, nose, and mouth)—but this isn’t thought to be the main way these viruses spread.
The flu is contagious for a day or so before symptoms appear. It is suspected that COVID-19 can be spread by infected individuals who are asymptomatic, but more research is needed.
Contrary to myth, receiving packages from China is not a method of coronavirus transmission. The COVID-19 virus does not live long enough on surfaces like packages to pose a danger.
How can you prevent these illnesses?
Despite differences in severity and types of viruses, the prevention for all three of these illnesses is very similar.
Wash your hands!
More than you think you need to! At least eight times a day, wash your hands in warm water with soap for 20 to 30 seconds. Try singing “Happy Birthday” twice to keep the time. Make sure to include the backs of your hands, and your nail beds. Washing your hands is the single best way to prevent the spread of all three of these illnesses (and most infectious diseases). Keep doing this, even when there is not a pandemic or outbreak, as part of your normal health routine—particularly before eating or preparing food, and after using the washroom.
Soap and water are best, but if none are available, use an alcohol-based hand sanitizer that is at least 60% alcohol.
Don’t touch your face.
You may not realize how often you touch your face until you try not to. “We touch our faces at least 200 times per day without noticing,” says Dr. Nanos. Touching your face after touching a contaminated surface can make you sick.
Disinfect commonly used objects and areas.
Door handles, toilets, handrails, countertops, anything people touch regularly—and especially your phone! Dr. Nanos recommends washing your phones as often as you wash your hands. “They are usually the most contaminated item we have in our possessions,” says Dr. Nanos. “Phones present an extra risk because we keep them so close to our face as well, so I recommend using a Bluetooth headset as much as possible to keep it away from your face.”
Stay home if you are sick.
The only place you should be going if you have or suspect you have the flu or COVID-19 is to see a healthcare provider—and even then, you should call ahead. Minimize your contact with others. Even if your symptoms are mild, you could infect someone for whom these illnesses could be severe or fatal.
There is no need to wear a mask unless you are sick and leaving the house, or if your doctor tells you to.
“Catch your cough.”
Sneezes, too. Cough or sneeze into a tissue, discard the tissue, then wash your hands. If no tissues are available, the inside of your elbow will do in a pinch. Try telling children (or adults!) to “make an elephant” or a “vampire” as a way to teach them how to do this.
Take care of yourself.
Get lots of sleep, eat well, exercise—do all those things you would normally do to stay healthy.
Get your flu shot.
To be very clear, there are no vaccines for the common cold or for COVID-19, and the flu shot does not offer protection against either of them. That said, the flu shot helps slow the spread of the flu and helps to lessen the severity of those who are infected. With COVID-19 requiring a lot of resources, keeping the flu—and the hospital visits it can require—to a minimum will help doctors manage COVID-19 cases more efficiently. The flu shot also lessens your chances of getting the flu in addition to COVID-19 should you contract it.
It’s never too late in the flu season to get vaccinated if you haven’t already. Remember you need a flu shot every year.
For COVID-19, evaluate travel plans.
“I would highly recommend that people avoid unnecessary travel to countries where the incidence of coronavirus is high, and if they must travel to those places, be diligent about following the previously noted preventive measures,” says Dr. Syed.
Avoid large gatherings of people as well. “Schools, businesses, and public gatherings will probably be closed for a short time, but this is a necessary and expected part of outbreak containment measures,” says Dr. Nanos
Check the Centers for Disease Control (CDC) website regularly.
Affected countries, prevention recommendations, and general information about both COVID-19 and seasonal flu are updated on the CDC website as information becomes available. Make sure you are up-to-date.
While the common cold, the flu, and COVID-19 may overlap in some ways, knowing the differences can help you know when to seek proper treatment, if needed. Up-to-date information is key. And remember, as the CDC says, “Keep calm and wash your hands.”