Flu vs COVID: How to Spot the Difference
Written by Melissa Schenkman, MPH, MSJ
Let’s be honest. It’s a flu season for the record books.
If you are not currently sick or have not already been sick, you most likely know at least one person who is.
I asked fellow millennial and infectious disease doctor, Lindsay Morrison, MD, MSCI, how we can navigate this ‘tripledemic’ of the flu, COVID-19, and what seems like a new player on the scene for adults this winter, Respiratory Syncytial Virus. She breaks down the symptoms we are having, how to determine which virus they are coming from, and what to do if you haven’t been able to make the time for your flu shot yet.
YMyHealth: When should you suspect you have the flu versus when you have COVID-19?
Dr. Morrison: Many of the symptoms of viral respiratory illnesses overlap so it can be challenging to differentiate one from another. Typically, the flu symptoms in adults (caused by influenza viruses) and COVID-19 (caused by SARS-CoV-2) are associated with fatigue, muscle aches, and fevers. Other potential symptoms include swollen lymph nodes especially in the neck, sore throat, and headache. Loss of taste and smell seems to be more associated with COVID-19. However, the only way to know for sure is to get tested. At home testing is readily available for COVID-19.
Lindsay Morrison, MD, MSCI, cares for patients at Georgia Infectious Disease in Atlanta, Georgia.
YMyHealth: If you get tested and the symptoms you are having actually turn out to be the flu, COVID-19, or another respiratory illness what’s your advice?
Dr. Morrison: For any respiratory illness I would advise avoiding contact with others to whom you could spread the illness. Rest and fluids are the mainstays of treatment for both of these viruses. Over-the-counter fever reducers can help with symptom management. Tamiflu (oseltamivir) and Paxlovid (nirmatrelvir/ritonavir) are prescription medications that can help reduce the length of time you are sick with the flu and COVID-19 respectively. Talk to your doctor about whether one of these medications might be appropriate for your illness.
YMyHealth: We are hearing a lot about Respiratory Syncytial Virus (RSV), a virus that is typically seen in young children, but seems to have a high number of cases in adults this year. Tell us about RSV in comparison to the flu. Should millennials have RSV on their radar for themselves personally?
Dr. Morrison: The 2022-2023 season is starting out with a high number of cases of multiple types of respiratory viruses. RSV is one that we see every year but is of most concern in those that are very young (<6 months old) or immune-compromised. Adults over 65 are at higher risk for severe illness as well.
Typically, RSV will be milder and more self-limited in those with healthy immune systems, including most millennials. If you are immune compromised and have breathing problems such as asthma or COPD or heart disease, you may be at risk for a more severe case of RSV should you get sick.
YMyHealth: Is there any new flu data out there as of late November/early December that you think millennials should pay attention to?
Dr. Morrison: Cases of influenza-like illnesses are much higher this year. The CDC catalogs flu data every week and at the time of publication of this article, the cumulative hospitalization rate for influenza is higher at week 47 than it has been since 2010. In the last week alone, the number of influenza-related hospital admissions doubled suggesting that not only is the number of flu illnesses high, but the number of severe flu illnesses is high.
The good news is that the vaccine appears to be effective with early estimates placing it at being around 34% effective at preventing you from getting the flu. A percentage that is on par with the effectiveness levels of the more successful vaccines for other viruses.
Information source: Centers for Disease Control and Prevention
YMyHealth: For those millennials who didn’t get their flu shot before Halloween like a lot of healthcare professionals were recommending, why should they make the time to do so now? Why is it important/worth their time?
Flu season is actually quite long, extending through the winter months. If you didn’t receive the vaccine yet, you may not have had protection for the early part of the season, but you still have the opportunity to benefit.
Getting the flu vaccine now would offer you protection through the remainder of the season. The number of newly diagnosed cases of flu is already higher than this time last year. Since we are seeing higher numbers now, we expect this trend to continue. With a large amount of virus circulating your chances of contracting the flu increase.
If you are vaccinated for influenza, you are less likely to get the flu. If you do get the flu and have been vaccinated, you are more likely to have a milder illness than if you have not been vaccinated. The other benefit of the vaccine is cutting down on circulating viruses. If you are in contact with others who are at higher risk for severe flu illness, such as the elderly or immune compromised, getting the vaccine is an important part of keeping them safe from the virus.
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