COVID-19 vs. the Flu: Will you be able to tell the difference?

Here's a few ways to tell the difference between COVID-19 and the flu.
Here's a few ways to tell the difference between COVID-19 and the flu.

Flu season is around the corner. As COVID-19 cases continue to rise in the U.S., you probably have questions about the difference between the two, how to know if you have the flu or COVID-19, and when to seek medical attention.

Although these viruses have many similarities, there are also some important differences. The University Health Center sheds some light on these two viruses and how to best navigate them this fall.

How do COVID-19 symptoms compare to flu symptoms?
Both viruses can affect different parts of the body and can cause varying degrees of illness—from mild or none to very severe symptoms. COVID-19 shares most of the symptoms that typically occur with the influenza virus, including fever, fatigue, cough, shortness of breath and gastrointestinal problems. With COVID-19, many people also report a change or loss of taste or smell.

How do you know whether you have the flu or COVID-19?
Because symptoms can be so similar, it may be difficult for you and even your doctor to determine if you have the flu or COVID-19 until you have been tested. If you suspect you have the flu or the coronavirus, contact the health center or your primary care provider by phone for evaluation and to arrange testing if appropriate.

Is COVID-19 more severe than the flu?
Both can cause severe illness and death each year. This season, we have both viruses in play.

Last flu season, there were up to 56 million flu-like illnesses diagnosed. Over the last six months, there have been more than 6.8 million people diagnosed with COVID-19.

However, far more people have already died from COVID-19 than died from influenza last year, and the deaths from COVID-19 continue to rise daily. In the U.S., 3% of everyone who has contracted COVID-19 has died (more than 210,000 people), compared to .1% for seasonal influenza cases (up to 62,000) last year. There may be several reasons for this. Some may be due to undercounting influenza cases and their indirect effect on people who have underlying disease. It may also be related to the fact that SARS-CoV-2, the virus that causes COVID-19, is a new virus, so our bodies have less immune system experience with the virus compared to influenza. How the SARS-CoV-2 virus behaves in the body may also be a contributing factor.

How quickly will I develop symptoms of COVID-19 compared to the flu?
According to the Centers for Disease Control and Prevention, COVID-19 has an incubation period of up to 14 days, and the average time from infection to becoming symptomatic is five days. Although the exact time from infection to the point where you can transmit the virus is uncertain, it is believed to be approximately two days before symptoms start.

Flu symptoms usually begin more quickly – within about two days of being infected. Like COVID-19, people with the flu can pass it on to someone else before they know they are sick.

How contagious is the flu compared to COVID-19?
Direct contact with respiratory droplets caused by coughing, sneezing or talking has been the primary known method of transmission for both illnesses. These droplets usually do not travel more than 6 feet, which is why it is important to stay at least 6 feet apart from others and wear a face covering.

However, tiny respiratory droplets called aerosols may also spread COVID-19 under the right conditions. Aerosols are small enough to float further than large respiratory droplets, which are heavier and fall more quickly to the ground.

People with COVID-19 can be contagious for 10 days or more after symptoms first appear, according to the CDC. This is a longer contagion period than people with influenza, so they can infect more people.

Most people who develop the flu are contagious for about one day before symptoms appear. And because symptoms usually appear more quickly, they can isolate themselves from others early on. People with the flu are usually contagious for the initial three to four days while they are ill and for about seven days after.

What are the differences in complications for the flu and COVID-19?
Most people who get the flu will recover quickly—within a few days or two weeks at most. In rare cases, they could develop complications such as pneumonia, fluid in the lungs, worsening chronic medical conditions and secondary bacterial infections. Severe cases of COVID-19 can cause similar complications as the flu, as well as kidney failure, blood clots in the veins and arteries of the lungs, heart, legs or brain. Chronic fatigue or “long haul” syndrome is also now identified in those moderate to severe COVID-19 infections.

How does treatment differ for these two viruses?
There are antiviral medications that can treat both moderate to severe COVID-19 and the flu. For people with mild to moderate symptoms, treatment involves managing the symptoms with lots of rest, fluids, and over-the-counter pain medications like acetaminophen and ibuprofen.

Remdesivir is the antiviral drug approved for COVID-19 in emergency cases and is used for sicker patients. Low dose dexamethasone is also being used for patients needing supplemental oxygen. These drugs do not cure the disease, but help how quickly some people recover.

Similarly, for influenza, a drug called oseltamivir, commonly known as Tamiflu®, treats the viral infection and reduces viral shed. It is most effective if given within two days of symptoms starting.

When is it time to seek medical attention?
Call the health center or your primary care provider if you experience symptoms such as shortness of breath, sustained temperature of 100.4 or greater, or loss of taste or smell. If you are unable to resume your usual activities after recovering from COVID-19, you should contact your provider as soon as possible to determine if further interventions are necessary.

Likewise, for the flu, if you experience trouble breathing, chest pain, severe or persistent vomiting or flu symptoms that appear to get better and then return with a fever or worse cough, call your doctor.

Will the flu vaccine provide any protection against COVID-19?
The influenza immunization is effective against influenza only. This year, more than ever, it will be very important to receive the flu vaccination because contracting influenza can make you more susceptible to other illnesses, including COVID-19. Learn more about how you can get your free flu shot at the health center and student flu shot clinics.

When the COVID-19 vaccine becomes available, are there any reasons why I should not receive it?
Barring any unforeseen developments, if a safe and effective vaccine is available, you should consider getting it.

Will wearing face coverings reduce the spread of the flu as well as COVID-19?
Multiple studies have shown that wearing a face covering decreases transmission of respiratory droplets and the potential of infection. Since the flu is also spread by respiratory droplets, wearing face coverings should be beneficial in reducing the spread of flu also. Hand hygiene, physical distancing and sanitizing high-touch surfaces in your environment also are important to decrease transmission of the virus.

If you are experiencing flu or COVID-19 symptoms, call the University Health Center at 402.472.5000 to make an appointment. Telehealth may be available depending on your concerns.

Learn more about how to get your free flu shot at the health center or a student flu shot clinic.

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