Colds, Flu and COVID, oh my!

McKenna Princing Fact Checked
A woman's hands hold a tissue.
© Kelly Knox / Stocksy United

There are many things to love about fall and winter: colorful leaves, Halloween season, crisp air and cozy sweaters. 

But there are scary things about this time of year, too. No, we’re not talking about haunted houses or the inevitable Seattle snowpocalypse: We’re talking about cold, flu and COVID-19. 

What will this cold and flu season be like?  

“The expectation is we’ll likely see more cold, flu and COVID-19 going forward, especially since people congregate indoors in winter,” says Dr. Abir “Abby” Hussein, assistant professor in the UW Division of Allergy & Infectious Diseases and associate medical director of Infection Prevention and Control at UW Medical Center. 

But a rise in cases doesn’t mean they will skyrocket. Flu cases were down last year and both Hussein and Chantal Cayo, chief nursing officer for UW Medicine Primary Care and Population Health, hope that trend continues. Efforts to curb the coronavirus are starting to get traction, too. 

“All we can do is try to mitigate what’s happening with this delta variant, and as more employers and government officials are requiring vaccination, hopefully we’ll see a downturn with COVID-19,” Cayo says. 

How can I differentiate between cold, flu and COVID-19 symptoms? 

The short and unfortunate answer is: You probably won’t be able to. 

The flu, COVID-19 and common colds — or, as doctors refer to them, upper respiratory infections — are caused by different types of viruses but can cause many of the same symptoms.  

A cough, runny or stuffy nose, sore throat, muscle and body aches, fever, fatigue and headache can all be symptoms of a cold, the flu or COVID-19. 

Colds tend to develop gradually, with the primary symptoms being things like coughing, sneezing and having lots of phlegm (eww). The flu is more likely to come on suddenly, with fever, headache, body aches, chills and fatigue more likely to be the primary symptoms.  

There are some symptoms, such as shortness of breath or a loss of taste and smell, that are more common with a COVID-19 infection, though they can occur during a flu infection, too. 

Basically, you shouldn’t make assumptions about what infection you have based on your symptoms. 

How can I protect myself against flu and COVID-19? 

You probably already know what we’re going to say: vaccinate, vaccinate, vaccinate.  

“People can get flu and COVID-19 shots at the same time now,” Cayo says, as opposed to when the COVID-19 vaccines first came out and doctors recommended not getting another vaccine within the two weeks following. 

If you haven’t gotten vaccinated against COVID-19, now is a great time to do so. If you did get vaccinated against COVID-19 and are immunocompromised, you may be eligible for a third dose.  

For the flu shot, it’s best to get it before the end of October, according to the Centers for Disease Control and Prevention.  

Other important prevention measures include things you’re probably familiar with: washing your hands regularly, wearing a mask, staying physically distant from others and staying home if you feel sick.  

When should I get tested for COVID-19? 

Because cold, flu and COVID-19 symptoms can be so similar, it’s a good idea to get tested for COVID-19 whenever you have new symptoms. Testing is especially important if you think you may have been exposed to COVID-19 or if you live with people who are more vulnerable to COVID-19.  

“If you have any symptoms, you should go get tested because we know COVID-19 can manifest in different ways. Don’t assume it’s nothing just because it’s mild,” Hussein says. 

She recommends locating your nearest testing center now, when you feel fine, so you’ll know where to go — and won’t need to scramble — if you should start feeling unwell.  

Polymerase chain reaction (PCR) tests, as well as other types of nucleic acid amplification tests (NAATs), are the most accurate types of tests, though you usually have to wait a day or so to get results. Rapid antigen tests are also available for you to purchase and use at home; they can give results within 15 minutes but aren’t as reliable, especially if you’re asymptomatic. 

Because of the recent surge in COVID-19 cases due to the delta variant, testing centers may not have as many available appointments as in the past. If you find yourself having to wait for an appointment and feeling anxious about it, Cayo recommends getting a rapid test at your local pharmacy that you can do at home in the meantime to ease your mind — while recognizing that rapid tests can sometimes give inaccurate results.  

Are flu and COVID-19 symptoms different in vaccinated people? 

“People who are vaccinated are definitely more likely to experience mild symptoms, something they’d typically write off as nothing,” says Hussein.  

This is true for people vaccinated against COVID-19 and the flu. If a vaccinated person gets infected, they may not have symptoms at all. 

While the thought of a breakthrough infection is alarming, it is pretty uncommon. 

COVID-19 vaccines are very effective at protecting people from the virus. Research has shown the COVID-19 vaccines greatly reduce the risk of infection and are highly effective in preventing severe illness, need of hospitalization and death. 

Flu vaccines tend to be less effective than the new COVID-19 vaccines because the flu virus mutates rapidly and the vaccine has to be redesigned each year to keep up with the strains that are expected to be most prevalent each year. 

Still, getting the flu shot is worth it. Even though it is still possible to get the flu if you’re vaccinated, your symptoms are likely to be milder and you’ll be less at risk for serious complications such as pneumonia. 

How can I treat mild cold, flu or COVID-19 symptoms? 

First off, if you have a confirmed but mild case of COVID-19 — or a highly suspected one, such as after being exposed to someone who has it — you need to stay home and stay away from other people. It’s OK to go to the doctor if you need to, but call ahead, wear a mask and stay physically distant from others. 

There are many things you can do at home to treat mild symptoms of a cold, flu or COVID-19. If you have a headache or fever, take over-the-counter medication like Tylenol. Cough syrups can help with a cough, while nasal sprays can help with nasal congestion.  

If your throat is sore, try gargling salt water, drinking warm liquids or sucking on hard candies or throat lozenges. Having a humidifier in the room or taking a hot shower can also help with congestion.  

It’s also important to rest as much as possible and drink plenty of fluids. You can also try some home remedies like chicken broth, honey or vitamin C if it makes you feel better (though it’s worth noting that there isn’t much evidence these things speed up recovery, especially with COVID-19). 

When should I see a doctor or go to the ER? 

One telltale sign that it’s time to see a doctor is if you’re having difficulty breathing. 

“If you are not able to walk around or catch your breath, we would want to make sure your oxygen levels are OK,” says Hussein. 

If you have a pulse oximeter at home, you can use that to check your oxygen levels if you’re feeling shortness of breath, Hussein adds, and if your reading is below 92% you should contact your doctor. 

Extreme fatigue (where you can’t do basic tasks), continued vomiting or diarrhea, or a high fever are also reasons to go in. 

“A high fever is a fever over 100.9 and above. Go to urgent care or the emergency department if you have a fever of 101, as that is not a normal temperature,” Cayo explains. 

Even if you don’t have any of these symptoms but are still concerned or feel like you aren’t getting better, you should feel free to make an appointment with your primary care provider, Hussein recommends.  

The bottom line 

No one knows exactly what this cold and flu season will be like, though with mask mandates and vaccination and testing requirements, experts are hopeful this year will have low rates of infections.  

In the meantime, it’s important to keep yourself protected. Get your COVID-19 vaccine if you haven’t already and get a flu vaccine as well. Keep up your masking, handwashing and distancing skills. Doing these things won’t just protect you but will also protect everyone around you.