All in all, you’re feeling terrible. You’ve got a cough and a fever. You ache all over, and you feel wiped out.
Is it COVID-19? Or the flu? Or a cold?
As we head into flu season, the answer is not so clear.
“Telling the difference between a cold, the flu and COVID-19 is challenging because many of the symptoms overlap,” says Eric Sachinwalla, MD, medical director for infection prevention and control at Einstein Medical Center Philadelphia.
“The take home message is really that patients should make sure they are staying home and staying away from anyone else if they feel sick. And they should call their doctor to find out what the next steps should be.”
Physician leaders from the Einstein Healthcare Network say there’s a lot you can do to prevent both COVID and seasonal flu.
There’s been some fear in the medical community that combining flu season with the COVID-19 pandemic this year might overwhelm hospitals. But recent developments have offered cause for optimism.
“One thing that’s a little bit interesting is that in the Southern Hemisphere, where their winter is our summer, the flu season really didn’t happen this year,” says Angela Nicholas, MD, a family physician and Chief Medical Officer at Einstein Medical Center Montgomery.
“It’s probably because of the masking, the social distancing and the recommendations to stay at home that everybody stuck to,” she says. “So we really don’t know what’s going to happen to our flu season this year.”
Christopher Scaven, DO, agrees. “We’re anticipating there may be a lighter than usual cold and flu season because we’re hypervigilant with COVID.”
But the doctors urged people to take precautions because the combination of flu and COVID in the community could still make many people very sick.
“The picture may change as restrictions are lifted in the community,” says Scaven, a family medicine doctor and Medical Director of Einstein Community Health Associates, the organization of Einstein primary care doctors in Philadelphia.
“As we start to see things like indoor dining, sporting events, social gatherings and people spending more time indoors, then I think that we may see a spike in COVID and flu.”
The doctors offer the following advice.
Should I get a flu shot?
Yes, flu shots are even more important than usual this year, Dr. Scaven says. “We don’t want to have a patient come down with a cold or flu, which could decrease their immune system and then put them at risk for getting COVID.”
Flu shots are strongly encouraged for everyone age 6 months and older. Dr. Nicholas notes that the shots help to protect other people as well as yourself, including those who are most vulnerable to severe illness, such as older adults, children and those who have certain chronic medical conditions or compromised immune systems.
In addition, she says, “if you get the flu shot and then you get a strain of the flu that is not covered by the vaccine this year, sometimes the symptoms aren’t as severe as they would have been without the shot.”
Einstein medical offices have begun vaccinating for flu, and shots also may be available in community settings such as pharmacy clinics.
What else can I do to stay well and protect other people?
- When you go out, keep at least a six-foot distance from others.
- Wear a cloth mask to protect yourself and those around you. Even people who don’t have symptoms can spread COVID-19.
- Wash your hands frequently.
- If soap and water are not available, use a hand sanitizer containing at least 60% alcohol.
- Clean and sanitize frequently touched surfaces daily.
- Stay home if you’re sick.
- Cough or sneeze into your elbow or a tissue. Throw the tissue away immediately and wash your hands.
What are the most common symptoms of colds, flu and COVID-19?
- Runny nose
- Sore throat
- Aches and pains
“Flu typically is usually sudden onset, feeling like you got hit by a truck,” Dr. Scaven says. “Usually it presents with a high fever and body aches; everything hurts from head to toe. With COVID, it can be a myriad of symptoms, and they may not be as dramatic and noticeable.”
All of these illnesses, particularly COVID, can have other symptoms besides the most common ones. See the chart at the top of this page for a more comprehensive list.
What should I do if I have symptoms like these?
Call your healthcare provider. Depending on your symptoms, you may be scheduled for a telehealth appointment or an in-person visit.
Will I be tested for flu and COVID?
It depends on your symptoms, how long you’ve had them and whether they have been getting worse.
In past years, Dr. Nicholas notes, doctors usually diagnosed flu based on symptoms. “Now I suspect there’ll be more testing because we’re trying to sort out whether someone has COVID or the flu.” Several community testing sites are available in Montgomery County.
In Philadelphia, patients who need tests will be directed toward one of several respiratory clinics for children or adults, Dr. Scaven says. Staff in the respiratory clinics wear full protective equipment and change gowns after each patient.
“We can do rapid testing for strep throat, flu and RSV [respiratory syncytial virus]. In addition, we just started doing rapid antigen testing for COVID,” he says. People who have a negative result on the rapid COVID antigen test will have a follow-up test to confirm the result.
What happens if I have to go in the hospital?
“We see a bit of a surge associated with flu every year in winter,” Dr. Nicholas says, “but this is what we do. We know how to take care of very critically ill patients.
“The good news with COVID is that now we know a lot more now than we did six months ago. We know there are some treatments that may shorten the course of COVID, and we know what we need to do right away.”
Learn about the steps Einstein has taken to protect patient safety during the COVID outbreak.