COVID, Allergies, or Something Else?

Imagine that you wake up one day sneezing with a runny nose and congestion. Could you have COVID? Or is it seasonal allergies? Or it could be a cold or something else. It is hard to tell. Symptoms for each can be very similar and easily confused. Here’s what you should do.

Know the symptoms. Symptoms of COVID-19 are fever (100.4 °F or higher), cough, shortness of breath or difficulty breathing, chills, fatigue, muscle or body aches, headache, sore throat, new loss of taste or smell, congestion or runny nose, nausea or vomiting, and diarrhea. Several of these symptoms could also be associated with allergies, a cold, or the flu. If you like, you can use the Centers for Disease and Prevention’s handy symptom checker tool.

There are some early reports that the symptoms of COVID are changing. For instance, people with the delta variant are more likely to report headache, runny nose, and congestion and less likely to report a loss of taste and smell. While symptomatic cases of COVID-19 are far less common among people who got vaccinated, research shows that sneezing is a more common symptom for vaccinated people.

Stay home. If you are feeling poorly in any way, your first thought should be to stay home. The days of working or attending school when sick are long gone. It’s just not safe. 

Don’t guess. Get tested. You could spend time thinking about whether you’ve had seasonal allergies in the past or wondering who might have given you a cold. Instead, I recommend getting tested for COVID right away for the following reasons:

• Telling the difference between any of the illnesses associated with these symptoms is difficult, even for physicians. That’s what testing is for.
• COVID is serious. The outcome of a test will really change your behavior. Knowing your COVID status and following the recommendations helps you protect your family and others in your community.
• Testing for COVID is readily available. Locally, you can schedule yourself online at svmcbookcovidtest.timetap.com. You can also find testing locations at the Vermont Department of Health website.
• It is so easy. There is no cost to patients. No referral is needed.

Follow instructions. If you test positive, follow the instructions you are given. Regardless of whether or not you have been vaccinated, you will need to isolate. In addition, the health department’s contact tracers will be in touch with you to share instructions and help identify the people who may have been affected.

Note, your COVID test result will not tell you whether you have the original strain of COVID or the delta variant. The genetic sequencing done to determine whether a sample is the delta variant or another strain is conducted mostly for the purposes of surveillance. Only a selection of positive tests are sent to a larger lab for genetic sequencing. You won’t likely learn whether your particular sample is one or the other. (Delta is the dominant strain nationwide, so it is likely that you have contracted the delta strain.) The treatments for all of the strains of COVID are the same, at this point, so knowing would not change your course of action.

If you have not already, get vaccinated. If your test is negative, get vaccinated as soon as you are feeling well. If your test is positive, talk to your doctor about when you should get vaccinated. If you received treatments for COVID, your doctor may recommend delaying vaccination for up to 90 days. Getting vaccinated is as easy as getting tested. Visit svhealthcare.org or the Vermont Department of Health website for locations and details.

Marie George, MD, FIDSA, is an infectious disease specialist at Southwestern Vermont Medical Center in Bennington.