Is it COVID-19 or a Cold?
What is known about the novel coronavirus (COVID-19) is evolving daily. There are still many unknowns about the actual number infected and the best public health measures to slow population progression. A common concern for the public is the reported similarities of COVID-19 symptoms to a seasonal cold or influenza, other viruses that are still circulating in the community. Based on symptoms alone it can be difficult to differentiate what virus is causing a patient’s symptoms. Here’s how the illnesses differ and what to do if you have symptoms.
How symptoms of COVID-19 differ from the common cold or flu
Coronaviruses are not new. They are a group of RNA viruses that cause a variety of diseases in humans and other animals. Symptoms from different coronavirus strains vary. Some cause common cold symptoms while others can cause more serious respiratory infections like SARS. The specific coronavirus making headlines today is highly infectious and new (novel) to humans meaning we have much to learn about it’s potential effect on our global community.
Many viral infections have similar symptoms, ranging from fever, mucus production, body aches and cough to shortness of breath and fatigue.
Common cold
In most cases, a cold typically comes on gradually. Symptoms typically start with a sore throat and runny nose and may be followed by coughing and sneezing. Fevers are less common. Most people recover in about 7-10 days.
Seasonal flu
Symptoms of the flu differ from colds in that they often start abruptly. Influenza can include fever (over 100.5) or chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, and fatigue. Some people may also have vomiting or diarrhea, though this is more common in children. Influenza (flu) can cause mild to severe illness.
COVID-19
Data from a recent study of patients in China with confirmed COVID-19 showed that the most common symptoms of this illness are a fever and cough. Shortness of breath is also a hallmark symptom that may peak on days 8-9 . The same study found that a small percentage of patients also experienced nausea or vomiting and diarrhea.
Immunocompromised individuals are more at risk for developing a more severe version of COVID-19. They may not be able to mount a strong enough initial immune response and are at risk of significant inflammation and tissue damage triggered by the virus.
What to do if you’re sick
Most importantly, if you get sick with fever, cough, and congestion stay at home. It is wise to reach out to a trusted health care provider for advice on differentiating between the viruses above. If you have not had the flu shot, a doctor may prescribe an anti-viral medication if the flu is suspected. If after a few days your symptoms stabilize—meaning you continue to have cough, low-grade fever, and body aches but no noticeable shortness of breath, you should continue to stay home and rest.
Reports from hospitalized cases of COVID-19 indicate that the potential for clinical deterioration appears to peak in the second week of illness (usually after day 8-9). Patients may develop shortness of breath—a major indicator of respiratory compromise.
If your symptoms worsen, particularly if you experience shortness of breath, it is imperative that you proceed to the closest emergency room. For safety, it is important to take private transportation and call ahead to let the ER know of your condition.
How to get tested for the coronavirus?
Currently, testing for COVID-19 is being performed at state public health laboratories and The Centers for Disease Control (CDC). The CDC has broadened their guidelines for coronavirus testing so that anyone can be tested for COVID-19 if they have symptoms and a doctor’s orders.
Testing is expected to continue to become more widely available. This, however, does not mean everyone with signs of a cold should be tested for coronavirus.
The CDC is currently recommending that the following patients be tested:
Hospitalized patients who have signs and symptoms compatible with COVID-19 in order to inform decisions related to infection control.
Other symptomatic individuals such as, older adults and individuals with chronic medical conditions and/or an immunocompromised state that may put them at higher risk for poor outcomes (e.g., diabetes, heart disease, receiving immunosuppressive medications, chronic lung disease, chronic kidney disease).
Any persons including healthcare personnel, who within 14 days of symptom onset had close contact with a suspect or laboratory-confirmed COVID-19 patient, or who have a history of travel from affected geographic areas within 14 days of their symptom onset.
What if you test positive for COVID-19?
If you are sick and have been diagnosed with COVID-19 or suspected to have COVID-19 because you have been exposed to someone with COVID-19, follow the steps below to help prevent the disease from spreading to people in your home and community. Since the Seattle area faced some of the earliest cases in the United States, the Washington State Department of Health has good recommendations on their website:
Stay home except to get medical care. You should restrict activities outside your home, except for getting medical care. Do not go to work, school, or public areas. Avoid using public transportation, ride-sharing, or taxis.
Separate yourself from other people in your home. As much as possible, you should stay in a specific room and away from other people in your home. Also, you should use a separate bathroom, if available.
Call ahead before visiting your doctor. If you have a medical appointment, call the healthcare provider and tell them that you have or may have COVID-19. This will help the healthcare provider’s office take steps to keep other people from getting infected or exposed.
Wear a facemask. You should wear a facemask when you are around other people (e.g., sharing a room or vehicle) or pets and before you enter a healthcare provider’s office. If you are not able to wear a facemask (for example, because it causes trouble breathing), then people who live with you should not be in the same room with you, or they should wear a facemask if they enter your room.
Cover your coughs and sneezes. Cover your mouth and nose with a tissue when you cough or sneeze. Throw used tissues in a lined trash can; immediately wash your hands with soap and water for at least 20 seconds or clean your hands with an alcohol-based hand sanitizer that contains at least 60 to 95% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry. Soap and water is preferred if hands are visibly dirty.
Avoid sharing personal household items. You should not share dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people or pets in your home. After using these items, they should be washed thoroughly with soap and water.
Clean your hands often. Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, clean your hands with an alcohol-based hand sanitizer that contains at least 60% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry. Soap and water is preferred if hands are visibly dirty. Avoid touching your eyes, nose, and mouth with unwashed hands.
Clean all “high-touch” surfaces every day. High touch surfaces include counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables. Also, clean any surfaces that may have blood, stool, or body fluids on them. Use a household cleaning spray or wipe, according to the label instructions. Labels contain instructions for safe and effective use of the cleaning product including precautions you should take when applying the product, such as wearing gloves and making sure you have good ventilation during use of the product.
Monitor your symptoms. Seek prompt medical attention if your illness is worsening (e.g., difficulty breathing). Before seeking care, call your healthcare provider and tell them that you have, or are being evaluated for, COVID-19. Put on a facemask before you enter the facility. These steps will help the healthcare provider’s office to keep other people in the office or waiting room from getting infected or exposed.
Discontinuing home isolation
From the Washington State Department of Health:
If you have tested positive for COVID-19, you should remain under home isolation precautions for 7 days OR until 72 hours after fever is gone and symptoms get better, whichever is longer.
If you have fever with cough or shortness of breath but have not been exposed to someone with COVID-19 and have not tested positive for COVID-19, you should stay home away from others until 72 hours after the fever is gone and symptoms get better.
Additional information for your household members, intimate partners, and caregivers is available here.
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