The flu, a cold or COVID-19? What to do if you’re feeling sick.

Prepare for flu season by getting a vaccine now. Then, if you are confused about your symptoms, stay home and check with your medical provider. You may need a test to determine if you have COVID-19 or the flu.
Oct. 21, 2020
Woman sick on her couch at home. Medical experts give advice on how to tell the difference between flu, a cold or COVID-19.
It’s very difficult to tell the difference between COVID-19 and the flu. Prepare for flu season by getting a vaccine. Then, if you’re sick, stay home and call your medical provider for advice. Photo: Getty Images.

By Katie Kerwin McCrimmon and Tyler Smith

This year’s flu virus is expected to arrive in the U.S. as soon as November. At the same time, COVID-19 infections are spiking in nearly every state.

Hopefully you already have gotten your flu shot. If not, get it as soon as possible.

COVID-19 already has sickened more than 8.3 million people in the U.S. and killed more than 220,000.

Now, as we head into flu and cold season, a difficult situation is going to get worse. What should you do if you have a fever, a cough, a sore throat or a runny nose? Should you assume you have a cold and carry on with your regular activities? If your children appear to have colds, should they go to school (if your child has in-person classes) and hang out with friends?

Not this year.

When in doubt, call your medical provider and get a test for COVID-19.

“If you’re sick, stay home,” said Dr. Michelle Barron, one of the leading infectious disease experts in Colorado and medical director for Infection Control and Prevention at UCHealth University of Colorado Hospital on the Anschutz Medical Campus.

All of us are used to downplaying illnesses and going on with our lives when we’re coughing, sniffling or feeling exhausted.

“We’re normally go, go, go, go, go,” Barron said.

But our “plow through it” impulses have to change this year.

“Use common sense,” Barron said. “Get tested.”

Colorado Gov. Jared Polis reiterated that same advice this week as epidemiologists have been tracking record-setting daily tallies of new coronavirus cases in the state.

“If you have a cough, a sore throat or respiratory symptoms, get a COVID test,” Polis said. “We have over 80 testing sites.”

Click here to learn about how to get tested through UCHealth and here to find community testing sites in Colorado.

To help people understand the basics about flu, colds and COVID-19, we consulted with various medical experts

But please keep in mind that on your own, without a test, you can’t rule out COVID-19. When in doubt, seek help.

How do I distinguish the symptoms of the flu, the common cold and COVID-19?

The symptoms of the flu and the common cold overlap. Both generally feature runny noses, coughing, headaches and sore throat.

The flu can come on very suddenly, and according to Dr. Emily Valenta, a family medicine doctor at UCHealth Primary Care – Rockrimmon in Colorado Springs, people who have the flu also often have a temperature of 100.4 Fahrenheit or higher, along with persistent muscle aches. (Keep scrolling down to learn more about the flu.)

Neither fevers nor persistent body aches are typical with the common cold.

Both the flu and COVID-19 can cause symptoms like fever, chest pain, coughing and difficulty breathing, among others. With the end of the 2019-2020 flu season, providers treating patients with these symptoms concentrated on ruling out COVID-19 without worrying much about a flu diagnosis.

“But it’s going to be a lot more difficult going into this flu season to differentiate between the two,” Valenta said. “We will have to test for both.”

Can doctors test for COVID-19, flu and other respiratory illnesses at the same time?

Yes. UCHealth can test for several respiratory viruses at the same time, including those that cause the flu and COVID-19, said Barron, She is also a professor in the Division of Infectious Diseases at the University of Colorado School of Medicine.

I have flu-like symptoms. What should I do?

First, call your medical provider who may recommend that you either come to a clinic to be tested or that you head to the nearest drive-through testing site.

If you are sick with any kind of symptoms, to the greatest extent possible, stay home, stay hydrated and quarantine. Non-steroidal anti-inflammatory medications like ibuprofen can help with muscle aches and soreness. Don’t ask for an antibiotic; drugs that go after bacteria do nothing against a virus, Valenta said. If you test positive for the flu, there are prescription antiviral medications, like Tamiflu, that can shorten the duration of illness if you take them soon after symptoms begin, but they are not substitutes for getting the flu vaccine.

Once you have flu symptoms, especially with a fever, that’s not the time to rush out for your flu vaccine, Valenta cautioned. But she does advise doing so a week or two after you get better.

“It is certainly possible, and has happened in the past, where patients will get the infection again in the same season. So the flu shot would protect against that potential second infection,” she said.

As we noted earlier, many of the symptoms of the flu and COVID-19 overlap. People who experience symptoms of COVID-19 can schedule a test from UCHealth through some 40 sites around Colorado. If you don’t live near these sites, check for other COVID-19 testing sites in your area.

Remind me again. What exactly is the flu? 

The flu is a respiratory illness caused by the influenza virus. There are four types of the virus, but only two (A and B) are responsible for the yearly outbreaks we call flu season, which typically stretches from September to March and sometimes into April. The disease is highly contagious and spreads primarily through respiratory droplets let loose when a person sneezes or coughs. The virus changes from year to year and that’s why we need a new flu shot every year.

Why should I worry about it?

The flu is not the common cold. It’s more dangerous and can make people critically ill. Its symptoms, including fever and body aches, are more intense and last longer than a typical cold. For most people, it causes a week or two of misery before recovery, but the most recent flu season also produced at least 410,000 hospitalizations and at least 24,000 deaths in the United States, according to Centers for Disease Control and Prevention (CDC).

For a detailed analysis of the toll of influenza over the past decade, click here.

How do I protect myself against the flu? Get your flu shot, of course.

The best move is to get vaccinated. Doing so isn’t a guarantee against infection, but it does lessen the risk considerably to yourself and others. And as Dr. Emily Valenta, who practices family medicine at UCHealth Primary Care – Rockrimmon in Colorado Springs notes, getting the vaccine decreases the chances that you’ll have to go to the hospital or visit the emergency department because of the flu.

“That’s more important this season than ever before,” Valenta said.

How does the flu vaccine help?

The vaccine, though not a foolproof protection against influenza, greatly increases your chances of warding off illness and protecting others from it. That, in turn, will prevent trips to the emergency room and the hospital and reduce stress on health care workers and facilities.

Flu season also brings with it plenty of questions about the disease and the need for vaccinations. Herewith, some answers.

Also very important are the basic public health steps most of us have followed for months now in the wake of COVID-19. These include frequent hand washing, maintaining social distancing, wearing masks, and sneezing or coughing into the crook of the arm rather than the hands.

Just what is the vaccine?

The flu vaccine contains pieces of the influenza virus, or antigens. Once administered, our immune systems learn to recognize the enemy and produce armies of antibodies to protect against it. The available shots are trivalent (which protects against two strains of Type A influenza and one of Type B) and quadrivalent (which adds protection against another, rarer strain of Type B). Some, but not all, people ages 2 through 49 can receive a nasal spray vaccine that protects against all four strains of the A and B viruses.

Is one vaccine better than the others?

No. “They are equivalent in terms of protection,” Valenta said. As noted above, the nasal spray vaccine isn’t for everyone.

Who should get vaccinated?

The short answer is everyone who is six months of age and older. There are only rare exceptions. It is particularly important for people ages 65 and older to get a flu vaccine, Valenta said.

“This is certainly a group that we have identified as high risk and will obviously benefit more from getting vaccinated,” she said.

The CDC also emphasizes the importance of vaccinating children younger than five years old because of their risk of developing serious complications if they are infected by the virus. A list of all groups at highest risk of flu-related complications is available here.

When should I get vaccinated?

It’s always best to do so as early as possible. Get vaccinated now. It’s especially important to get your flu shot this year because of the added challenges that COVID-19 will cause.

“The earlier you can protect yourself, the better,” Valenta said.

When will vaccinations be available?

Flu vaccines are available now. Patients with UCHealth can schedule appointments online through My Health Connection, the patient portal. Many other sites will offer the vaccine, including some for free or at reduced cost. The Colorado Department of Public Health and Environment (CDPHE) has more information on available locations throughout the state.

I’ve never gotten the flu and I have no health problems. Why should I get vaccinated?

Valenta said she hears this objection often from patients. I usually respond to this by comparing it to any other preventive measure such as a seatbelt,” she said. “I ask them if they have ever been in a bad car accident and if they say ‘no’ I ask them if they still wear a seatbelt.” That example seems to sway most patients, she said.

Valenta added that she also explains the concept of herd immunity – the idea that increasing the number of vaccinated people reduces the risk of the virus spreading through the community. More people with immunity means fewer opportunities for the virus to find victims – especially the most vulnerable, Valenta said.

I got vaccinated and I got the flu. Why would I do that again?

Simply put, “there is no way to get the flu from the flu shot,” Valenta said. That’s because the trivalent and quadrivalent vaccines contain particles of the influenza virus that have been rendered inactive in the laboratory. The nasal spray contains live viruses that have been “attenuated,” or weakened in the laboratory such that they don’t cause disease.

So what causes the post-vaccination symptoms that people mistake for the flu itself? “What people experience is a brief reaction that typically lasts 24 to 48 hours and involves some low-grade fevers and muscle aches or soreness at the site of injection,” Valenta said. The symptoms are an over response by the immune system to the vaccine that “people commonly misinterpret as the actual influenza infection itself,” she added.

Where can I get more information about the flu?

The CDC is the most comprehensive source. The Colorado Department of Public Health and Environment provides regularly updated data for the state of Colorado.

About the author

Katie Kerwin McCrimmon is a proud Colorado native. She attended Colorado College, thanks to a merit scholarship from the Boettcher Foundation, and worked as a park ranger in Rocky Mountain National Park during summer breaks from college. She is also a storyteller. She loves getting to know UCHealth patients and providers and sharing their inspiring stories.

Katie spent years working as a journalist at the Rocky Mountain News and was a finalist with a team of reporters for the Pulitzer Prize for their coverage of a deadly wildfire in Glenwood Springs in 1994. Katie was the first reporter in the U.S. to track down and interview survivors of the tragic blaze, which left 14 firefighters dead.

She covered an array of beats over the years, including the environment, politics, education and criminal justice. She also loved covering stories in Congress and at the U.S. Supreme Court during a stint as the Rocky’s reporter in Washington, D.C.

Katie then worked as a reporter for an online health news site before joining the UCHealth team in 2017.

Katie and her husband Cyrus, a Pulitzer Prize-winning photographer, have three children. The family loves traveling together anywhere from Glacier National Park to Cuba.