Do I Have COVID-19 or Allergies?

“This is obviously a tricky question,” says Aaron Pearlman, an otolaryngologist at Weill Cornell Medicine. Luckily, though, there are several ways to distinguish the two.

In the fall, public-health experts worried that the winter would bring a so-called twindemic, in which flu season and the coronavirus pandemic’s third wave would strike simultaneously and compound each other. They feared that emergency rooms, already filled almost to capacity with COVID-19 patients, would be overwhelmed by an onslaught of flu patients. They feared that if contracted together, the viruses could be doubly, or more than doubly, deadly. And they feared that the near indistinguishability of the symptoms would cause triage chaos for hospitals trying to separate the coronavirus patients from the flu patients. Both viruses tend to induce fever, muscle aches, and coughing. COVID-19 does have certain unique symptoms—patients sometimes lose their ability to taste and smell, for example—but in many cases, the illnesses are identical. Mercifully, flu season was virtually nonexistent. None of these dreaded scenarios came to pass.

Allergy season is not flu season, and none of the doctors I spoke with for this story predicted that the spring would bring anything like the ravages experts feared last fall. Influenza is a highly transmissible virus that, in an ordinary year, kills tens of thousands of Americans. Seasonal allergies, as uncomfortable as they make our lives for a few weeks each spring, kill almost no one. They will not strain emergency rooms the way flu season threatened to.

But they may cause a similar sort of confusion. Though not nearly so COVID-like as flu symptoms, allergy symptoms are alike enough to prompt a moment—or more than a moment—of panic. Thankfully, COVID-19 and seasonal allergies each have distinct symptoms that can help differentiate the one from the other. Most symptomatic COVID-19 patients develop a fever, and some have diarrhea or nausea, which allergy sufferers never do. Allergies, by contrast, can cause sneezing, a scratchy throat, and red, itchy eyes, which COVID-19 rarely does. (The Mayo Clinic and a number of other hospitals have put together helpful charts comparing the symptoms of COVID-19, allergies, a cold, and the flu.)

Maybe the most useful guide, Pearlman told me, is your own personal history. If this year’s symptoms align closely with last year’s, you’re probably in the clear. If you notice any irregularities, getting tested for COVID-19 can’t hurt. “Rather than being like, ‘Oh you have allergies; don’t worry about it,’” Pearlman explained, “I would say, ‘Listen, it’s likely allergies, but getting tested can only make you feel more confident in that diagnosis.’”

Subhadra Siegel, the director of the Allergy and Immunology Program at Boston Children’s Health Physicians, says that COVID-or-allergies confusion has already begun to affect her patients—though they’re not the ones who are confused. In recent weeks, a number of children with seasonal allergies have come to her after being sent home by schoolteachers worried their students had the coronavirus. The children’s parents didn’t seem particularly concerned; they knew that their child’s symptoms were the same ones they saw every spring. “The schools are just being hypervigilant in order to stay open, and trying to not let anyone in with any kind of a sniffle,” Siegel told me. “But that becomes more challenging as allergy season starts.”

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