Is that cough the flu, COVID, RSV or a cold? How to tell the symptoms and what to do next
Sneezing? Feeling congested? Coughing? Are these signs of flu season, RSV, a cold or allergies, or do you have COVID-19? This year, it could be any of them.
The Centers for Disease and Prevention (CDC) issued an advisory in December warning about a dangerous rise in respiratory illnesses and a dangerously low rate of vaccinations and urged healthcare providers to recommend immunizations and antiviral medications where appropriate.
Last week, the CDC listed 39 states, including Florida, that reported high or very high levels for respiratory illnesses with fever, cough and other symptoms in the week ending Dec. 30, 2023.
That includes influenza (flu), COVID-19, RSV (respiratory syncytial virus) and other viruses, but the flu has seen the largest increase. Positive lab tests for the flu rose to 17.5% of all tests given during that period nationwide.
The numbers from the Florida Department of Health show decreases in flu positivity rates and emergency room visits for the week ending Jan. 6 in most areas of the state, except for Bay, Flagler, Highlands, Martin and Taylor counties. But the percent of emergency room visits with discharge diagnoses of flu, while down from the week previous, are still considerably higher than the last three years, according to FDOH data.
The same is true for RSV, a common respiratory virus that's usually more like a cold for adults but can be dangerous for young children, babies and older adults with chronic medical conditions. ER visits for RSV have dropped down to last year's levels as of last week but over the holiday season, the number of children and adults rushed to emergency rooms was well above the rates for the past three years.
COVID-19 also has been rising back up, thanks to JN.1, a new, easily spread strain the CDC said now accounts for nearly two-thirds (61%) of all cases in the country.
Reported cases in Florida hit 43,178 in December, according to FLHealthCharts data, twice the 21,975 from the month before (although still far fewer than the 102,662 cases reported in December 2022). And that's almost certainly a fraction of the actual number, as most people self-diagnose with home tests and often do not report the results.
So what should you do if you start coughing? Without testing, it is difficult to determine whether the congestion is more than a cold, but either way, don't panic, say medical experts. Just take proper precautions.
What are the symptoms for COVID?
According to the CDC, the most common symptoms of any variant of COVID-19, including JN.1, are:
Fever or chills
Cough
Sore throat
Congestion or runny nose
Headache
Muscle or body aches
Shortness of breath or difficulty breathing
New loss of taste or smell
Brain fog (fuzziness, difficulty thinking or focusing).
Nausea or vomiting, mild diarrhea
Some people with COVID are asymptomatic and never display any symptoms, although they can still pass it to others. And many people with COVID have mild symptoms. If symptoms arise or you've been exposed to someone with COVID, get yourself tested and, if it's positive, observe the recommended isolation and distancing methods. Ask your healthcare provider for the antiviral Paxlovid, which has been shown to be highly effective for people at risk of severe complications.
According to the CDC, if you are showing any of the following signs, seek emergency medical care immediately:
Trouble breathing
Persistent pain or pressure in the chest
New confusion
Inability to wake or stay awake
Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone
While public urgency has lapsed concerning COVID, please note that 8,366 Floridians died last year from it and 53 have died already in 2024. Even people with mild or no symptoms at first have found themselves dealing with the debilitating effects of long COVID later.
What are the symptoms of the flu?
More or less the same thing, except for the loss of taste or smell and brain fog, and not everyone will run a fever.
COVID-19 symptoms usually appear two to 14 days after exposure to the coronavirus. Flu symptoms start to show up about one to four days after exposure to an influenza virus.
However, COVID-19 can cause more serious illnesses in some people than the flu, as well as complications such as blood clots and lasting respiratory problems, and it's impossible to tell the difference without testing.
Last year, the Food and Drug Administration authorized the first over-the-counter at-home test that can detect and differentiate between flu and COVID-19.
The Lucira COVID-19 and Flu Home Test is a single-use test that can be purchased without a prescription and displays results in 30 minutes or less for influenza A, influenza B and COVID-19.
Should I get a flu shot?
Yes. Influenza is a dangerous virus and flu shots, while not perfect, still help a great deal.
The CDC recommends that, with rare exceptions, everyone 6 months and older should get a flu vaccine every season. Public health experts say vaccination is vital to protect individuals and communities and to avoid burdening already overtaxed health care systems.
If you are prone to catching the flu or colds, the same methods used to prevent the spread of COVID work the same way. In 2021, when people across the nation were social distancing, wearing masks and washing their hands, the flu virtually disappeared.
Getting vaxxed: Is it safe to get a flu shot and a COVID-19 vaccine at the same time? Experts explain
What are the symptoms of RSV?
Symptoms of RSV tend to show up within four to six days after infection, the CDC says, and may include:
Runny nose
Decrease in appetite
Coughing
Sneezing
Fever
Wheezing
The symptoms usually appear in stages rather than all at once, and health experts say they typically resolve on their own within a week or two. In infants under 6 months, the only discernible symptoms may be increased irritability or lethargy and breathing difficulties.
Healthy adults and infants with RSV infections generally don't need to be hospitalized, according to the CDC. However, it may be necessary if the person is having trouble breathing or is dehydrated.
What are the symptoms for a cold?
Like other respiratory illnesses, the symptoms of the common cold are often coughing, sneezing, a runny or stuffy nose, a sore throat, tiredness and sometimes a fever. Symptoms usually appear one to three days after exposure to a cold-causing virus.
Unlike flu or COVID, or RSV for babies and young children, a cold is usually harmless and cold-sufferers, while miserable, generally recover in three to 10 days. But it is highly contagious, especially when “your symptoms are at their worst,” according to the Cleveland Clinic.
What are Americans catching this winter? It's not just flu and COVID-19 anymore.
Other CDC recommendations to avoid respiratory illnesses
Wash your hands often with soap and water, or use hand sanitizer in a pinch.
Avoid crowds and poorly ventilated indoor spaces.
Stay 6 feet from people outside the home.
Get a flu shot and stay fully vaccinated against COVID-19 with the latest boosters.
You also should take steps to strengthen your immune system such as improving your eating habits, getting enough sleep, exercising and avoiding stress.
This article originally appeared on The Daytona Beach News-Journal: Flu, COVID-19, RSV all have similar symptoms. How to tell the difference
