Is that cough or sneeze allergies, COVID-19 or the flu? An ER doctor shares tips

With pollen swirling, and coronavirus cases creeping up again, how do you know if that cough or sniffle is spring allergies, or COVID-19?

Dr. Darria Long Gillespie, an emergency physician in Chattanooga, Tennessee, says if your symptoms are from your neck up, it is probably the pollen.

"So, allergies: sneezing, runny nose, sore throat, itchy eyes, that itchiness can predominate with allergies," Gillespie says. "But, while allergies might give you a little fatigue or leave you feeling rundown, that is not the predominant symptoms.  With allergies, they're pretty much chest-up.  Viral infections like COVID and the flu can be your whole body."

Dr. Gillespie is a spokesperson for the American College of Emergency Physicians, or ACEP, which came up with a list of several questions to help you differentiate between spring allergies and COVID-19.

First up: do you have a fever?

"Fever is likely not going to happen with allergies," Gillespie says.  "It's much more likely to happen with COVID or the flu.  So, again, COVID and the flu are these total-body symptoms, allergies (are) clavicle up. "

Next question: do you typically have spring allergies?

"Is this kind of your MO, or does it get worse every time you go outside, when the pollen counts are high,"Gillespie asks. "That's going to suggest it's allergies, versus if you're someone who don't get allergies, and it doesn't have anything to do with the pollen.  Again, that's going to point away from allergies and more towards something like COVID or the flu."

Another question: do your symptoms go beyond coughing and sneezing?

"COVID is kind of famous for that loss of smell," Dr. Gillespie says. "Now, you can get loss of smell with allergies, but it's a different mechanism. You're only going to get it because your sinuses are so swollen, and you'll notice that, versus COVID when you've just suddenly lost your sense of smell."

The coronavirus is also more likely to cause respiratory symptoms coupled with stomach issues like nausea and vomiting and diarrhea, she says.

"That's not going to happen with allergies, and that's not going to happen with a cold," Dr. Gillespie says.  "It's more classic for COVID.

One last question to ask yourself: have you taken any avoidable risks?

"Have you been around people who have been sick," Gillespie asks.  "Again, that's data that suggesting COVID or the flu."

And if you're still not sure if you have spring allergies or COVID-19, Gillespie says there is a quick way to get answers.

"So, if in doubt, take a test," she says.  "Whether it's taking a PCR test or a rapid antigen (test), have a bunch at home.  My family, we've been having allergies.  So, we've been having to take them a lot, too.  Don't make it a mind game.  Don't overthink it.   If you're having symptoms, just get tested."

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