When it comes to respiratory illnesses, it can be difficult to distinguish between the common cold, influenza, and COVID-19 due to overlapping symptoms. Early reports indicate that COVID-19 infection rates are currently low worldwide.
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According to Dr. William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center, mild symptoms above the neck—such as nasal congestion or a slight sore throat—usually point to a common cold. More severe symptoms, including persistent coughing, muscle aches, and extreme fatigue, may indicate a viral infection such as influenza or COVID-19. Even specialists find it challenging to identify the virus based on symptoms alone.
Influenza and COVID-19
Both influenza and COVID-19 can cause coughing, shortness of breath, fatigue, headaches, body aches, sore throat, digestive problems, and loss of smell. However, the underlying mechanism differs: colds and influenza often affect the sense of smell due to nasal inflammation, whereas COVID-19 impacts the nerves responsible for smell. Recently, loss of smell has become less common among COVID-19 patients compared with the early stages of the pandemic.
Speed of Symptom Onset
One key factor in distinguishing between these illnesses is how quickly symptoms appear. COVID-19 symptoms usually develop gradually, with nasal congestion and sore throat worsening over several days. Influenza, by contrast, often strikes suddenly, with patients commonly describing the onset as feeling like they were “hit by a truck.” Fever can occur in both illnesses but typically appears earlier in cases of influenza.
Testing remains the most reliable way to differentiate between influenza and COVID-19. At-home COVID-19 tests and combined COVID-19/flu tests are available and usually provide results within 15 minutes. Results may be negative in the early stages of illness, so retesting after 48 hours is recommended if symptoms persist.
Testing is especially important for high-risk groups, such as older adults, pregnant women, and people with chronic conditions. Accurate diagnosis helps guide treatment decisions, including the use of antiviral medications such as Paxlovid or Tamiflu, and determining the recovery period.
Prevention strategies for both illnesses are similar: frequent handwashing, staying in well-ventilated spaces, avoiding crowded places, wearing masks, staying home when sick, and getting vaccinated. Experts stress that it is not too late to receive the flu vaccine or the latest COVID-19 booster to provide protection during the illness and holiday season.
