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Spot the difference: is it the common cold, hay fever, flu, pneumonia, or coronavirus?

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Updated 16th August 2021 - We recommend the coronavirus page on the Government website for more up to date information.

It’s normal to feel poorly with a cough, headache, and runny nose from time to time. But sometimes symptoms can be more serious and leave us in bed for days or even weeks at a time. In severe cases, symptoms that start out mild may end up needing medical care in a hospital.

With COVID-19 still circulating around the world, it’s important to understand when symptoms may be more than they seem. Read on for a guide to spotting the differences between the common cold, flu, coronavirus, pneumonia, and hay fever, and for some simple answers to some frequently asked questions on this topic.

The common cold

The common cold is a respiratory illness, meaning it affects your airways. It’s caused by a group of similar viruses. There’s very little risk of becoming seriously ill from a cold, and most people recover fully within a couple of weeks. You’ll usually only be at risk if you’re already very unwell e.g. you have a weakened immune system.

Symptoms of the common cold include:

  • Sneezing
  • Runny or stuffy nose
  • Sore throat
  • Cough
  • Headache

The flu

Influenza or "flu" is an infection of the respiratory system caused by strains of the influenza virus. It’s especially common in winter and can cause illness for several days or weeks. Tiredness and feeling achy can make it difficult for you to carry on as normal.

Symptoms of the flu include:

  • High temperature
  • Headache
  • Aches and pains
  • Sore throat
  • Tiredness

After exposure to the flu, symptoms tend to come on very quickly and are more intense than the common cold. However, the flu is unlikely to cause a stay in hospital unless you’re in a high-risk category e.g. you’re pregnant or have a serious health condition.

If you're at risk, it’s best that you get your annual flu vaccine.

The coronavirus (COVID-19)

COVID-19 is a respiratory illness caused by a new coronavirus first identified in Wuhan, China in 2019. The virus has never been in circulation before, meaning no-one had any natural immunity to it.

Symptoms of COVID-19 include:

  • High temperature
  • Loss or change to your sense of taste and smell
  • Cough that is new and continuous (i.e. you’re coughing a lot for long periods)

What to do if you’re having COVID-19 symptoms

If you're displaying symptoms, return to your home to self-isolate and you should get tested as soon as possible. You can get a free NHS test, or you can request a swab test kit from LloydsPharmacy Online Doctor.

The self-isolating guidance varies depending on your age, vaccination status and where you live. In England please follow the below advice:

  •  If you’re displaying symptoms you should complete a PCR test as soon as possible and self-isolate until the test comes back.
  • If your result is negative, you don’t need to self-isolate
  • If the test is positive or unclear you should self-isolate for 10 days from the day of onset of the symptoms
  • If you don’t have symptoms and test positive, you should continue to self-isolate for 10 days
  • If you live with (or are in a support bubble with) someone who has tested positive or had an unclear result you should self-isolate unless you are fully vaccinated (having received the second vaccine dose at least 14 days previously), or under the age of 18 years and 6 months old

For more guidance about self-isolating, read this page on the NHS website. You can continue to protect yourself from COVD-19 by following Government guidance, getting regularly tested, wearing a face mask and getting the COVID-19 vaccine.

You can learn more about protecting yourself from COVID-19 by reading the section at the end of this article: How to stay safe.

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Pneumonia

Pneumonia is a very serious respiratory illness that causes swelling in the lungs and leads to difficulty breathing. It is usually caused by a bacterial infection. It can also be caused by a viral infection, like coronavirus (COVID-19).

The main difference between bacterial and viral pneumonia is that you can treat bacterial pneumonia with antibiotics.  Viral pneumonia doesn’t tend to have a specific treatment other than the management of symptoms, although antiviral medicines are sometimes used .

Symptoms of pneumonia include:

  • Dry cough
  • Wet cough that produces phlegm that is green, yellow, brown, or bloody
  • Difficulty breathing
  • Fast heartbeat
  • Fever and chills
  • Feeling unwell
  • Loss of appetite
  • Chest pain that worsens when breathing or coughing

Pneumonia can have serious health complications, so if you’re experiencing any of these symptoms it’s a good idea to speak to your GP or call 111.

If you’re over 65, have asthma or smoke you are more at risk of get seriously ill from pneumonia and should consider getting the pneumonia vaccine. Find out more about who’s at risk and whether you can get the pneumonia vaccine in one of our stores on our service page.

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Hay fever and allergies

The symptoms of hay fever and other allergies can sometimes be mistaken for a viral infection. Hay fever symptoms are usually at their worst between late March and September, when it’s warm, humid, and windy. This is also when the pollen count is at its highest.

Symptoms of allergies tend to develop more rapidly than the symptoms of a cold, which can take a couple of days. 

Symptoms of hay fever include:

  • Sneezing
  • Coughing
  • Runny or blocked nose
  • Itchy, red, watery eyes
  • Itchy throat and nose
  • Loss of smell
  • Headache
  • Earache
  • Feeling tired

If you have asthma, you might also experience shortness of breath, a tight feeling in your chest, and wheezing.

If you think hay fever or other allergies may be the cause of your symptoms, try taking some antihistamines

Similarities and differences in symptoms

Signs
and symptoms
Common cold Flu  COVID-19 Pneumonia Hay fever
Onset of
symptoms
Gradual Sudden Gradual or sudden Gradual or sudden Gradual or sudden
Fever Unlikely Common Common Common Unlikely
Chills Unlikely Sometimes Sometimes Common Unlikely
Body aches Unlikely Sometimes Sometimes Sometimes Unlikely
Fatigue
(tiredness)
Sometimes Common Common Sometimes Sometimes
Sneezing Common Sometimes Unlikely Unlikely Common
Cough Sometimes Common Common Common Common (usually dry)
Sore throat Common Sometimes Sometimes Unlikely Sometimes (itchy throat)
Headache Sometimes Common Sometimes Sometimes Common
Runny or
stuffy nose
Common Sometimes Unlikely Unlikely Common


How difference illnesses are spread

COVID-19, the common cold, and the flu are all caused by viruses, and can all spread from person to person through tiny droplets in the air caused by coughing, sneezing, or talking.

A virus can also exist on surfaces and spread when a person touches a contaminated surface and then touches their face. In all cases, transmission can happen in people who are asymptomatic (i.e. they do not show any symptoms) or even before symptoms begin to show.

Pneumonia is different from the other three types of infection described in this guide, as it’s normally caused by bacteria.

Commonly, the cause of bacterial pneumonia is streptococcus pneumoniae. These bacteria live harmlessly in the throat, but in some circumstances can travel down into the lungs and cause pneumonia – this normally happens if your immune system is weakened due to illness, malnutrition, or old age.

With viral pneumonia, the initial cause is a viral infection, such as the flu or COVID-19, which goes down into the lungs. Sometimes viral pneumonia can lead to bacterial pneumonia, as it weakens the immune system .

Your treatment options

Viruses can’t be treated with antibiotics, so in most instances it’s simply a case of waiting for your body to fight off the infection on its own. While you’re recovering you should:

  • Get plenty of rest
  • Stay hydrated
  • Take over-the-counter painkillers if appropriate

In the case of pneumonia, your GP may prescribe some antibiotics if they think the cause is bacterial infection, rather than a virus.

Treatments for hay fever

Depending on your hay fever symptoms you experience, you might want to look at different medications. For example, if you experience a runny nose you might want a nasal spray or if you get itchy eyes you could try eye drops or even a soothing eye mask. For more tips on hay fever, here’s our advice on 5 ways to avoid pollen.

Frequently asked questions about the common cold, the flu, COVID-19, and pneumonia

Is coronavirus more severe than the flu?

COVID-19 can be more serious than seasonal influenza in some people. That’s why it’s important to follow government advice and take appropriate precautions to keep you and those around you safe and well.

Both COVID-19 and the flu can result in severe complications, such as:

  • Respiratory failure – a condition where not enough oxygen passes from your lungs into your blood
  • Pneumonia – an infection in one or both lungs that causes swelling and fluid to build up, causing difficulty in breathing
  • Sepsis – when the immune system goes into overdrive in reaction to an infection, and begins to damage the body’s own tissues and organs
  • Multiple organ failure – where two or more organ systems begin to shut down
  • Worsening of pre-existing conditions – for example asthma or heart disease
  • Secondary bacterial infections – a second infection that occurs as a result of the damage caused by the initial influenza or COVID-19 infection

COVID-19 is associated with some additional complications, including:

  • Blood clots – clots in the veins or arteries of the heart, lungs, legs or brain have presented themselves in more severely ill patients, leading to strokes or amputations
  • Paediatric multisystem inflammatory syndrome associated with COVID-19 – a condition where different parts of the body become inflamed.

The good news is that there are now vaccines available for COVID-19. To have the best protection against COVID-19, it’s important to get the vaccine when you are offered it. It’s also a good idea to get your annual flu jab.

Who is more at risk from coronavirus?

On top of being in a high risk category, Public Health England have identified the following factors that may place you more at risk of catching COVID-19:

  • Being a man (men appear more susceptible to COVID-19)
  • Where in the country you live, as the risk is higher in poorer more crowded areas
  • Being from a Black, Asian or Minority Ethnic (BAME) background
  • Living in a care home
  • Having certain high-exposure jobs such as nurse or bus driver

How is the transmission of COVID-19 in children different from flu?

According to studies, it appears that children are less affected by the COVID-19 virus than adults. This is in contrast to the flu, where children are equally affected and significantly drive influenza transmission rates within a community. 

However, you should still take steps to keep your children protected. This includes keeping an eye out for symptoms, which generally seem to be the same as those seen in adults.

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How to stay safe

There are a few different ways to keep yourself protected from viruses:

  • Get vaccinated for the flu, COVID-19, and pneumonia. The COVID-19 vaccine is free for everybody, and the flu vaccine and pneumonia vaccine are free for people who are high-risk. If you aren’t eligible for free vaccines, you can order your flu vaccine or pneumonia vaccine from LloydsPharmacy and receive your injections in your local store.
  • Frequently wash your hands with soap and warm water – you should try to wash them for at least 20 seconds to make sure they’re properly clean. If soap and water isn’t available, use a hand sanitising gel, and wash your hands with soap and water at the next available opportunity.
  • Avoid touching your nose, eyes and mouth when out and about, as viruses can linger on surfaces and enter the body in this way.
  • Stay away from infected people and keep your distance from those not in your household. 
  • Keep healthy – ensure you maintain a healthy diet and proper exercise.
  • Use face coverings, such as face masks– this limits the spread of virus-spreading droplets in the air, and is especially important during the COVID-19 pandemic.

References

www.nhs.uk/conditions/flu/
www.nhs.uk/conditions/common-cold
www.nhs.uk/conditions/coronavirus-covid-19/symptoms
www.nhs.uk/conditions/pneumonia
www.nhs.uk/conditions/hay-fever
www.cdc.gov/flu/symptoms/coldflu.htm
www.cdc.gov/flu/symptoms/flu-vs-covid19.htm
www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---3-march-2020
www.cdc.gov/flu/prevent/actions-prevent-flu.htm
www.nhs.uk/conditions/coronavirus-covid-19/people-at-higher-risk/whos-at-higher-risk-from-coronavirus/
www.webmd.com/lung/bacterial-pneumonia
www.webmd.com/lung/viral-pneumonia