Your head hurts, your chest feels tight, your throat itches, and you keep coughing. Is it coronavirus — or perhaps just the same allergies that sneak in every spring?
“We are at a unique time when it comes to respiratory issues: the flu is decreasing in prevalence, while seasonal allergies are picking up steam. And of course, standard colds continue to circulate — all in the middle of the COVID-19 pandemic,” says Arizona-based family physician Natasha Bhuyan, M.D., regional medical director for One Medical.
Now, let’s be clear: If you have any respiratory symptoms (coughing, wheezing, trouble breathing), you should self-isolate and call your primary care doctor ASAP in case they are indeed markers of COVID-19, she says. And you can have both seasonal allergies and a cold, or seasonal allergies and COVID-19 simultaneously.
But there is a lot of cross-over between symptoms of coronavirus and seasonal allergies — and allergies are starting to gain real momentum for the season already: Normally, tree pollen season starts as early as January in some states and usually causes trouble through July, while things like grass pollen start popping up in May, according to the Asthma and Allergy Foundation of America. But spring 2020 is said to be a particularly bad year for allergies, with more rainfall than normal and warm temperatures putting tree and grass pollen into the air earlier and longer than normal, according to AccuWeather meteorologists. In fact roughly 33 percent of the country is already at medium-high status of pollen count — and it's only March. It’s particularly bad already in the southeast and southwest.
More than 50 million Americans suffer from seasonal allergies every year, according to the American College of Allergy, Asthma & Immunology (ACAAI). But because we’re all spending more time indoors during lockdowns, surrounded by pets, dust mites, mold, and other potential allergens, you could be experiencing allergies worse than normal — or even for the first time, points out Purvi Parikh, M.D., a New York-based allergist and immunologist with Allergy and Asthma Network. In fact, some people develop allergies for the first time in their 20s and 30s (it's called adult-onset allergies), says the ACAAI.
While the symptoms do overlap, there are also major differences. So before you start live tweeting descriptions of your cough, here are five questions to ask yourself.
1. Do you have a temperature?
COVID-19 generally runs a fever over 100.4°F, while allergies rarely cause high temperatures, Dr. Parikh says.
2. Are you congested?
Both COVID-19 and allergies can cause a cough, but corona’s is usually dry whereas one from allergies is the direct result of post-nasal drainage. Coronavirus can definitely cause nasal congestion or a scratchy throat, but it’s more rare, experts say.
3. Are you itchy?
Anywhere — your skin, throat, nose, eyes. This is a hallmark sign of allergies and not associated with coronavirus.
4. Do your symptoms change throughout the day?
If so, it’s probably just allergies: Pollen peaks in the morning, which is when most allergy sufferers find their symptoms to be the worst, Dr. Bhuyan says. (Even if you haven’t been outside today, it can get into your house on your pet’s coat, through open windows, or just from poor insulation.) COVID-19 symptoms stay consistent through the day.
5. Does an allergy pill help?
Long-acting antihistamines like Allegra, Zyrtec, and Claritin are helpful for both allergies as well as a cold, Dr. Parikh points out. If you pop one and your symptoms get better, that’s a good sign you’re fighting something other than coronavirus.
The bottom line on coronavirus vs. allergies:
If it is spring allergies at play, limiting allergens in your home (in addition to popping that Zyrtec) can go a long way in symptom control. Change your sheets, vacuum, buy an air purifier, and clean up pet dander, and see if that helps your woes, Dr. Bhuyan advises.
However, it’s worth repeating: Right now, any breathing symptom like a cough, wheeze, or shortness of breath should be treated by a physician, regardless of cause. If your respiratory symptoms are really bad, call them ASAP. But if they’re mild, it’s helpful to take the above steps first and rule out some of the key hallmarks of allergies before discussing next steps with your doc.
The coronavirus pandemic is unfolding in real time, and guidelines change by the minute. We promise to give you the latest information at time of publishing, but please refer to the CDC and WHO for updates.