Do you have the flu, COVID or allergies this fall? An SC doctor explains the differences

Autumn brings cooler weather, fall activities and holidays, but amid all things pumpkin spice and Halloween, a cough, runny nose or fever can bring down the fall fun.

“Now that we’re getting into what I call the fall season, we see a lot more respiratory bugs pick up,” said Dr. Sean Nguyen, a physician at Tidelands Health Family Medicine at The Market Common.

If you’re feeling under the weather this season, it could be allergies exacerbated by seasonal changes like dying grass, this year’s flu or the latest strain of COVID.

Here’s how to figure out what’s ailing you this autumn, how to protect yourself and what treatment looks like for allergies, coronavirus and the flu.

“A lot of the initial complaints we’re seeing in August, September and into the fall with the temperature changes, is we’re getting a lot of people with cough, congestion and just not feeling well,” Dr. Nguyen said. “The problem is there’s not a really distinguishing factor.”

Do you have allergies, the flu or COVID this fall?

It’s easier to differentiate allergies from COVID and the flu, although all three often present with cough and congestion.

Allergies are brought on by environmental triggers, like pets and plants and can last weeks or even months at a time. Because they’re influenced by exposure, allergies might be worse at certain times of day.

If you’re waking up with post-nasal drip or suffering an itchy throat after walking home in the evening, allergy medications could improve your symptoms. Unlike the flu and coronavirus, which are respiratory illnesses, allergies aren’t typically associated with those classic “flu-like” symptoms like fever and muscle aches.

But if you catch the flu, you could experience fever, muscle aches, congestion, cough and chills. For some patients, Dr. Nguyen says COVID presents like a bad case of the flu, making it tough to distinguish based on symptoms alone.

At this point in the coronavirus’s evolution, it’s more variable than ever before, according to Dr. Nguyen, who sees coronavirus patients with cough, congestion and runny nose. Some people suffer from the loss of taste and smell associated with COVID, some have gastrointestinal symptoms like diarrhea and some have no symptoms at all.

“I think most of the time, patients can have a gut feeling,” said Dr. Nguyen. “You usually have some familiarity of, ‘This is not like my typical allergies. Something is different this time. I feel worse this time.’ Or, ‘Hey, I’ve had the flu before. This feels like the flu.’”

But the only surefire way to identify whether you’re facing the flu or coronavirus is to take a test. Rapid combination tests are available over the counter at pharmacies like CVS and Walgreens, but Dr. Nguyen says seeing a doctor can help rule out false results and eliminate user error in swabbing.

How to protect your health this fall

For respiratory illnesses like COVID and the flu, there are steps you can take to protect yourself and others this autumn. Washing and sanitizing your hands regularly helps prevent the spread of germs that make you sick.

It’s also a good idea to see your doctor about vaccinations, which Dr. Nguyen says are the best way to avoid the latest strain of flu. A vaccine might make you feel crummy, but the actual illness could make you feel worse.

“You’re not getting flu. You’re actually mounting an immune response that prevents you from getting sicker from flu down the road, in terms of when the season flares up, so it kind of turns on your immune system to prepare you for the future infections,” said Dr. Nguyen.

You may not need a coronavirus shot this fall, but Dr. Nguyen recommends talking to your doctor every year about whether you’d benefit from a vaccine, particularly if you’ve never gotten a COVID shot or are over the age of 65.

And as tired as you may be of masks, Dr. Nguyen says they remain an effective way to limit the exposure of illness. If you’re coughing badly or severely congested, consider minimizing contact with others to decrease the chance of infection.

What does treatment look like?

If you’re feeling under the weather this fall, a doctor can help determine what’s making you sick and help make a treatment plan.

Because you can’t catch allergies like a respiratory illness, allergies can be managed by limiting exposure to the irritating allergen or using medications like antihistamines, nasal sprays, allergy shots or a course of steroids to address your symptoms.

For a respiratory illness, treatment for less severe symptoms may simply require sleep, fluids and over-the-counter pain management medications. In other cases patients may benefit from antiviral or steroid treatments.

“Most people, I would say, as long as you’re keeping up with your vaccines, maintaining good hand hygiene, precautions when you’re sick, just taking care of yourself, physically in terms of eating right [and] sleeping right, we generally do okay through the seasons,” said Dr. Nguyen. “Now, people at risk as a whole, this is where you may need an individual plan on how to prepare for each upcoming season. That’s where your doctor or provider may help guide you a little bit more, because you may be unique.”