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Cold, flu or coronavirus? How to tell the difference, and when to get tested. - NJ.com

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The coming winter months are likely to be a confusing time for people who get sick, with cases of the flu and common cold entering the picture just as coronavirus cases begin to rise again in New Jersey.

How can you figure out which of the different respiratory infections you have, and when should you get tested? We asked three New Jersey medical and health experts for advice.

There is a lot of overlap in symptoms between these highly contagious illnesses, and telling them apart may be difficult, says Dr. Lawrence Kleinman, Chief of the Division of Population Health, Quality, and Implementation Science (PopQuIS) at Rutgers University.

The coronavirus and flu have many similarities, and may be most difficult to diagnose without testing, he said.

Both generally share symptoms of a cough, fever, chills, sore throat, runny or stuffy nose, muscle or body aches, headaches and fatigue. However, symptoms unique to coronavirus include diarrhea, loss of taste or smell and difficulty breathing, he said.

Colds typically result in a runny or stuffy nose, sneezing and sore throat, but no fever. The symptoms are usually milder than flu and coronavirus and more short lived, Kleinman said.

Dr. Anat Feingold, associate professor of pediatrics at Rowan University’s Cooper Medical School and Division Head for pediatric infectious diseases at Cooper University Health Care, says young kids will likely have worse symptoms with the flu than with coronavirus.

“They could have higher fever. They could be iller in the sense of having more chills, more achy. If you compare flu to COVID-19, the kids with flu would be generally sicker," Feingold said.

But because the symptoms overlap so much, testing is the only way to know what’s causing your illness.

Dr. Sandra Adams, a professor of biology at Montclair University, suggests people err on the side of caution and get tested if they feel sick.

Fear over limited testing supplies has diminished since the beginning of the pandemic, she said, so that shouldn’t guide a person’s decision to visit the doctor. With more people inside during the colder months, there may be a spike in cases and testing will become more important, she said.

“The average person will not be able to tell the difference between flu and COVID-19,” Adams said. “When you find the combination of fever, cough, fatigue, you won’t be able to determine whether that’s the flu or COVID. I’d say, get a test.”

Getting the nasal swab is important to keep others safe, not just yourself.

Confirming you have coronavirus— even if your symptoms are mild— helps officials with contact tracing, Kleinman said. And if a family member is at higher risk of having severe complications from COVID-19, such as those with diabetes or asthma, it can also be helpful to know if you or your child is infected, Feingold said.

Kids should always be kept home if they’re sick, she said.

“The question is, are you going to do something different if (your child) is positive?" she said. “The reason to know for influenza, is there’s an option of treating with an anti-viral to shorten the influenza. If the COVID test is positive, there’s not much to do except treat the patient symptomatically.”

“If they have fever and it is significant illness and there are people at risk in the home, it may make a difference (to get tested),” Feingold said.

It is possible for a person to have both the coronavirus and influenza, or other illnesses, Kleinman said. In California, officials last week reported the first case of a person testing positive for the flu and COVID-19.

Therefore, Kleinman says physicians might want to test for coronavirus, influenza and strep throat if a patient has symptoms that correlate with all three.

“Our instinct as doctors is you look for a cause and once you have a cause, most of the time, symptoms have a single cause so you can stop... With coronavirus, it adds a layer of complexity,” he said.

Getting immunized is critical this year for a number of reasons, Feinberg said.

The vaccine consists of four different types of inactivate influenza, Feingold said. The strains put into the vaccine are the most common ones that have been circulating in countries in the southern hemisphere, where winter has already passed, and it allows your body to pre-form antibodies against those strains.

Since the vaccine decreases the chances of getting influenza, it will help answer the question of whether someone has flu or COVID-19, she said. It will also cut down on the number of flu hospitalizations and help prevent medical centers from being overwhelmed, she said.

“Every year, hospital beds fill up during influenza season with people who are high risk or have underlying disease,” she said. “We want as few patients in the hospital with influenza of the ones we can prevent so we have medical services available for people with COVID. There’s a multitide of reasons to get influenza vaccine.”

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Avalon Zoppo may be reached at azoppo2@njadvancemedia.com. Follow her on Twitter @AvalonZoppo.

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