We may have reached the point where it’s harder than ever to tell the average case of COVID-19 apart from a more mild case of the sniffles, or even your seasonable bout of allergies. So if you’re experiencing less-than-specific symptoms and you’re feeling uncertain whether you’re fine to leave the house (viruses are contagious, allergies aren’t), know you’re not alone.
“It’s very common that people who have allergies, they think they’re having a series of viral infections,” said Dr. Geoff Rutledge, chief medical officer at HealthTap, a telehealth company. And on the other end — some people have reported COVID-19 symptoms from the newest variant that are typically linked to allergies, including pink eye. This can make it even trickier to know what you’re down with, and why it’s still important to test for COVID-19 if you plan on being around others.
However, there are some symptoms and clues that are “very suggestive” you’re experiencing a virus versus seasonal allergies, or vice versa, Rutledge says.
Allergies (also called allergic rhinitis or hay fever) affect millions of adults and children each year and are caused by pollen or debris in the air that trigger an immune reaction and symptoms that follow — sneezing or itchiness, for example.
Viruses including COVID-19, respiratory syncytial virus (RSV) and the flu also trigger symptoms from a disease infecting the body and the immune system responding, but they can also result in secondary infections, such as sinus infections.
Here’s what to know about the differences between allergies and a virus.
Quick tips to help check whether it’s allergies or a virus
In general, when telling one sickness apart from another: “It is always best to have a healthcare provider confirm the diagnosis if you are unsure,” Dr. Jennifer Bourgeois, pharmacy expert at SingleCare, said in an email. That being said, there are some clues you can use to help yourself get the right medication or plan your week accordingly.
If you have a fever, it’s not allergies
While “fever” is in the name, hay fever does not actually cause a fever, according to the American College of Allergy, Asthma and Immunology. However, if you have a sinus infection or other bacterial infection, that may cause a fever and can be caused “sometimes secondarily” from allergies, according to Rutledge.
If you’re really itchy, it might be allergies
“Allergies typically cause itching of either the eyes, nose or top of mouth, which is not usually common in viral infections,” said Bourgeois. It’s important to note that, while it’s hard to pin symptoms down to specific variants of COVID-19, there have been some reports of more cases of conjunctivitis or pink eye with the newest version of the virus. Viruses and bacteria can also cause pink eye, which in turn can cause itching around the eye.
According to the Cleveland Clinic, other symptoms of allergic rhinitis besides itching include congestion, sneezing, headaches and sinus pain, dark circles under the eyes, increased mucus, postnasal drip (mucus draining down the back of your throat), trouble breathing and fatigue or generally feeling bad.
Take the antihistamine test
For people who experience seasonal allergies, but aren’t entirely sure if that congested feeling is from the same cold your friend had or the familiar allergies that usually kick in this time of year, Rutledge suggests what he calls a “therapeutic trial” of taking an over-the-counter antihistamine to see if that clears up your symptoms.
“There are specific treatments that only work for allergies,” he said, and antihistamines are one of them. Histamine is what your body releases when you have an allergy and your immune system is activated. Antihistamines work by blocking the effects of histamine and helping many allergy symptoms. On that note, if you have sinus pain or sneezing and your symptoms improve after you take a histamine, it might be safe to say you have allergies.
Take a COVID-19 test
This one’s pretty simple, but the best way to find out whether you have COVID-19 or something else is by taking an at-home test, or a more accurate lab test in a doctor’s office. This might be especially important if you plan on being around a person who’s older or otherwise at higher risk of serious illness from COVID-19.
Read more: FDA Authorizes Another COVID Booster for Older Adults
Pollen is the culprit behind many people’s allergy symptoms.
What are the most common COVID-19 symptoms now?
While the US Centers for Disease Control has a long list of COVID-19 symptoms, severity of the disease and symptoms will depend on your age and other factors like which strain of COVID-19 is circulating. The UK-based ZOE health study is a good reference for the “most popular” COVID-19 symptoms because its researchers have been keeping track of how COVID-19 symptoms change by collecting information from people in the country with a positive test who offer up their symptoms. As of December 2022, the top 10 most common COVID-19 symptoms in the UK, according to ZOE, were:
What are some effective allergy treatments?
What kind of medication you need depends on which symptoms you have.
“Each medication is designed to treat specific symptoms, so it’s important to find the correct over-the-counter medicine in order to manage and relieve your symptoms,” Bourgeois said. For example, antihistamines like Claritin or Zyrtec are standard allergy medications, but you could also find relief from a decongestant.
In a pinch, a fever-reducing medication like ibuprofen might also work for allergies because they have anti-inflammatory properties, Bourgeois said.
You might even try stopping allergy symptoms before they start with a steroid nasal spray, according to Bourgeois. They do the work before you’re exposed to the allergens in the air.
“It is best to begin the steroid nasal spray a couple of weeks before the allergy season that triggers your symptoms and continue throughout the duration of the season, as it’s typically not required to use the steroid nasal spray all year long,” she said.
If you choose to do a nasal rinse after symptoms and mucus sets in, Bourgeois refers to the CDC’s guide for safely carrying it out with sterile material.
Many people will manage allergy symptoms with help from their primary doctor or the right medication, Rutledge says, and they won’t need further medical help. But if you’re still not getting relief from your symptoms, and you’ve done some detective work into what’s causing your allergies, then you might be a good candidate for in-clinic allergy testing or a follow-up appointment with a specialist to get to the source, according to Rutledge.