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News / Health

Is it the flu or COVID? Does it matter? 5 questions about winter viruses

By Helena Oliviero, The Atlanta Journal-Constitution
Published: January 16, 2024, 6:02am

With COVID-19 and flu both surging across the country, chances are you or someone close to you is sick or getting over a virus.

“Here in the Southeast we are experiencing very high flu activity. The rest of the country is increasing as well,” said Georgia state epidemiologist Cherie Drenzek on Tuesday at a Department of Public Health board meeting. But not as sharply as Georgia.

“We’re higher than anywhere else,” she said.

Early symptoms can be the same — sudden fatigue, body aches, and a fever. How can you tell the difference? The Atlanta Journal-Constitution connected with doctors and public health experts to answer questions about what to do if you get sick, whether it is still worth getting a flu vaccine, and other questions about this year’s respiratory season.

  • You or a family member woke up feeling lousy. Is it the flu or COVID? Does it matter?

You can’t tell the difference between flu and COVID by symptoms alone because they can be so similar, according to the Centers for Disease Control and Prevention.

Only a test can distinguish between the two. And getting a test quickly is key to getting early treatment. Prescription antivirals are available for both COVID and the flu, but need to be taken shortly after symptoms appear. For the flu, Tamiflu works best when taken within 48 hours. For COVID, Paxlovid needs to be taken within five days of symptoms beginning.

Knowing whether it’s the flu or COVID also provides a better idea of how quickly you and your family members can return to work and school.

With COVID, the CDC still recommends isolating for at least five days after a positive test or symptom onset. A person should then wear a mask in public for an additional five days. With the flu people are most contagious for the first three days of their illness.

The CDC recommends staying home until at least 24 hours after any fever is gone — without the use of fever-reducing medication.

  • My child is sick. When they can go back to school?

A child with a fever should not go to school and any temperature of 100.4 degrees or higher is considered a fever. Not only are fevers a sign of an active infection, they also can signal the sick person is shedding virus. Children’s Healthcare of Atlanta experts say a child should be fever-free for 24 hours before they return to school — without the use of fever-reducing medications. Children should also not go to day care or school if they had episodes of vomiting or diarrhea within the past 24 hours.

Dr. Jim Fortenberry, chief medical officer at Children’s Healthcare of Atlanta, said while most children can recover with home care, whether a child needs urgent medical care depends on the severity of their symptoms.

The emergency department is the best place to provide care to children with difficulty breathing, who are refusing to eat and drink, and whose symptoms are becoming worse, he said. An urgent care center can provide care to children who may require fluids or other supportive care. The child’s pediatrician is the best source of medical care for less severe symptoms in children.

  • How do we manage these illnesses right now? What’s the quickest way to get better?

Regardless of the virus, most can manage their symptoms at home. Doctors emphasize the need for hydration, rest and nutrition.

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It’s a recommendation that can be easier said than done.

Dr. Aneesh Mehta, chief of infectious diseases at Emory University Hospital, admitted when he got COVID in the fall of 2022, he realized he wasn’t following his own advice. And once he did, he saw first-hand the benefits of simple rest, hydration, and eating well.

“I realized that despite me advising my patients, very early on I wasn’t doing enough,” Mehta said in an interview after he recovered. “It just reinforced why I need to talk to all of my patients about the importance of rest and nutrition when they have an illness.”

People who are at high risk of being severely ill from COVID or the flu, including people who are 65 and older, those with diabetes or lung disease, and those who are immunocompromised, should talk to their health care provider for advice and whether any prescription medicines are needed.

Even adults who are at low risk for complications are advised to watch for serious symptoms that require immediate care, such as wheezing or difficulty talking without getting winded, severe chest pain or sudden dizzy spells.

When in doubt, call your doctor.

  • What about a flu shot? Is it too late to get one now?

While it’s best to get a flu shot by the end of October, doctors say it’s better to get the vaccine late than to skip it entirely. Flu season runs from October to May with a peak usually occurring in February.

“It’s definitely not too late,” said Children’s Fortenberry.

Early reports indicate the flu vaccine this year is a good match for circulating strains. But doctors stress vaccines offer strong protection from serious illness and complications, even when they are less-than-ideal matches for the viruses. CDC analysis of pediatric deaths has shown most children who die of the flu didn’t receive their annual flu shot.

The CDC also points to a 2020 study that found among children, flu vaccination reduced the chance of flu-related hospitalizations by 41 percent and reduced the risk of emergency room visits by 51 percent during the 2018-2019 flu season. A 2017 study also found flu vaccine sharply reduced the risk of hospitalizations among adults, too.

  • What can I do to prevent getting sick?

Doctors agree getting vaccinated against the flu is the best thing you can do. Vaccination against COVID is key in helping ward off serious illness and complications. Other good daily habits to keep viruses at bay include: frequent hand washing; staying at least six feet away from people who are sick; and a good diet, exercise and plenty of sleep.

“It’s about making sure we stay healthy at baseline, so if we have chronic illnesses, it’s important that these (aspects) are maximally managed to have the least complications if we do get these infections,” said Dr. Danny Branstetter, medical director of infection prevention for Wellstar Health System. “So if you have lung disease or high blood pressure or diabetes, making sure those are well controlled and your therapy is maximized will help during this season.”

He said paying attention to a healthy lifestyle and managing stress can help boost immunity and help the body fight off infections.