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Flu or COVID? As Washington heads into peak flu season, it's important to know how to tell the difference

By Alec Regimbal, SeattlePI

Sick woman laying on sofa blowing nose

Sick woman laying on sofa blowing nose

Tom Merton/Getty Images

Washington is heading into peak flu season, and with the coronavirus pandemic still raging, there’s a good chance you might not know which respiratory virus you’ve caught if you start feeling under the weather.

Viruses tend to spread more in colder months. Dr. Seth Cohen, the medical director of infection prevention at the University of Washington Medical Center, said there are two possible reasons for this.

“Well first, people tend to congregate indoors where it’s easier to transmit the virus,” he said. “The other has to do with humidity. A lot of these viruses do better with lower humidity, and not only ambient humidity, but also humidity in the nose. When your nose is drier, it’s likely easier for you to acquire infections.”

The data confirms what Dr. Cohen is saying. Since the CDC started tracking flue cases in the U.S. in 1982, cases have always peaked in one of four months: December, January, February or March.

The nation’s new COVID-19 case numbers are also creeping up as the temperature drops. The U.S. is now reporting an average of more than 94,000 cases a day, up by 47% since late October.

So, if you start feeling sick this winter, how do you know which virus you have? Unfortunately, there’s no easy way to tell.

“I have almost completely given up trying to guess who has influenza and who has COVID,” Cohen said. “The Venn diagram of symptoms is almost identical.”

Those symptoms include fever, chills, cough, sore throat, congestion, muscle or body aches, headaches, fatigue, nausea, vomiting and diarrhea. Even the loss of taste or smell, considered the telltale COVID-19 symptom early in the pandemic, might be a symptom of either virus.

“It seems to be more common with COVID, or at least more commonly described, but that loss of smell or taste could potentially happen with any respiratory infection, and it happens to people every year with seasonal allergies” Cohen said. “So, unfortunately, it’s not a specific symptom.” 

Cohen recommends getting tested for COVID-19 if you start to experience any flu-like symptoms. If a test comes back negative, your symptoms could be due to a number of things: the flu; the rhinovirus, which causes the common cold; coronaviruses that aren’t SARS-CoV-2, the virus that causes COVID-19; or your test was a false negative, which is more common with rapid tests than with PCR tests.

Cohen said the best way to avoid this dilemma all together is to continue taking routine preventative steps — wear a mask, wash your hands, stay away from sick people and stay home if you’re feeling sick — and to get vaccinated against both viruses.

“We have great data here in Washington that shows that people who are unvaccinated for COVID are at much, much higher risk of not only catching COVID, but also from becoming hospitalized and dying,” Cohen said. “The same is true for influenza.”  

He said booster shots — which are now available for everyone over 18 — are especially important given the potential for new coronavirus variants to emerge. On Monday, the CDC urged everyone who is eligible to get a booster now that the new Omicron variant, which early data suggests is highly transmissible, has been detected in North America.

You can learn more about where to get vaccinated in King County by visiting the county’s website.

“Vaccination is really the backbone for prevention both of these infections,” Cohen said.

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Alec Regimbal is a politics reporter at SFGATE. He graduated from Western Washington University with a bachelor's degree in journalism. A Washington State native, Alec previously wrote for the Yakima Herald-Republic and Seattle Post-Intelligencer. He also spent two years as a political aide in the Washington State Legislature.