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COVID-19? How to tell it's not cold or flu

October 14, 2020

Sniffles, cough, sore throat and fever — as the initial symptoms are often similar, the anxious question quickly arises: Do I just have a cold or am I infected with the coronavirus?

A woman under a blanket blowing her nose
Image: picture alliance/dpa/C. Klose

At first glance, the symptoms caused by SARS CoV-2 resemble those we know from a "normal flu." 

Frequent  symptoms of COVID-19 

  • Fever
  • Dry cough 
  • Loss of smell and taste

Other symptoms that sometimes occur 

  • Sniffles
  • Muscle aches 
  • Tiredness/fatigue
  • Sore throat
  • Shortness of breath
  • Headaches
  • Pneumonia 

Rare symptoms of COVID-19 

  • Diarrhea (more likely in children) 
  • a rash on skin, or discoloration of fingers or toes 

Sneezing is not a symptom caused by the novel coronavirus. So if you have to sneeze all the time  and have a runny nose, you probably have a cold or a normal flu. 

The sudden loss of smell and taste, on the other hand, is a very common symptom of COVID-19 and does not occur with flu or colds, even though they can sometimes also temporarily cause you not to smell or taste as well as usual because of a stuffy nose and inflamed throat. 

Read more: Coronavirus vaccination: What are we actually waiting for?

Infografik COVID-19, Grippe, Erkältung: die Symptome EN

These typical symptoms can occur, but do not have to: In very many cases, the COVID-19 infection proceeds with no symptoms or with only mild ones.

According to Germany's public health agency, the Robert Koch Institute,  the average incubation period for COVID-19 is 5-6 days, but it can be up to 14 days.

Those who feel unwell or simply below par should not go to work, school, etc. and should reduce their social contacts. 

A self-diagnosis is not always useful. If you are not sure or are worried, you should call a doctor or a COVID-19 hotline. Please do not go to the hospital or doctor's office on your own initiative, as COVID-19 is highly infectious. If there is doubt, the doctor or a test center will carry out a coronavirus test so you know whether you have been infected or not.

Most frequent transmission paths 

The main transmission route for SARS-CoV-2 is the inhalation of virus-laden droplets or aerosols that are released when infected people breathe, cough, speak, sing or yell. For this reason, a minimum distance of 1.5 meters (5 feet) should be maintained to other people. 

If you stay for extended periods of time in small, poorly ventilated or unventilated rooms in which an infected person is present, the risk of infection increases. That is why regular and effective airing is so important. 

Provided the minimum distancing is maintained, transmissions occur less frequently outdoors because the air is generally in motion. 

Contact transmission through contaminated surfaces cannot be ruled out, especially in the immediate vicinity of an infectious person. 

Effective measures for risk minimization 

  • Keeping a distance to other people
  • Compliance with hygiene rules
  • Wearing protective face masks  
  • Frequent airing
  • Rapid isolation of people who have tested positive
  • Identification and early quarantine of close contacts

Keeping a distance, washing hands, wearing masks and regular airing prevent the spread not only of the new coronavirus, but also help against the flu and other infectious diseases. 

A person in a face mask
Masks reduce the probability of infected people infecting othersImage: Reuters/C. G. Rawlins

Flu or cold? Here are the little differences

On average, adults catch a cold two to three times a year, and children up to as many as 10 times a year. But how do you tell if it is a normal cold or the flu?

Even doctors can have difficulty telling the difference between a case of influenza infection and a common cold when confronted with a patient's symptoms. 

Read more: What constitutes an international public health emergency?

With a cold, most people get a scratchy throat, then a runny nose and eventually develop a cough. Those symptoms, as well as fever and headache, can plague a person for days, making them feel listless.

By comparison, the flu hits you all at once: A flu patient's head and limbs ache, a dry cough begins, one's voice becomes hoarse, painful throat aches occur and a high fever (up to 41°C / 105°F), often accompanied by chills, can knock you out in short order. One just wants to stay in bed, feels exhausted, has no appetite and can sleep for hours on end. 

A person blowing their nose
The flu comes on quickly and usually takes a week or more until you're feeling healthy againImage: picture-alliance/dpa/K.-J. Hildenbrand

A common cold typically passes within a few days and most symptoms go away after about a week. The flu is more tedious, keeping a person bedridden for at least a week, in some cases requiring several weeks before a person truly feels healthy again.

Read more: Coronavirus: What you should know about tests

The RKI's Standing Committee on Vaccination (STIKO), recommends that all German residents at high risk of serious illness get an annual flu vaccination. That group includes people 60 and over, people who are chronically ill, pregnant women, and residents at senior and nursing homes. Beyond that, STIKO urges those who have a lot of contact with others (i.e., medical workers or those in public businesses or institutions) to protect themselves through vaccination as well.

When should antibiotics be used?

Most colds and flu cases are caused by viruses, against which antibiotics are useless. 

Antibiotics strengthen the body's defenses by killing or hindering the growth of bacteria, but they also attack the cell walls or metabolic processes of micro-organisms. Penicillin, for instance, destroys the cell wall synthesis of bacteria. Porous cell walls make it impossible for pathogens to survive, literally causing them to burst. But this only works on bacteria, not viruses.

Read moreLancet coronavirus study explores risk of reinfection

Antibiotics do, however, make sense in instances in which bacteria enter the body via a weakened immune system and begin to multiply. That process can lead to infection, sometimes permanently damaging the body's organs. Pneumonia, tonsillitis, cystitis or meningitis are most often caused by bacteria — thus, it makes sense to fight them with antibiotics. 

Editorial note: This article from early February 2020 has been updated in line with the current data situation.

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