Allergies, Colds and COVID: How to Tell the Difference

As we begin to shift into the warmer months, common health concerns often jump from cold and flu to allergies. This is made all the more complicated by the presence of COVID-19, and the fact that we are still learning new information about this novel virus from day to day.

What follows is a breakdown of the symptoms of allergies, cold and flu, along with what we know so far about COVID. My hope is that this will provide parents with a quick checklist that can help assess what their child may be experiencing so they can then pursue the appropriate treatment.


Allergies occur when the body perceives certain particles, like dust or pollen, as foreign invaders. Allergies often arise if a child did not experience much exposure (say, to pets or pollen) growing up, or the predisposition can be passed down genetically. While these tiny particles are not necessarily a threat to health, the body may categorize their presence as an attack, resulting in a disproportionately aggressive response. In order to rid the body of these particles, an excess of mucous is produced, the blood vessels in the nose begin to dilate, the eyes water, and there may be a scratchy feeling within the throat.

The main characteristic that differentiates allergies from other respiratory illnesses is the presence of histamine release. This strongly suggests an allergic response. Histamine release triggers swelling, itchiness, and redness around the eyes and nose. Another key indicator that it is allergies at work is the presence of clear, runny mucous. In contrast, mucous produced by illnesses of a bacterial or viral nature will often become thick and cloudy at some point as a result of the white blood cells that have been called to fight the infection.

To deal with pollen allergies and lessen the intensity of allergic reaction, encourage your children to wear light layers that can be easily removed once indoors. Gently wash hands and rinse the eyes and nose with saline solution after exposure; this will reduce itchiness and swelling later in the day. Antihistamines and steroid nasal sprays are also options but are best given daily before exposure to any allergens occur. You may also find that an air purifier helps to reduce symptoms, especially if allergies are of a household nature (dust, dander, etc.), or if it’s high season for pollen. Changing bed linens frequently is also helpful. Your doctor will also be able to tailor recommendations specifically to your family’s needs.


Colds are one of the most frequent causes of illness in children and adults. Adults tend to average 2-3 colds a year, and children often experience even more than that. While there are many types of viruses that cause colds, rhinoviruses are the most common, easily spread from person to person in close contact with one another.

Cold symptoms often include a sore throat, runny nose, coughing, sneezing, and headaches. Mucous will often be thicker and cloudier than the mucous produced by allergies. Some colds are relatively mild, while others might knock you flat for a few days.

Although there is no “cure” for colds, treatment is relatively simple. The best option is to rest well and ingest plenty of fluids, as dehydration makes it more difficult for the body to fight illness. Zinc lozenges may help shorten the duration of colds. Oral over the counter cold medicines may ease symptoms, and improve sleep, but they won’t shorten the duration of illness. Antibiotics do not eliminate colds or flu, as these illnesses are more the result of viruses and not bacteria. It is ideal to use antibiotics only when necessary, as overuse lessens their effectiveness, and can also cause digestive issues.

If cold symptoms last more than 10 days or seem severe or unusual, see your doctor. It’s also best to see a pediatrician if you have a child under 6 months experiencing these symptoms accompanied by a fever, or if they seem especially lethargic.


Flu symptoms usually appear very suddenly, whereas a cold may creep up for a few days before symptoms are full blown. Like the common cold, the flu is typically passed from person to person in schools, work, and public places such as the grocery store.

Flu symptoms may share some of those of the common cold, such as cough, sore throat, stuffy or runny nose, and headaches. However, there are also usually additional and more unpleasant signs including chills, fever, body aches, and extreme fatigue, possibly paired with diarrhea and vomiting. It’s important to note that while fever usually accompanies the flu, it’s not always the case.

If you seek medical treatment, especially in the first day or two, your doctor may offer antiviral drugs that can decrease the severity of symptoms and shorten the duration of the flu by 1-2 days, in addition to preventing more serious complications such as pneumonia. As with a cold, the other ways to treat the flu involve lots of rest and plenty of clear liquids. acetaminophen or ibuprofen may lessen symptoms of aches and pains. Getting a flu shot in the fall can reduce the likelihood of contracting the flu, but unfortunately, it will not rule out the possibility completely.

There are some groups at high risk for complications associated with the flu. Those include very young children, individuals who are pregnant, adults over 65, or people with a history of asthma, diabetes, and heart disease. If you or your children fall into any of these categories pay special attention to symptoms and seek medical attention if conditions are severe or do not resolve themselves after a week.


Because this is a new illness, we are constantly learning more about COVID-19. The understanding is that the virus is primarily passed from person to person when droplets are exhaled through the nose and mouth. This is why wearing masks and maintaining a 6+ foot distance from one another is recommended.

So far research indicates that those patients treated for COVID-19 have reported a wide range of symptoms. Some cases are mild and some extremely severe. There is also evidence that someone can be a carrier of the disease without experiencing any symptoms themselves, so it’s especially important to practice hygiene and safety measures, even if you and your family appear healthy. Research is underway but there are no COVID vaccines as of yet. The best method of prevention is to maintain regular hygiene and distancing measures.

If symptoms of COVID-19 appear (and keep in mind research suggests it is possible to be a carrier without any symptoms), they tend to show up 2-14 days after exposure. Diagnosis without a specific COVID testing kit may be difficult, as some of the symptoms mimic those of cold and flu. Those who are ill with COVID-19 may experience any or all of the following: cough, sore throat, congestion or runny nose, headache, fatigue, fever or chills, shortness of breath or difficulty breathing, muscle or body aches, recent loss of taste or smell, confusion, inflammation of the toes, nausea, vomiting or diarrhea.

Because research is ongoing, the previous and the following lists cannot comprise all possible symptoms of the disease. Err on the side of caution; call 911 if you or a family member are experiencing trouble breathing, persistent pain or pressure in the chest, inability to wake or stay awake, recent onset of confusion, or a bluish color in the lips or face. Notify the operator that you are seeking care for someone who has or may have COVID-19.

Prevention Tips for Allergies, Colds, COVID and Flu

  • Wash your hands often with soap and water. Be sure to wash them for at least 20 seconds, and help young children do the same. You can even create a sing-a-long routine to make it more entertaining for little ones.
  • If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol. Viruses that cause illness can stay on your hands, and regular handwashing can help protect you from getting sick.
  • Avoid touching your eyes, nose, and mouth with unwashed hands. Viruses can enter your body this way, causing illness.
  • If possible, stay away from people who are experiencing any symptoms listed in the cold, flu, and COVID sections.
  • Disinfect frequently touched surfaces, including hard surfaces and objects such as toys and doorknobs.
  • Current safety measures include keeping a minimum distance of 6 feet from anyone who is not a member of your household. Wearing masks in public places is also recommended in order to reduce the spread of COVID-19.
  • As always, getting lots of sleep, incorporating healthy movement and a good diet go a long way in maintaining a healthy body and mind. Incorporating plenty of fruits, veggies, and fish or omega supplements help to increase nutrients and manage inflammatory response.
  • Taking vitamin D and probiotics may also help to prevent respiratory illnesses.
  • Participate in activities you and your children enjoy. Spending time in nature, reading a good book, or doing anything that increases fun and reduces stress will support the body and mind, thereby increasing overall health.

For more information about seasonal allergies, sleep, and other tips for keeping kids healthy, listen to our podcast here.

Published on: June 17, 2020
About the Author
Photo of Alan Greene MD
Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.
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