Common Cold or Flu vs. COVID

Experts help parents and caregivers recognize the signs

CDC graphic showing the common differences between a cold and flu.

Sniffles, sneezes, coughs and sore throats. Cold and flu season has arrived, but with an added symptom: COVID anxiety. How can parents and caregivers differentiate between common cold symptoms and something more serious, like influenza or COVID?

 “COVID-19 has a highly variable presentation in children, with most kids having no symptoms or very mild symptoms,” says Noah A. Sutter, MD, Pediatrician and Maumee Pediatrics Associate. “However, anything from cold to influenza-like symptoms are possible. Loss of taste/smell is a symptom that is more indicative of COVID-19.”

Cold and Flu signs and treatments

“The common cold will generally have mild symptoms, like a runny or stuffy nose, cough, sore throat and low grade fever,” Dr. Sutter adds. “Influenza symptoms are typically more moderate to severe with high fevers, aches and chills, headaches and common cold symptoms.”

Dr. Sutter recommends supportive care for colds and flu, which includes plenty of rest, fluids, and acetaminophen or ibuprofen for fever and aches. 

“In some cases, it may be helpful to start an antiviral medication like Tamiflu,” he suggests. “Call your child’s pediatrician to see if this is appropriate for them.”

COVID signs and testing

“Children generally have mild symptoms if they have symptoms at all from COVID,” Dr. Sutter explains. “Parents can manage any symptoms they have and make sure [their children] are getting appropriate fluids and rest. If there are concerns for difficulty breathing, they should be evaluated by their health care provider. Testing may be indicated, especially if they are in settings around other children or adults who may be at a higher risk from COVID.”

When it comes to COVID testing, many parents may be confused by the options as well as the results. False positives? False negatives? Do-it-yourself testing kits or walk-in clinics?

“There is significant variation between COVID testing options, but overall, some things are important to consider,” Dr. Sutter said. “If someone tests positive for COVID, regardless of the test, it is likely a true positive (false positives are uncommon). On the other hand, false negatives are relatively common. If you have a known positive contact and symptoms, it may be a good idea to retest and continue quarantining as if it were a positive case.”

Dr. Sutter recommends seeking out guidance and testing from your medical provider if you suspect your child has COVID, as your doctor likely has access to more sensitive tests. “At-home tests are a good place to start, though,” he says.

COVID, Flu, and Community Response

When it comes to influenza and COVID, it is important to remember that both are respiratory viruses, and both can be spread with close contact during infectious stages.

“New signs of any contagious illness are a reason to stay away from others as much as possible and to avoid spreading the illness,” said Susan Ringler Cerniglia, Public Information Officer with the Washtenaw County Health Department. “Testing is appropriate with any symptoms consistent with COVID. If a child has known exposure to COVID, but no symptoms, wait three to five days to test. Typically, a person will experience symptoms about five days after being infected with COVID, but symptoms can appear anywhere from 2 to 14 days after infection.”

Susan Ringler Cerniglia is the spokesperson for the Washtenaw County Health Department.

Cerniglia also notes that most people recover from a virus without medical treatment, but children can be more susceptible to complications from influenza.

“Children may become seriously ill or dehydrated very quickly,” she says. “Signs of serious illness in children with flu may include difficulty breathing (bluish lips/face), dehydration (no urine or tears), high fever (over 104 degrees), seizures, severe muscle pain, and/or lack of interaction when awake. For babies younger than twelve weeks, any fever is a concern.”

Studies have shown that adults typically have more severe reactions to COVID than children; however, Cerniglia notes that children are still at risk.

“The warning signs of severe illness for children with COVID are similar to those of flu and include difficulty breathing, pain/pressure in chest, new confusion, inability to wake or stay awake, and/or pale, gray or blue-colored skin, lips or nails. Also, be alert to the warning signs of multisystem inflammatory syndrome (MIS-C), which is not well understood but is associated with COVID-19 in children.”

Covid-19 vs. Flu comparison: graphic courtesy of @cdcgov on Instagram.

For more information on COVID-19, Influenza, and Common Cold Symptoms, visit the CDC website or speak with your doctor.  Additional information can be found at  county office websites or the state department of health and human services.