How to tell if it’s a cold, flu or Covid

    5 October 2020

    As we head into autumn and winter the weather gets cold, the heating gets turned up, and GP waiting rooms start to slowly fill with sniffling and sneezing patients.

    It doesn’t help that there are over 200 different cold viruses and it’s likely that most of us will catch at least one or two colds every year. This year is different however as the spectre of COVID hangs over all of us, with more consultations being carried out remotely than ever before and patients being vetted before walking into a waiting room.

    The key question being asked by both doctors and patients will be a simple one – do I have a cold, flu or COVID? The short answer is that it can be hard to tell. The slightly longer answer is it may be nigh on impossible to tell in some cases without rapid access to testing and – just as importantly – rapid results. But there are some key symptoms to look out for.

    The common cold

    A cold is usually a relatively mild self-limiting viral infection affecting the upper airways which gradually comes on over a few days and so the standard symptoms are of a dry, scratchy sore throat , sneezing, a blocked nose , and a general feeling of being run down and under the weather. There are no drugs of proven benefit for treating the common cold, and antibiotics do not alter its outcome, with the average length of a cold being 7 to 10 days.

    Treatment is therefore aimed at providing relief of symptoms. Paracetamol is an effective painkiller and antipyretic in most people and there is a range of over the counter products that can be given to children over the age of 2 if required to help with symptoms such as cough.  Aspirin should not be given to children under the age of 16. It is important to have an adequate fluid intake when suffering from a cold to keep well hydrated, and decongestants can provide short-term relief of a blocked nose) but these should only be used for a day or two and never long-term.


    Flu, by contrast, is an infection of the respiratory system caused by the influenza virus and each year up to 15 per cent of us will catch flu. Unlike a cold, the symptoms start suddenly and are more severe – usually a high temperature, extreme fatigue and significant widespread aches and pains – and there may also be a dry cough and sore throat in some people.

    People at risk of complications from influenza will be offered flu vaccines this year as usual and changes this year mean that if you’re aged 50 to 64 and have a health condition that means you’re more at risk from flu, you should also get vaccinated, with other 50 to 64 year-olds being contacted about having a flu vaccine later this autumn. General measures to get better include getting enough rest and sleep, keeping warm, taking paracetamol or ibuprofen to lower your temperature and treat aches and pains and drinking plenty of water. Flu remedies are also available from pharmacies but be careful not to use flu remedies if you’re taking paracetamol and ibuprofen tablets as it’s easy to take more than the recommended dose.

    Is it Covid-19?

    COVID symptoms vary enormously, ranging from none at all to fatal and we now know there is a wide range of these but the big three to look out for are a temperature of 37.8C or greater, a dry cough and a loss of the sense of taste and smell. There may also be an associated shortness of breath and fatigue and current advice is that if any of the main symptoms develop then you should self-isolate and arrange for a test. While many people globally have built up some degree of  immunity to seasonal flu strains, COVID-19 is a new virus and so the level of immunity to it is not yet known. More people are susceptible to infection, along with severe disease and fatalities.

    Rapid, effective, easily accessible COVID testing will be absolutely critical in the coming weeks in our handling of seasonal winter viral infections. I also have everything crossed that the country does not also experience a major flu epidemic this winter too. If that happens, then we really are in uncharted waters.