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As we head toward colder fall and winter months, we approach a potentially confusing and tough time when we must battle both the coronavirus and influenza. The flu can look very similar to COVID-19, especially in children and younger adults. It’s going to be tough for us to tell the two apart.

Both COVID-19 and the flu can cause fevers, body aches, cough, shortness of breath, headaches, nasal congestion or a runny nose, vomiting/diarrhea and other symptoms. With younger kids, COVID-19 will often present as a “flu-like illness,” and it’s thought that many cases of presumed flu last winter and spring may have actually been undiagnosed COVID-19.

There are a few key differences between the two viruses, which can sometimes help determine which infection is at work. In general, flu symptoms show up one to four days after exposure, while COVID-19 can take two to 14 days for symptoms to develop. The characteristic loss of taste and smell are much more likely to occur because of the coronavirus. While nasal congestion can occur with the flu, it’s usually not severe enough to cause a full loss of taste or smell. Beyond these few small differences, the two viruses can be indistinguishable without a diagnostic test.

Luckily, the same preventive and treatment methods that help with one virus can also help with the other. If children are sick with a flu-like illness, whether it’s influenza or COVID-19, the best thing to do is to isolate them and provide supportive care. Make sure your child is getting enough rest and fluids, and treat fevers with Tylenol or ibuprofen for children over 6 months old.

For some people with more severe flu symptoms, early treatment with an antiviral medication such as Tamiflu can help lessen the duration and severity of the illness, so it’s good to contact your doctor within the first 24 hours of a possible flu-like illness to see if medication might be helpful. Currently, there is no antiviral medication for COVID-19, but the same supportive care is useful. For either illness, if your child shows signs of difficulty breathing (struggling to take in breaths, gasping or breathing so hard that the ribs are visible with each breath) or dehydration, it’s important to take them to urgent/emergency care.

The most important way to reduce the double threat of flu and COVID-19 is to do whatever you can to help prevent the spread of these viruses. Everyone is probably sick of hearing this advice by now, but again, we can help keep everyone safer by maintaining social distance, washing hands frequently, and – for those who are old enough – wearing masks when out in public. These measures will help prevent the spread of not only COVID-19 but also other viruses, including influenza.

Of course the most important thing you can do right now, if you haven’t already, is to get your annual flu shot. The flu vaccine is available and recommended for anyone who is healthy and over 6 months of age.

By helping control the spread of flu-like illnesses this fall and continuing the steps we are already taking to help prevent the spread of disease, we can help make this winter season a little easier for all of us.


Dr. Laura Shefner writes about pediatric care for the Cleveland and Columbus Jewish News. She is a pediatrician at The MetroHealth System and practices in Beachwood and Parma.

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