The Difference Between the Flu and COVID-19

Oct. 29, 2020

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Flu season in the United States started in September amid the coronavirus pandemic. It is important to know the differences between the two diseases and when to seek care.
The Centers for Disease Control and Prevention* (CDC) estimates between October 2019 and April 2020, 24,000 to 62,000 people died from flu-related illness in the U.S. In South Carolina, 139 people died from flu-related illness during the 2019 – 2020 season, according to the South Carolina Department of Health and Environmental Control* (SC DHEC). 
The coronavirus has led to more than 225,000 deaths in the U.S. since March. More than 3,840 South Carolinians have died from COVID-19 and there are more than 170,000 confirmed cases. Those numbers increase daily.

Symptoms of COVID-19

People who have COVID-19 report a wide range of mild to severe symptoms. These symptoms may appear within 2 – 14 days of exposure:

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of senses of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

Symptoms of the seasonal flu

Flu symptoms typically come on quickly and appear within 1 – 4 days after infection. People with the flu usually feel some or all of these symptoms:

  • Fever or feeling feverish/chills
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Muscle or body aches
  • Headaches
  • Fatigue (tiredness)
  • Possible vomiting and diarrhea, though this is more common in children than adults

It’s important to note that not everyone with the flu will have a fever, according to the CDC.

Differences between the two

Because symptoms of the two viruses are similar, it may require testing to determine a diagnosis. SC DHEC has information on where to get tested.

Dr. Lena Bretous, a medical director with BlueCross BlueShield of South Carolina, says one of the biggest differences is the loss of the senses of taste or smell that typically comes with COVID-19 infection.

With the flu, muscle aches and pains are severe, she says. The flu typically causes a sudden fever and severe chest discomfort. 
Another key difference is who is most at risk. Children are at more risk for complications from the flu than from COVID-19. Other groups at risk of complications from the flu include pregnant women, adults who are over 65 and people with underlying health conditions. 
Children with the flu will usually have a very high fever and difficulty breathing. If your child isn’t acting like himself or herself, trust your instincts, Bretous says. Err on the side of caution if you are concerned. Your pediatrician would want you to call immediately if you are concerned that your child has the flu or COVID-19.

Older adults and people who have underlying medical conditions — like heart or lung disease or diabetes — seem to be at higher risk for developing more serious complications from COVID-19.
How long you may be sick varies with the two viruses. People with COVID may be sicker and contagious longer than those with the flu, the CDC says.

Other ways the two viruses are different:

  • Treatment: There are prescription antiviral drugs that can help treat the flu virus. Currently there is only one experimental antiviral treatment being explored for use in COVID-19 cases. There are no drugs or treatments currently approved by the Food and Drug Administration to prevent or treat COVID-19.
  • Complications: The majority of people who contract the flu recover in about two weeks. Some people may develop complications, such as bronchitis or pneumonia. Complications are also possible with COVID-19, including pneumonia and even blood clots in the veins and arteries of the lungs, heart, legs or brain. Children with COVID-19 are also at-risk of developing Multisystem Inflammatory Syndrome in Children (MIS-C), a rare but severe complication of COVID-19.
  • Spreading: Both viruses spread through close contact, but COVID-19 seems to spread more quickly among certain populations and age groups. COVID-19 has also been observed to have more “superspreading” events. This means the virus easily spreads to a lot of people and results in more infections as time progresses.

One more way the two diseases are similar — they are both highly contagious, Bretous says. 

How to prevent infection

The best way to prevent the flu is to get an annual flu shot. Stay home if you're sick. Practice good hygiene by washing your hands frequently and coughing or sneezing into your elbow. More ways to prevent spreading the flu can be found on the CDC website. 
Many of our members are eligible for no-cost flu shots. Coverage may be through your preventive care or pharmacy benefits. 

Unlike the flu, there is no vaccine to prevent the spread of COVID-19. To prevent spreading COVID-19 wear a mask around others, practice social distancing and wash your hands frequently.

Because both viruses are transmitted through close contact, taking proper precautions to prevent the spread will protect you from both.


*The Centers for Disease Control and Prevention and the South Carolina Department of Health and Environmental Control are independent organizations that offer health information you may find useful. 

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