COVID-19: how to tell hay fever and coronavirus apart

The weather is getting warmer and many of us are gladly welcoming the arrival of spring and summer. But for people who suffer with hay fever, it's the start of grass pollen season and can bring misery. During the pandemic hay fever could prove even more troublesome as some of the symptoms could be confused with those of COVID-19.

What is hay fever?

Hay fever, also called seasonal allergic rhinitis, is an allergic reaction to pollen. The most common cause is grass pollen, which is typically most prevalent from May to July; hence that's when most people exhibit hay fever symptoms. But tree pollen can also bring on symptoms from as early as February until June, and weed pollen from June until as late as September.

Many people will only get mild symptoms that are very easily managed, but some are very badly affected and their symptoms can significantly impact their daily lives for several months.

Hay fever symptoms can vary from person to person, but the most common ones include:

  • Runny or blocked nose.
  • Itchy nose.
  • Sneezing and feeling sniffly.
  • Itchy and watery eyes.
  • Itchy throat.

Less commonly, you might experience a loss of smell, headaches, pain in your face (especially the sinuses) and sweats. If your hay fever is very bad, you might feel quite run down and even have difficulty sleeping.

Community pharmacist Thorrun Govind recommends that you treat symptoms promptly. "Hay fever can make you feel really awful, and there is no cure - but there are things you can do to help yourself," she says. An all-round treatment, like one-a-day antihistamines cetirizine or loratadine, will usually bring relief.

"If your symptoms tend to affect one area more, you could also use an over-the-counter treatment to target those areas, like eye drops or nasal spray," Govind adds. "It might also help to put some Vaseline around your nostrils to trap pollen and stop it from entering your nose."

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What are the symptoms of COVID-19?

The main symptoms of COVID-19 are a new, continuous cough, a high temperature (37.8°C or above) and or a loss of smell or taste. But, as with hay fever, each case is different and the exact symptoms might vary depending on how seriously you are affected.

Many people with COVID-19 have flu-like symptoms for around seven to ten days.

When it's mild, the virus tends to affect the upper respiratory tract, and symptoms include:

  • Raised temperature, which might not reach 37.8°C, and possible sweats.
  • Loss of smell and/or taste.
  • Tiredness and muscle aches.
  • Headache.
  • Less often, sore throat or blocked or runny nose.
  • Possibly slight breathlessness, but it doesn't affect your normal level of activity.

If you have moderate COVID-19, it's likely the virus is affecting the lower respiratory tract, so symptoms tend to affect the lungs more and include:

  • More troublesome, persistent cough.
  • High temperature that reaches or exceeds 37.8°C.
  • Breathlessness.
  • Headache.
  • Tiredness that might keep you bedbound for a few days.
  • Dry mouth from breathing through your open mouth.

Hay fever: how your pharmacist can help

With hay fever season approaching, many sufferers will be stocking up on hay fever remedies. But...

Why could hay fever and COVID-19 be confused?

Some of the symptoms of hay fever could also be present in coronavirus, namely loss of smell, headache, blocked nose and generally feeling unwell.

If you have asthma and hay fever, you might also find that hay fever worsens some of your asthma symptoms, like wheezing and breathlessness. In fact, some people only get asthma symptoms during the hay fever season.

Since breathlessness is one of the signs of coronavirus, it's understandable that some people might be unsure if they are suffering from hay fever, or if they've contracted coronavirus.

Most hay fever sufferers are affected from childhood and will likely get symptoms at the same time every year, so they know what to expect. But if you've never had hay fever before, suddenly developing nasal or respiratory symptoms could give you cause for concern.

However, around one in five people with hay fever get symptoms for the first time over the age of 20, so there's no reason to assume an adult's symptoms can't be caused by hay fever just because they've never had it before.

I'm not sure whether it's hay fever or COVID-19 - what should I do?

If you have any new cough, fever or lose your sense of smell or taste, you must self-isolate - that means not going out at all, even for a short walk. These could be signs of coronavirus infection. You should book a COVID-19 test online and continue to self-isolate until you have received your result. If you test positive, you must continue to self-isolate for at least ten days from the onset of your symptoms.

Mild illness doesn't require medical attention so you should self-manage at home, taking paracetamol or ibuprofen to treat symptoms if you need to. If you begin to feel worse or develop more symptoms, you can use the NHS 111 online service to find out what to do next. In a medical emergency, call 999 or the emergency number for your region.

Most importantly, don't go to your GP practice, pharmacy or hospital if you think you have COVID-19. Stay at home and phone if you need medical advice.

How can I manage my hay fever during lockdown?

Hay fever can be treated effectively at home. Even if your symptoms are quite bad and make you feel really unwell, the good news is that they will subside eventually.

"If you have over-the-counter hay fever remedies at home, take them as normal," Govind advises. "You could also minimise your exposure to pollen. Usually that means staying indoors and keeping windows closed where possible."

While the COVID-19 pandemic is ongoing, frontline health services are under greater pressure, but that doesn't mean you can't get medical advice when you need it - and that includes for hay fever.

You could phone your local pharmacy for advice or, if you're isolating or shielding you could ask someone to visit the pharmacy on your behalf. You can also access advice from many pharmacies online (with a telephone or video consultation) through Patient Access.

Govind's advice is that you shouldn't suffer unnecessarily. "Hay fever is a health condition and if you need treatment, don't be put off getting it," she comments.

"Pharmacies are busy at the moment. You might have to wait to be seen or even queue outside, and most have implemented social distancing measures inside or will only let one person in at a time. But we don't want people to stop coming into pharmacies if they need to." 

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