Is it COVID-19 or flu this winter?

Flu (influenza) and COVID-19 are contagious respiratory illnesses, each caused by different viruses. COVID-19 is a result of a coronavirus infection and flu is from influenza viruses. There are other differences between them, such as how they are spread. However, their similarities in symptoms can be confusing, so it's important not to make a judgement on symptoms alone and to get a professional diagnosis.

Dr Sarah Jarvis explains what to do if you think you have either COVID-19 or flu: "Regardless of which infection is causing your symptoms, you should stay at home if you think you have either, to avoid infecting others."

Similarities between COVID-19 and flu

Symptoms shared by COVID-19 and flu viruses

Both COVID-19 and flu can be asymptomatic and you may have the illness without showing any signs. However, they also both share a range of moderate to severe symptoms including:

• Fever.

• Having chills.

• Coughing.

• Difficulty breathing.

• Fatigue.

• Sore throat.

• Runny or blocked nose.

• Muscle pain or aching body.

• Headaches.

• Being sick.

• Diarrhoea.

• Change in or loss of taste or smell, although this is more frequent with COVID-19.

The latest COVID-19 variant Pirola may also trigger some less common symptoms.

How do these viruses spread?

Both COVID-19 and flu are spread through particles containing the virus when someone with either illness coughs, sneezes or talks. These particles can travel to the mouths or noses of nearby people, especially when people are within six feet of each other.

Particles containing the viruses can also spread further in environments with poor ventilation.

Both COVID-19 and flu are mostly caught by inhalation, but also through physical contact with an infected person - shaking hands - or touching a contaminated surface and then touching your own mouth, nose or eyes.

Both viruses can be passed on regardless of whether someone is showing severe symptoms or not. Flu can spread for at least one day before any symptoms begin showing and COVID-19 for at least two days.

Who is at high risk?

Those most at risk of becoming very ill or dying as a result of COVID-19 and flu are:

• Older adults.

• Pregnant people.

• Those with underlying health issues.

These groups are more likely to develop complications from the viruses and need hospital care.

What complications can develop from having COVID-19 or flu?

Severe forms of COVID-19 and flu can lead to other health complications such as:

• Pneumonia.

• Respiratory failure.

• Fluid in the lungs - acute respiratory distress syndrome.

• Sepsis.

• Heart attack and stroke.

• Organ failure.

• Worsening of existing long term (chronic) medical conditions involving the lungs, heart or nervous system, or diabetes.

• Inflammation of the heart, brain, or muscle tissues.

• Secondary bacterial or fungal infections.

Treating COVID-19 or flu

Treatment for the viruses depends on their severity. Many people with mild to moderate symptoms of COVID-19 or flu can get better at home using medicine bought from the pharmacy, drinking plenty of fluids and resting. However, those who fall into high-risk categories or have been hospitalised as a result of COVID-19 or flu should receive professional medical care.

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Differences between COVID-19 and flu

Differences in symptoms of COVID-19 and flu

COVID-19 and flu have different incubation periods - the number of days it can take between becoming infected and starting to see symptoms. Those infected with COVID-19 can start showing symptoms 2-14 days after becoming infected, whereas flu has an incubation period of 1-4 days.

Though they share many symptoms, some symptoms are more common in one virus than another. For example, body aches, headaches and chills are common flu symptoms that only appear sometimes in someone with COVID-19.

Shortness of breath and respiratory issues are common signs of COVID-19, but are less common in someone with flu.

Flu symptoms also appear suddenly, whereas COVID-19 symptoms may develop more gradually.

Is one virus contagious for longer?

COVID-19 and flu viruses spread in very similar ways, but COVID-19 is generally more contagious. COVID-19 can spread more quickly to infect a larger number of people.

COVID-19 is also contagious for longer than the flu. It is not known exactly how long COVID-19 remains contagious in an infected person but a person with COVID-19 can be capable of passing on the virus for at least 10 days after symptoms appear. Even if someone is asymptomatic or has recovered, it can still be passed on.

Most people with flu are contagious for one day before they show symptoms, but many remain contagious for around seven days. Those with weakened immune systems can be contagious for longer.

People who are hospitalised with COVID-19 or flu can be contagious for 20 days or more.

Which virus is more dangerous?

Older people, those with underlying health conditions and pregnant people have the same chance of becoming seriously ill or dying from COVID-19 or flu.

As with flu, complications following COVID-19 may lead to hospitalisation or death, even in healthy people with no pre-existing health conditions.

Some people who have had COVID-19 can develop ongoing conditions which can last for weeks or even months - or long COVID.

Common symptoms of long COVID include:

• Always feeling tired.

• Difficulty breathing.

• Heart palpitations.

• Coughing.

• Sleep problems.

• Changes in smell and taste.

Multisystem inflammatory syndrome (MIS) can also happen. This causes different body organs to become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. This very rare complication mainly affects young children.

What are the complications?

Most people recover from flu with a few days or a couple of weeks. Most people can manage their symptoms at home without hospital treatment. However, some complications may require hospitalisation if you become very unwell.

Pneumonia is a serious complication which can result from either flu alone or from co-infection of flu virus and bacteria. Other possible serious complications following the flu can include inflammation of the heart, brain, or muscle tissues, and multi-organ failure.

Flu also can worsen existing medical problems. For example, if you have asthma you may have more asthma attacks when you have the flu.

Secondary bacterial or fungal infections are more common with flu than with COVID-19.

With COVID-19, further health complications could include blood clots, and long COVID, where symptoms last for many weeks or months following infection. Long COVID can affect your mental as well as your physical health. Anyone can be affected by long COVID, even someone who didn't have any symptoms when they had COVID-19.

How are flu and COVID-19 treated?

Most people can manage flu or COVID-19 at home. Sometimes your doctor will prescribe medicines which fight viruses helping to speed up recovery, and ease symptoms. Neither flu nor COVID-19 can be treated with antibiotics as they are caused by viruses.

Medication is usually not available to those with COVID-19 outside of hospitals but NHS England may contact you if you meet the criteria for treatment in the community. Many people find that painkillers and over-the-counter remedies commonly used for coughs, colds and sore throats can ease symptoms.