Are those symptoms hay fever or COVID?

Australians who suffer from hay fever are being urged to get tested for COVID-19, because the symptoms of the two conditions are so similar.

“It’s coronavirus until proven otherwise, full stop, end of story,” said Ian Taylor, deputy chair of Western Australia’s Midwest GP Network.

That means if you have a sore throat, runny nose or a cough – all the usual symptoms of hay fever, now kicking in as spring arrives – you should get tested for coronavirus.

“It’s like if you get a bit of a cold, you know it’s a cold but you have to have the COVID test, you have to go into isolation for two days, to make sure it is not coronavirus.

“We have to do this for the safety of ourselves and the whole community,” Dr Taylor told the ABC.

He said the early stages of coronavirus infection can look exactly the same as hay fever, which is an allergy caused by dust, pollen, and mites.

“It can be a confusing picture.”

Respiratory clinician Dr John Blakey told Nine the difference in symptoms between the coronavirus and hay fever or asthma are “difficult to untangle”.

The trick is to understand the incidence of symptoms. Hay fever is triggered by specific things in the environment, such as a cat or a plant. Move away from these triggers and symptoms “wax and wane”. However, viral symptoms “continue to worsen over coming hours after they have first been noticed”.

Dr Blakey suggests hay fever sufferers identify the pattern of their allergic reaction.

“People are used to that pattern for them and how it affects them, most people would have an idea of the sensation of something different,” he said. “Something that falls outside that pattern, then they should be concerned.”

Hay fever (allergic rhinitis) affects between 10 per cent and 30 per cent of the global population each year. It’s caused by an allergic response to pollen and mould and has a seasonal spike in late winter and spring, when pollen counts are highest from flowering trees and grass seeds.

The immune reaction to these releases histamine, which makes blood vessels leaky and puts water into the eyes and nose, causing sneezing.

Dr David King, from the University of Queensland, worries that if everyone who suffers hay fever symptoms was tested for COVID-19, Australia’s testing capacity would be overwhelmed: 21 per cent of us suffer seasonal hay fever.

But he told The Conversation there are ways to differentiate between the annoying but relatively manageable hay fever and potentially deadly COVID-19.

“There are two classic hay fever symptoms that can help you tell allergies and viruses apart. Hay fever can cause you to have an itchy nose or throat; and when it’s more severe it can cause swollen, blue-coloured skin under the eyes (called allergic shiners).

“Hay fever, despite its name, does not cause increased body temperature. Flu-like illnesses do cause fever, and sore muscles (myalgia), malaise and fatigue.

“An itchy nose and eyes are classic hay fever symptoms, as is intense, prolonged sneezing.

“You can sneeze with a cold or flu, but usually only in the first few days of the infection.

“If your nasal symptoms improve with antihistamine medication, then you likely have an allergy or hay fever. Antihistamines do not alleviate symptoms of the common cold.”

The ABC reported that in April the United Kingdom’s Royal College of General Practitioners (UKRCCP) issued a warning about the similarity between hay fever and COVID-19 symptoms.

Professor Martin Marshall, chair of the UKRCCP, said characteristics of hay fever helped patients distinguish it from COVID-19.

“Allergy symptoms tend to be milder and fluctuate depending on the time of day as pollen levels are often higher in the afternoon and evening,” he said.

Dr Marshall said patients who regularly suffer from hay fever can recognise the symptoms they usually get and the severity of them.

“In instances where a patient experiences a significant deviation from this or have specific symptoms of COVID-19 a new, persistent cough and a high temperature we urge them to follow government advice and self-isolate.”

The official advice in Western Australia is to get tested for COVID-19 if you have a fever of 37.5C or above, had a fever in the past few days, have acute respiratory symptoms such as a cough, shortness of breath or sore throat, or have experienced acute loss of smell or taste.

Queensland Health lists the most common coronavirus symptoms as:

    • fever (temperature higher than 37.5C)
    • cough
    • sore throat
    • runny nose
    • fatigue
    • shortness of breath
    • loss of taste and smell.

Less-common symptoms include:

    • aches and pains
    • headaches
    • diarrhoea.

The World Health Organization (WHO) also lists conjunctivitis, a skin rash or discolouration of fingers or toes as less common symptoms.

Serious symptoms include:

    • difficulty breathing or shortness of breath
    • chest pain or pressure
    • loss of speech or movement.

Australian National University infectious diseases epidemiologist Meru Sheel said people should get tested if they have any of these symptoms.

“Especially loss of taste, loss of smell we’ve seen those are definitely symptoms that do present,” Dr Sheel said.

She said COVID-19 was difficult to diagnose because it presented with a large number of symptoms and differently among different age groups.

“It’s really difficult when you have a disease such as SARS-CoV-2, which is causing such a wide range of symptoms that are not unique or specific to the disease.”

August figures from the Australian Department of Health found a cough listed as a symptom in 44 per cent of COVID-19 cases in Australia since the start of the pandemic.

More than 30 per cent of coronavirus patients had a sore throat and tiredness, 26 per cent had a runny nose, and 22 per cent had a fever.

Five per cent experienced a loss of taste or smell, nausea, arthralgia (joint pain), diarrhoea, chest pain or sneezing.

Asthma Australia chief executive Michele Goldman told Nine it can take up to two weeks for asthma preventer medication and nasal steroid treatment for hay fever to become effective, so people should control symptoms as soon as possible.

“In a pandemic, if you can prevent sneezing, a runny nose, rubbing your eyes and getting shortness of breath, you should; it will be better for you and those around you,” Ms Goldman said.

Medications for hay fever, including antihistamines and nasal sprays, are available from chemists.

Ms Goldman said people should get tested for COVID-19 if they were not sure about their symptoms.

“If you’re treating asthma and allergy regularly and symptoms persist or change, like a new continuous cough or fever, please seek further medical advice,” she said.

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