If you’ve had a bout of the sniffles in the past two weeks, you could be forgiven for assuming it’s just a cold.
Or you could easily point the finger at hay fever if you’re particularly inclined, given that Britain has been repeatedly hit by the pollen bomb.
But as the pandemic has passed, Covid itself has become much milder.
And with the virus once again sweeping the country, it means the symptoms that leave you stuck on the sofa with a box of tissues may actually have been caused by Covid.
So, given that all three ailments can strike people in similar ways, here’s the ultimate guide to finding out what’s really behind your runny nose, cough or aches and pains.
Chart shows: Common (green tick), occasional (orange circle) and never (red cross) common cold, hay fever and Covid symptoms
Covid infections have almost doubled in two weeks in England, reaching around 1.4 million in the past week
Covid symptoms
Common
- Fever
- cough
- Loss of taste or smell
Sometimes
- Headache
- Runny nose or stuffy nose
- Sneezing
- Fatigue
- Sore throat
- Pain or ache
- Lack of air
- diarrhea
- Nausea and vomiting
- Loss of appetite
Never
- Itchy, red or watery eyes
Covid
At the start of the pandemic, people were told to look out for three warning signs of Covid: loss of taste or smell, persistent cough and fever.
But as new variants and vaccines emerged and repeated waves blunted the threat of the virus, the official list of symptoms continued to grow.
The NHS now recognizes 12 symptoms associated with Covid.
According to the ZOE Symptom Tracker, the most commonly reported signs of the virus are now runny nose (66 percent), sore throat (65 percent), headache (64 percent), persistent cough (63 percent) and fatigue (62 percent).
But because of the range of symptoms and the high prevalence of the virus, Professor Tim Spector, an epidemiologist at King’s College London who led the study, is encouraging people to get tested anyway.
The virus is currently in its fifth wave in the UK, driven by Omicron’s BA.4 and BA.5 substrains, which are believed to be more virulent but just as mild as their progenitor.
The most unique feature of Covid is the complete loss of smell or taste, known as anosmia, which is rarely reported in colds and hay fever.
Harvard University researchers published a study in Science Advances in July 2020 showing that the virus invades the blood vessel cells and stem cells in the nose that provide energy to the nerves that transmit the sense of smell to the brain.
However, Omicron is less likely to cause loss of taste or smell because the variant multiplies deeper in the lungs rather than the nose, experts say.
Of the newer symptoms listed for Covid, only diarrhea and nausea or vomiting are unique to the virus and not caused by hay fever or colds. This suggests that if you have those as well as a cough, it could be Covid.
NHS guidance instructs people to stay at home and avoid contact with others if you have Covid symptoms – and to get a PCR test. People are no longer required by law to get tested if they have symptoms, nor do they have to self-isolate if they test positive.
Symptoms of hay fever
Common
- Runny nose or stuffy nose
- Sneezing
- Itchy, red or watery eyes
Sometimes
- cough
- Loss of taste or smell
- Headache
- Fatigue
- Lack of air
Never
- Fever
- Sore throat
- Pain or ache
- diarrhea
- Nausea and vomiting
- Loss of appetite
Hay fever
Sky-high pollen levels over the past few weeks have left millions suffering from hay fever.
Experts suspect that staying indoors more than usual during the past two years of the pandemic has left many unexposed to pollen, making their reactions to it stronger this year.
Unlike colds and Covid, hay fever is an allergic reaction to pollen, not an illness caused by an infection.
This means that the symptoms are caused by the body’s immune system overreacting to a foreign body it perceives as a threat – in this case, pollen.
A runny or stuffy nose, sneezing, and itchy, red, or watery eyes are the most common signs of an allergy.
But in theory the watery eyes are the only unique feature that isn’t at least a random feature of Covid or colds.
The body naturally tries to wash the pollen out of the body, which causes the tear ducts to start producing fluids to help relieve the presence of plant-made dust.
The eyes are also injured as the body causes an inflammation known as allergic conjunctivitis – when a thin, clear membrane covers the whites of the eyes and the inside of the eyelids.
Histamine produced during the reaction also irritates nerve endings, causing itching, while blood vessels dilate and swell to combat the irritant, resulting in redness.
Unlike the other two illnesses, hay fever doesn’t cause higher temperatures, said Mark Donovan, chief pharmacist at Boots, so it’s safe to rule out allergy if these are your symptoms.
Mr Donovan said: “Hay fever does not cause a fever and most people do not feel unwell.
“Symptoms include sneezing, runny or stuffy nose, itchy red watery eyes or itchy throat.”
He said to use barrier balms, such as petroleum jelly, around the nostrils to trap pollen and to wear sunglasses with a shell to keep pollen out of the eyes to control symptoms.
Antihistamine tablets and nasal sprays can also be used to manage symptoms.
Cold symptoms
Common
- cough
- Sore throat
- Runny nose or stuffy nose
- Sneezing
Sometimes
- Pain or ache
- Fever
- Loss of taste or smell
- Headache
- Fatigue
- Loss of appetite
Never
- diarrhea
- Nausea and vomiting
- Lack of air
- Itchy, red or watery eyes
A cold
The common cold, although less common in the summer, can affect people year-round and is especially prevalent during festival seasons when people return from live events mingling with thousands of people.
Two years of lockdown have lowered people’s immunity to colds, while the hundreds of thousands who went to Glastonbury last week will inevitably have been exposed to viruses in the busy conditions.
A cough, sore throat, runny or stuffy nose, and sneezing are the most common symptoms caused by the hundreds of viruses that cause common colds.
Pain, fever, headache, fatigue and loss of appetite can also be telltale signs, while loss of taste or smell is also an incidental symptom.
Not having puffy, puffy eyes could be a sign that you’re actually suffering from a cold rather than a seasonal allergy.
Meanwhile, having diarrhoea, nausea or shortness of breath in addition to the previous symptoms could mean that it is actually Covid and not a common cold that you are experiencing.
Symptoms are caused when any of 200 different viruses cause inflammation of the membranes covering the nose and throat.
They are not actually caused by cold weather, but the body is more susceptible to infection when the immune system is weaker – which can be caused by a drop in temperature.
Mr Donovan said: “Colds can still occur in the warmer months and usually involve sneezing and coughing, along with a sore throat, headache and sometimes loss of taste and smell.
“You might consider taking pain relievers to ease the pain or relieve a stuffy nose with a decongestant nasal spray or decongestant tablets.”
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