Is it Hay Fever or COVID-19?   

Words Dr Emma Amoafo-Mensah

It’s that time of year again! The atmosphere is warmer, the days are longer, there are daisies in the garden and the corner shops are selling ice creams again. For most, spring is a time to rejoice. For hay-fever sufferers, the enjoyment can be dampened by dreaded symptoms. But now we’re in a national pandemic, every sneeze is suspicious. Dr Emma is being asked the following question a lot – Is it hay-fever or COVID-19?

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Hay-fever, or seasonal rhinitis, is basically an allergic reaction to pollen that comes from grass, trees and weeds. The levels of pollen in the air are highest during early spring and summer. The pollen comes into contact with our eyes, nose, throat and mouth and that’s why those body parts are the site of most symptoms – itchy and watery eyes, a blocked nose, sneezing, coughing, itchy throat and loss of smell. Some people’s lungs, especially those with asthma are also affected and this can lead to shortness of breath, wheezing and a feeling of tightness in the chest.

Of course, many of these symptoms overlap with those caused by COVID-19, so sometimes people find it difficult to tell which is which.

COVID-19 - Corona (CO) Virus (VI) Disease (D) 19 (2019) is an infectious disease caused by the SARS-CoV-2 virus, and in most people manifests as a mild, maybe moderate respiratory illness. Most people don’t need admission to hospital and will be able to recover at home.

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One particular reason for the confusion is that COVID-19 causes a variety of symptoms, and new symptoms are being reported in scientific journals as we speak! As of now, the symptoms NHS UK want us to look out for are fever (that is, a new high temperature) and a new, continuous cough (that is, coughing a lot for more than an hour, or three or more coughing episodes in 24 hours).

From my own personal experience of treating patients with COVID-19, I know that the symptoms vary quite greatly. As well as the above symptoms, patients often complain of diarrhoea, loss of appetite, difficulty breathing and even loss of smell and/or taste. Another common symptom is profound tiredness and weakness. I know of people who have been infected who needed to sleep for the vast majority of the day, and felt so weak that getting out of bed to go to the toilet was a huge task.

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How do we differentiate the two?

The first, probably easiest method of differentiation is to examine your own past experience. People who get hay-fever often get it every year and should hopefully be able to recognise their symptoms arriving with Spring. Unfortunately, this isn’t foolproof because the pollen released into the atmosphere changes yearly. This means some people sometimes suffer from hay-fever one year and not the other, or the severity of symptoms is variable.

Secondly, COVID-19 rarely causes eye symptoms. If your eyes are itchy, red and sore hay-fever is likely to be the offender. That itchy feeling in the back of your throat and forever-running nose is pretty specific for hay-fever too.

There is also a lot to gain from listening to your body on the whole. Having hay-fever can be extremely annoying, but shouldn’t usually make you feel unwell. COVID-19 can be accompanied by general malaise – that is, feeling generally “meh”.

Hopefully this helps clear up some of the uncertainty. Ultimately, if you think you have COVID-19, you should begin to self-isolate. Most people are safe to be managed at home, but if your symptoms are making you feel too unwell, especially if your breathing is an issue, you should call 111 for advice. If you have underlying medical problems, especially cardiovascular disease or lung disease, you should let your usual healthcare provider know. Hay-fever can usually be treated with over the counter antihistamines such as loratadine and chlorpheniramine. The most important thing to remember is that neither condition should be a cause for panic! There are lots of resources available to help you, whatever the outcome.

 Dr Emma Amoafo-Mensah - NHS Doctor, Founder and Philanthropist