With a longer fall allergy season on the horizon (thanks, climate change), you're going to want to bookmark this.

By Rachael Schultz
Updated Sep 28, 2020 @ 4:30 pm
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Your head hurts, your chest feels tight, your throat itches, and you keep coughing. You spent the spring trying to decipher whether what you’re feeling was coronavirus or the same allergies that sneak in whenever it warms up. Now, as the weather cools and the pandemic still rages across the U.S. — alongside the wildfires’ sending smoke coast to coast — we’re entering a new guessing game: Is it coronavirus, fall allergies, or wildfire smoke irritation?

“Particulate matter from wildfires can travel quite a distance and irritate the eyes, skin, and respiratory tract of people who are dozens of miles away. Many of these symptoms are similar to allergy symptoms, such as eye irritation, scratch throat, coughing, sneezing, and nasal congestion,” says Arizona-based family physician Natasha Bhuyan, M.D., regional medical director for One Medical.

And then, of course, we have the scarier crossover: “With both allergies and COVID-19, we can see respiratory symptoms including coughing, sore throat, nasal congestion, or shortness of breath,” Dr. Bhuyan adds.

Now, let’s be clear: If you have any respiratory symptoms (coughing, wheezing, trouble breathing), you should self-isolate and call your primary care doctor ASAP in case they are indeed markers of COVID-19, she says. And you can have both seasonal allergies and a cold, or seasonal allergies and COVID-19 simultaneously.

But there is a lot of cross-over between symptoms of coronavirus and seasonal allergies — and the latter are starting to gain real momentum for the season already: The main culprit of fall allergies is ragweed, which tends to be worse from August to October. But some scientists think that ragweed season might be lasting longer due to climate change, Dr. Bhuyan adds.

The plant grows mostly in the East and Midwest. But "a single ragweed plant can have one billion pollen grains, and because the pollen is so light, they can travel far in the wind," she says. In other words: Nowhere is safe from the pollen.

In addition to other pollen-producing fall plants, mold often gathers on fallen leaves — and as the colder weather brings us indoors more, dust mites and indoor allergens like pet dander start to kick up, adds Purvi Parikh, M.D., a New York-based allergist and immunologist with Allergy and Asthma Network.

In fact, in addition to the 50 million-plus Americans already suffering from seasonal allergies every year, because we’re all spending more time indoors thanks to lockdowns and wildfire smoke, you could be experiencing allergies worse than normal this year — or even for the first time, points out Dr. Parikh. Some people develop allergies for the first time in their 20s and 30s (it's called adult-onset allergies), says the ACAAI.

To top it all off, the wildfire particulate matter that's in the air from California to New York (and everywhere in between) right now can actually be a trigger for allergies or asthma, Dr. Bhuyan adds.

We know — that’s a lot of irritants in the air. And with coronavirus cases still climbing, every tickle of the throat has reason to sound alarm bells. While the symptoms do overlap, there are also major differences. So before you start live-tweeting descriptions of your cough, here are six questions to ask yourself to differentiate between the two.

1. Do you have a temperature?

COVID-19 generally runs a fever over 100.4°F, while allergies rarely cause high temperatures, Dr. Parikh says. (Note: It’s also possible to have other coronavirus symptoms without a fever.)

2. Can you smell and taste?

Both docs agree that losing your sense of taste and smell are very unique to COVID-19. It’s not a fool-proof tell: If you also have a stuffy nose from allergies, the nasal congestion can make it hard to smell, Dr. Bhuyan points out.

3. Are you congested?

Both COVID-19 and allergies can cause a cough, but corona’s is usually dry whereas one from allergies is the direct result of post-nasal drainage. Coronavirus can definitely cause nasal congestion or a scratchy throat, but it’s rarer, experts say.

4. Are you itchy?

Anywhere — your skin, throat, nose, eyes. This is a hallmark sign of allergies and not associated with coronavirus.

5. Do your symptoms change throughout the day?

If so, it’s probably just allergies: Pollen peaks in the morning, which is when most allergy sufferers find their symptoms to be the worst, Dr. Bhuyan says. (Even if you haven’t been outside today, it can get into your house on your pet’s coat, through open windows, or just from poor insulation.)

But if they stay consistent throughout the day, that’s not a sure-fire sign of COVID-19: “Because ragweed pollen is lightweight and can travel far, many people experience symptoms all day,” Dr. Bhuyan points out.

5. Does an allergy pill help?

Long-acting antihistamines like Allegra, Zyrtec, and Claritin are helpful for both allergies as well as a cold, Dr. Parikh points out. If you pop one and your symptoms get better, that’s a good sign you’re fighting something other than coronavirus.

The bottom line on coronavirus vs. allergies:

If it is allergies at play, limiting allergens in your home (in addition to popping that Zyrtec) can go a long way in symptom control. Change your sheets, vacuum, buy an air purifier, and clean up pet dander, and see if that helps your woes, Dr. Bhuyan advises. Also, limiting moisture in the fall and winter can go a long way to fighting mold, she adds. Deep clean any visible mold, use fans in the bathroom, and run a dehumidifier.

However, it’s worth repeating: Right now, any breathing symptom like a cough, wheeze, or shortness of breath should be treated by a physician, regardless of cause. If your respiratory symptoms are really bad, call them ASAP. But if they’re mild, it’s helpful to take the above steps first and rule out some of the key hallmarks of allergies before discussing next steps with your doc.

The coronavirus pandemic is unfolding in real-time, and guidelines change by the minute. We promise to give you the latest information at time of publishing, but please refer to the CDC and WHO for updates.