COVID & Allergies - Which Is It
Dr. Tucker Harris explains how to tell the difference between seasonal allergies or COVID-19 symptoms and what you should do if you're unsure.
Featuring:
Tucker Harris, MD
Otolaryngologist and Allergist Tucker M. Harris, MD, is part of St. Joseph’s Physicians ENT (ear, nose and throat) team at Northeast Medical Center in Fayetteville. As an ENT physician and surgeon, Dr. Harris’ practice is focused on the treatment of disorders of the head and neck with emphasis on otological (middle and inner ear) disorders and otological surgery, including implantable hearing devices. Harris also has a special interest in the treatment of allergy, including immunotherapy (allergy shots and oral allergy drops/tablets). Transcription:
This St. Joseph’s Health MedCast COVID-19 podcast was recorded on July 28, 2020.
Prakash Chandran (Host): During this time of COVID-19, it’s nerve wracking for seasonal allergy sufferers to know when they are dealing with allergies versus possible COVID-19 symptoms. 2020 has turned out to be a brutal year for allergies and it’s not over yet. Ragweed is the biggest allergy trigger in the fall, though it usually starts to release pollen with cool nights and warm days in August, it can last into September and October. About 75% of people allergic to spring plants, also have reactions to ragweed. Because of this, it’s really important to distinguish the various symptoms you experience that best prepare you for your health. We’re going to talk about it today with Dr. Tucker Harris, an Otolaryngologist also known as an ear, nose and throat doctor, and Allergist at St. Joseph’s Health.
This is St. Joseph’s Health MedCast from St. Joseph’s Health. I’m Prakash Chandran. So, Dr. Harris, what exactly are the main differences between the way your body responds to allergies versus COVID-19 symptoms?
Tucker Harris, MD (Guest): The main difference to keep in mind is fever. That is something you will never get with allergies and it’s the main differentiating symptom we have to tell us if it is COVID-19 or is it allergies. So, fever is the big thing. A couple of other subtle differences would be that with the COVID-19, symptoms basically will onset within a 24 hour period. You’ll go from normal to feeling all the nasal congestion, loss of sense of smell. It will be rather sudden whereas with allergies, it’s typically not an overnight thing. It kind of builds continuously as the season progresses. And the other difference that some patients will notice, some will not is that they’ll reproducibly be able to trigger their symptoms by going outside or getting close to some of the offending agents like a patch of ragweed or somebody’s freshly trimmed lawn or mowed lawn. They’ll reproducibly get a sudden onset of their symptoms, go back inside and give it a little bit more time and they’ll improve within the course of minutes to an hour. That will not be seen with COVID-19 either.
Host: Now you talked about fever and nasal symptoms. I think the most common things that I’ve personally heard about is that wheezing, shortness of breath, the dry cough as the symptoms of COVID-19. Does COVID-19 also cause those nasal symptoms?
Dr. Harris: Yes, so COVID-19 can cause a runny nose, postnasal drip, more than anything nasal congestion and one of the hallmarks is a sudden loss of the sense of smell and taste. So, those – a lot of those symptoms will overlap with allergies and make it difficult to determine which is it that I’m dealing with COVID-19 or allergies.
Host: So, is it safe to say when you have itchy eyes, a runny nose, then it’s allergies? Those are the types of things that I experience when I go outside.
Dr. Harris: Yeah, not all patients that have allergies will get those symptoms. But watery eyes, itchy eyes, itchy nose, having to scratch the nose and rub it to make it feel better, having to snort through the nose; all of those things go along with allergies and you really shouldn’t get any sort of itchiness happening with COVID-19. So, you can pretty much rest assured if the symptoms are reproducible with exposure to an offending agent and you’ve got itchiness and no fever; it’s almost certainly allergies to something.
Host: So, what about people especially with children, who suffer from allergies and asthma, you know coughing and chest tightness can be signs of COVID-19 but is wheezing and those asthma symptoms that we just discussed?
Dr. Harris: Yeah, that’s overlap areas well with some patients who have COVID-19. Wheezing, cough, chest problems, so that also makes it a little bit difficult to determine which of these problems is it. is it allergies, asthma or is it COVID-19. It’s more likely asthma if patients happen to have a inhaler or a puffer and they use it and it seems to improve their symptoms greatly. It’s less likely to be COVID-19 if that’s the case.
Host: I see. So, people with allergies that want to rule out COVID-19, how do they go about managing it? Do they go to a pharmacy and do they get over the counter medications or do they need to see an allergist?
Dr. Harris: Ideally, visiting an allergist is the best way to test for allergies. There’s a couple of ways to do it. One is with skin scratch testing and that’s a little tougher to do and still maintain social distancing, but many offices figured out ways to actually perform it. The other option is to do a one time blood draw. Either method can test for the same types of allergens or things that you can be allergic to whether it’s pollens, molds, dust, or even foods. Sometimes the accuracy level between the two is in most cases, negligible so either method would work fine. And in this day and age of Telemedicine, a lot of times the blood testing or the skin testing should be ordered without even an in-person visit. And we can hopefully get some answers.
Host: Yeah, that’s really good. What about the options when it does come to managing these seasonal allergies at home? Does that just consist of getting certain over the counter medicines or going through certain home remedies?
Dr. Harris: That’s a great question. Over the counter medications certainly have their place and are very helpful for a lot of patients. So, topical nasal steroid sprays, and over the counter antihistamines are very helpful. Another thing that most allergists recommend to their patients is to use some sort of device to irrigate or rinse out the nose. Rinse it out with saline and that’s fairly harmless and can be done once a day, twice a day, numerous times throughout the day. There’s various manufacturers that make various products but one of the more commonly termed products is a Neti Pot. But anything that’s similar to it will work. And it basically just flushes the nose with salt water and that’s designed to help thin out some of the thick mucus from allergies and it’s also designed to remove some of the particulates or pollens or dust particles or what have you that’s irritating the nose. And a lot of patients find that very helpful to do.
Most of those devices or instruments that are used to do the irrigation are found over the counter, mostly in the grocery store or pharmacy or even through various online vendors.
Host: Got it. That’s helpful. Just a basic question here, allergies and illnesses can coexist together right?
Dr. Harris: Yes, correct. And in fact they do so allergies are extremely common and it’s not unusual to have other underlying illnesses along with allergies. So, asthma can be related to allergies. There are some rare patients out there that are having migraine headaches triggered by allergies. So, there’s a few different things out there that can be somewhat related.
Host: And can you talk to us a little bit about the progression of COVID-19 symptoms? I’m wondering if there is a possibility that someone fights off those initial symptoms like the fever and the nasal things that we were discussing so it never actually gets to the later stage wheezing and dry cough and things of that nature that we hear about in the news. So, maybe talk a little bit about that just how it progresses over time and if someone is able to fight it off.
Dr. Harris: Yeah, that’s tough to discuss in depth because there’s such a wide variety of symptoms and presentations that can be possible including patients that has absolutely no symptoms of infection all the way to having basically only the stroke and blood clot symptoms that some people have been hearing about in the media. So, it’s tough to tell patients exactly what to expect in any individual or given case. But most patients, if they do get symptoms are going to be nasal congestion, fever, loss of sense of smell, possibly a dry cough and those kinds of symptoms can linger for several days or even a few weeks. Lethargy, headaches, just feeling kind of run down. Those are fairly common as well. So, it’s tough to give a overall sense of how the disease is going to progress for people. But those other – those symptoms I just mentioned, are what will happen for most patients that develop a symptomatic infection.
Host: So, just as we close here, what is something that people should do if they are just not sure about the symptoms they’re experiencing?
Dr. Harris: Yes if they are not sure, by all means, please contact your primary provider or if you already have an allergist, they would be a good resource as well and discuss the symptoms. And most primary providers will be able to advise as to whether it’s a good idea to do a COVID-19 test versus skip doing a test and just presume that it’s a COVID-19 infection and take precautions to self-isolate or quarantine and keep close updates with primary provider or any other medical professionals if there’s any downturn progression for the worse in the symptoms.
Host: And just final question here, I’m sure that you’ve probably seen a lot of patients with this concern that we’re talking about today. Is there any final piece of advice that you might have for people that are worried about COVID-19 and allergies?
Dr. Harris: My final piece of advice is don’t stay silent and try and self-diagnose. Don’t hesitate to contact your doctor or primary provider or even contact an urgent care center or helpline. Contact somebody in the medical field and explain the situation and I would say just don’t sit back and hope that it’s not COVID-19. Do some investigating, don’t hesitate to contact us, that’s what we’re here for. And we’re more than happy to help people out and help them through it.
Host: Well Dr. Harris, I truly appreciate your time today. Thank you so much for educating us today. That’s Dr. Tucker Harris, an Otolaryngologist and Allergist at St. Joseph’s Health. For more information please visit www.sjhsyr.org. That’s www.sjhsyr.org. If interested, call 315-744-1505 to schedule an appointment. If you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is St. Joseph’s Health MedCast from St. Joseph’s Health. I’m Prakash Chandran. Thank you so much for listening.
This St. Joseph’s Health MedCast COVID-19 podcast was recorded on July 28, 2020.
Prakash Chandran (Host): During this time of COVID-19, it’s nerve wracking for seasonal allergy sufferers to know when they are dealing with allergies versus possible COVID-19 symptoms. 2020 has turned out to be a brutal year for allergies and it’s not over yet. Ragweed is the biggest allergy trigger in the fall, though it usually starts to release pollen with cool nights and warm days in August, it can last into September and October. About 75% of people allergic to spring plants, also have reactions to ragweed. Because of this, it’s really important to distinguish the various symptoms you experience that best prepare you for your health. We’re going to talk about it today with Dr. Tucker Harris, an Otolaryngologist also known as an ear, nose and throat doctor, and Allergist at St. Joseph’s Health.
This is St. Joseph’s Health MedCast from St. Joseph’s Health. I’m Prakash Chandran. So, Dr. Harris, what exactly are the main differences between the way your body responds to allergies versus COVID-19 symptoms?
Tucker Harris, MD (Guest): The main difference to keep in mind is fever. That is something you will never get with allergies and it’s the main differentiating symptom we have to tell us if it is COVID-19 or is it allergies. So, fever is the big thing. A couple of other subtle differences would be that with the COVID-19, symptoms basically will onset within a 24 hour period. You’ll go from normal to feeling all the nasal congestion, loss of sense of smell. It will be rather sudden whereas with allergies, it’s typically not an overnight thing. It kind of builds continuously as the season progresses. And the other difference that some patients will notice, some will not is that they’ll reproducibly be able to trigger their symptoms by going outside or getting close to some of the offending agents like a patch of ragweed or somebody’s freshly trimmed lawn or mowed lawn. They’ll reproducibly get a sudden onset of their symptoms, go back inside and give it a little bit more time and they’ll improve within the course of minutes to an hour. That will not be seen with COVID-19 either.
Host: Now you talked about fever and nasal symptoms. I think the most common things that I’ve personally heard about is that wheezing, shortness of breath, the dry cough as the symptoms of COVID-19. Does COVID-19 also cause those nasal symptoms?
Dr. Harris: Yes, so COVID-19 can cause a runny nose, postnasal drip, more than anything nasal congestion and one of the hallmarks is a sudden loss of the sense of smell and taste. So, those – a lot of those symptoms will overlap with allergies and make it difficult to determine which is it that I’m dealing with COVID-19 or allergies.
Host: So, is it safe to say when you have itchy eyes, a runny nose, then it’s allergies? Those are the types of things that I experience when I go outside.
Dr. Harris: Yeah, not all patients that have allergies will get those symptoms. But watery eyes, itchy eyes, itchy nose, having to scratch the nose and rub it to make it feel better, having to snort through the nose; all of those things go along with allergies and you really shouldn’t get any sort of itchiness happening with COVID-19. So, you can pretty much rest assured if the symptoms are reproducible with exposure to an offending agent and you’ve got itchiness and no fever; it’s almost certainly allergies to something.
Host: So, what about people especially with children, who suffer from allergies and asthma, you know coughing and chest tightness can be signs of COVID-19 but is wheezing and those asthma symptoms that we just discussed?
Dr. Harris: Yeah, that’s overlap areas well with some patients who have COVID-19. Wheezing, cough, chest problems, so that also makes it a little bit difficult to determine which of these problems is it. is it allergies, asthma or is it COVID-19. It’s more likely asthma if patients happen to have a inhaler or a puffer and they use it and it seems to improve their symptoms greatly. It’s less likely to be COVID-19 if that’s the case.
Host: I see. So, people with allergies that want to rule out COVID-19, how do they go about managing it? Do they go to a pharmacy and do they get over the counter medications or do they need to see an allergist?
Dr. Harris: Ideally, visiting an allergist is the best way to test for allergies. There’s a couple of ways to do it. One is with skin scratch testing and that’s a little tougher to do and still maintain social distancing, but many offices figured out ways to actually perform it. The other option is to do a one time blood draw. Either method can test for the same types of allergens or things that you can be allergic to whether it’s pollens, molds, dust, or even foods. Sometimes the accuracy level between the two is in most cases, negligible so either method would work fine. And in this day and age of Telemedicine, a lot of times the blood testing or the skin testing should be ordered without even an in-person visit. And we can hopefully get some answers.
Host: Yeah, that’s really good. What about the options when it does come to managing these seasonal allergies at home? Does that just consist of getting certain over the counter medicines or going through certain home remedies?
Dr. Harris: That’s a great question. Over the counter medications certainly have their place and are very helpful for a lot of patients. So, topical nasal steroid sprays, and over the counter antihistamines are very helpful. Another thing that most allergists recommend to their patients is to use some sort of device to irrigate or rinse out the nose. Rinse it out with saline and that’s fairly harmless and can be done once a day, twice a day, numerous times throughout the day. There’s various manufacturers that make various products but one of the more commonly termed products is a Neti Pot. But anything that’s similar to it will work. And it basically just flushes the nose with salt water and that’s designed to help thin out some of the thick mucus from allergies and it’s also designed to remove some of the particulates or pollens or dust particles or what have you that’s irritating the nose. And a lot of patients find that very helpful to do.
Most of those devices or instruments that are used to do the irrigation are found over the counter, mostly in the grocery store or pharmacy or even through various online vendors.
Host: Got it. That’s helpful. Just a basic question here, allergies and illnesses can coexist together right?
Dr. Harris: Yes, correct. And in fact they do so allergies are extremely common and it’s not unusual to have other underlying illnesses along with allergies. So, asthma can be related to allergies. There are some rare patients out there that are having migraine headaches triggered by allergies. So, there’s a few different things out there that can be somewhat related.
Host: And can you talk to us a little bit about the progression of COVID-19 symptoms? I’m wondering if there is a possibility that someone fights off those initial symptoms like the fever and the nasal things that we were discussing so it never actually gets to the later stage wheezing and dry cough and things of that nature that we hear about in the news. So, maybe talk a little bit about that just how it progresses over time and if someone is able to fight it off.
Dr. Harris: Yeah, that’s tough to discuss in depth because there’s such a wide variety of symptoms and presentations that can be possible including patients that has absolutely no symptoms of infection all the way to having basically only the stroke and blood clot symptoms that some people have been hearing about in the media. So, it’s tough to tell patients exactly what to expect in any individual or given case. But most patients, if they do get symptoms are going to be nasal congestion, fever, loss of sense of smell, possibly a dry cough and those kinds of symptoms can linger for several days or even a few weeks. Lethargy, headaches, just feeling kind of run down. Those are fairly common as well. So, it’s tough to give a overall sense of how the disease is going to progress for people. But those other – those symptoms I just mentioned, are what will happen for most patients that develop a symptomatic infection.
Host: So, just as we close here, what is something that people should do if they are just not sure about the symptoms they’re experiencing?
Dr. Harris: Yes if they are not sure, by all means, please contact your primary provider or if you already have an allergist, they would be a good resource as well and discuss the symptoms. And most primary providers will be able to advise as to whether it’s a good idea to do a COVID-19 test versus skip doing a test and just presume that it’s a COVID-19 infection and take precautions to self-isolate or quarantine and keep close updates with primary provider or any other medical professionals if there’s any downturn progression for the worse in the symptoms.
Host: And just final question here, I’m sure that you’ve probably seen a lot of patients with this concern that we’re talking about today. Is there any final piece of advice that you might have for people that are worried about COVID-19 and allergies?
Dr. Harris: My final piece of advice is don’t stay silent and try and self-diagnose. Don’t hesitate to contact your doctor or primary provider or even contact an urgent care center or helpline. Contact somebody in the medical field and explain the situation and I would say just don’t sit back and hope that it’s not COVID-19. Do some investigating, don’t hesitate to contact us, that’s what we’re here for. And we’re more than happy to help people out and help them through it.
Host: Well Dr. Harris, I truly appreciate your time today. Thank you so much for educating us today. That’s Dr. Tucker Harris, an Otolaryngologist and Allergist at St. Joseph’s Health. For more information please visit www.sjhsyr.org. That’s www.sjhsyr.org. If interested, call 315-744-1505 to schedule an appointment. If you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is St. Joseph’s Health MedCast from St. Joseph’s Health. I’m Prakash Chandran. Thank you so much for listening.