As Long Island enters the heart of cold and flu...

As Long Island enters the heart of cold and flu season, while seeing a massive uptick in omicron variant cases, health experts explain how to tell the difference between the three. Credit: NurPhoto via Getty Images/NurPhoto

Feeling a tickle in your throat? Coughing, sneezing and a runny nose? Could it be COVID-19? Maybe it's just a cold or worse, influenza?

As Long Island enters the heart of cold and flu season, while simultaneously seeing a massive uptick in omicron variant cases, it may be hard to distinguish between the three ailments, particularly for those fully vaccinated and who may experience milder symptoms if they contract the virus.

Here are some common questions to help determine what's ailing you.

What are the symptoms of omicron compared with the cold or flu?

Medical professionals concede the symptoms can be similar, particularly among those vaccinated for COVID-19 and influenza, making a diagnosis — absent a test or doctor visit — difficult to discern.

All three ailments typically involve coughing, sneezing and congestion. Those suffering from influenza will likely also experience fever, chills and body aches, according to the Centers for Disease Control and Prevention. Most doctor's offices can test patients for influenza, with results available often within 15 minutes.

One potential way to distinguish between influenza and COVID-19 is the temporary loss of taste and smell that some individuals experience after testing positive for COVID-19, said Dr. Sharon Nachman, chief of the division of pediatric infectious diseases at Stony Brook Children’s Hospital.

But those symptoms, common with the delta variant, are seen less frequently with omicron, health officials said.

"There is no easy way" to distinguish between the symptoms, Nachman said. "But importantly, if the person you were with two days ago has flu, it's much more likely you have flu."

What's the best way to determine if its COVID-19 or influenza?

The only sure fire way to know is to get tested, said Dr. Mangala Narasimhan, senior vice president and director of critical care services at Northwell Health.

"It's impossible for a lay person, or even me, to tell the difference between the two," Narasimhan said. "It's a question of getting tested. But right now, the rates of omicron are so high in our communities that the assumption should be that you have COVID rather than the flu."

Will a rapid test sniff out omicron, and rule out cold or flu?

Rapid antigen tests are good for detecting SARS CoV-2, the virus that causes COVID-19, in patients who are symptomatic, said Dr. Matthew Harris, medical director of the Northwell Health vaccine program and a pediatric emergency doctor at Cohen Children’s Medical Center in New Hyde Park.

"So, if you are one or two days into a cold, sore throat, headache, and you test positive on a rapid test — it’s a highly reliable test," Harris said. "For patients who are asymptomatic, it’s not a great screening test. It requires the presence of a certain viral load in the nose to test positive."

Harris said PCR tests remain the "gold standard," and rapid tests have a roughly 15% false negative rate.

What should I do while waiting for my test results?

"Whether it's COVID or influenza, we don't want to spread disease around the population," Harris said. "If you are symptomatic and if it's at all possible, you should isolate until you have the results of your COVID-19 tests."

People with symptoms who test negative on rapid tests should test again if their symptoms persist, he said, because sometimes early in the disease people may not have a significant viral load in their nose.

What is 'flurona' and how common is it?

A mix of omicron and seasonal flu, flurona presents as a potentially severe illness, particularly among the unvaccinated, the elderly and those with underlying medical issues.

Stony Brook and Northwell have each seen a handful of patients admitted with flurona.

"They are sicker and staying sicker longer," Nachman said, adding that there have been no flurona fatalities to date at the hospital.

Narasimhan agrees and said it's "definitely much riskier to have both. It's two things your body has to battle back from. Two things that can cause you to have pneumonia."

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