Coronavirus or hay fever? Which one is it?

If you develop a cough or shortness of breath at the moment, it’s only to wonder about the worst possible scenario. Doctors say the onset of hay fever season, which recently spiked due to an early spring, has led to many suffering with seasonal allergies to worry that they have coronavirus, leading some to self-isolate and feel unnecessarily panicked.

Professor Martin Marshall, Chair of the Royal College of GPs, has said that hay fever sufferers who have a cough are worried that they are experiencing symptoms of Covid-19, but that actually they are often just allergy related. “If you're allergic to pollen, you might be getting symptoms now and these could be confused with Covid-19,” Jessica Kirby, Head of Health Advice at Asthma UK, says.

One of the symptoms of Covid-19 is a new cough, something that can also affect many of the UK’s 13m hay fever sufferers who also have seasonal asthma. The histamine released by as a reaction to pollen can trigger a potentially life-threatening asthma attack and those with underlying respiratory conditions are already on high alert the threat of coronavirus.

Different hay fever sufferers react to different pollen seasons: Tree pollen is from late March to mid-May; grass pollen is mid-May to July and weed pollen is end of June to September (a test at the GP can determine which you’re affected by). Some sufferers are affected by multiple seasons.

“Pollen levels have increased and with the virus being at the front of everyone’s minds, we can see why people might get confused between the two,” says Marc Donovan, Chief Pharmacist at Boots.

Becky Johnson, 29, from Hampshire, is one of those. She is self-isolating because of her severe allergies, including allergic asthma. Last summer her hay fever caused her to feel “really tight chested to the point where if I did anything physical, I wouldn’t be able to breathe and I’d be glowing red.” After specialist advice from Asthma UK nurses, she started on a steroid nasal spray. “So, a couple of weeks ago when I had a day feeling breathless, I knew it was probably allergy based and I took a stronger antihistamine. But if that hadn’t worked, I’m pretty sure I would have started thinking it might be Covid-19.”

Sinéad Doherty, a clinical nurse specialist on the allergy team at Whittington Health NHS Trust, agrees that “anecdotally, I’ve heard more people asking about the overlapping symptoms between hay fever and Covid-19. I can understand why they might be worried, but they shouldn’t unnecessarily. The main difference is that with Covid-19, a person can have a high temperature and a new, continuous cough.” She adds that “while hay fever can be quite debilitating, people don’t generally feel unwell with it.”

The NHS say the main symptoms of coronavirus are “a high temperature – this means you feel hot to touch on your chest or back” along with “a new, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours.” By contrast, typical hay fever symptoms “tend to vary in severity depending on the pollen count,” Doherty says. Allergy symptoms also vary on times of day, with pollen levels typically being higher first thing in the morning and again in the afternoon and evening.

Doherty, who suffers from hay fever herself, says that when her symptoms started last month, she “took an antihistamine and kept a brief symptom diary and that was enough to reassure me that it was my annual hay fever.”

The World Health Organisation advises everyone to avoid touching our faces – something that is hard to do if your eyes and nose are streaming. Sufferers have taken to Twitter to describe getting terrified looks from other people when they sneeze. The WHO recommends practicing respiratory hygiene and either sneezing into a tissue and throwing it away (then washing your hands), or a sleeve. Sneezing is not a symptom of the virus, but it is thought to be a way that droplets can spread; a recent study, published in the British Medical Journal, suggested that four fifths of people with Covid-19 are asymptomatic.

But it is important not to dismiss all symptoms as allergies. Sarah McGregor, 24, from Scotland, says she developed a cough in mid-March, “which I would have written off as an allergy to begin with, because it’s usually when my hay fever symptoms start to appear. I usually get a cough with hay fever, and I started to cough, but it turned into a dry, constant one  - it felt like it would never end no matter how I tried to remedy it. Then I developed a mild temperature, as well as being fatigued and having aches and pains all over the place.”

Her family, including mother, brother and his partner and daughter, all fell ill at the same time; doctors think they picked up coronavirus after visiting Johnson’s grandmother in hospital after a fall. “We’re all clear of the virus now, but we still all have a day every few days when we’re exhausted and run down; our doctors have said it was because of the virus taking so much out of our systems.”

Asthma UK warns that “If you have hay fever and get Covid-19, then you could be more at risk of both setting off your asthma symptoms.”

If it is just hay fever – a condition that 81 per cent says affects their mood, according to Allergy UK – it’s important to treat it. Doherty recommends “preventative treatment, ideally before symptoms start. Once symptoms start, it’s like an avalanche: they can start off quite small before becoming more difficult to stop.” But she adds that even if you’ve missed the preventative stage, “you can still control it”.

Antihistamines, nasal sprays and eye drops are often the first line of treatment. Own brand once-a-day tablets are just as good as the branded variety, but check they contain the non-sedative Loratadine, which is also safe for pregnant women to take, according to the NHS.

The experts say that it is especially important to control allergy symptoms now. “It’s important that if you take regular medication that you have adequate supplies; don’t leave it to the last minute to get more,” Doherty says. Kirby adds that “hay fever sufferers need to make sure they take their asthma medicines as prescribed alongside their usual hay fever medicines to reduce the risk of hay fever triggering an asthma attack.”

Non medicinal ways to treat hay fever

Along with medicines, there are some extra steps you can take to ease your hay fever suffering.

“Nettles are thought to have the ability to block histamine activity and other pro-inflammatory molecules involved in hay fever,” nutritionist Holly Huntley says. Try Pukka Herb’s Cleanse tea, which contains nettles.

An air filter, especially at night, can help as hay fever sufferers are advised to keep windows closed. Try the Dyson Pure Humidify + Cool purifier humidifier, which filters pollen, along with pollution. £599.

After spending time outdoors, “try and make time to have a shower to wash away any stray pollen on your hair and skin, and put all clothes straight in the wash,” Donovan says.

Wear sunglasses – preferably wraparound ones – on high pollen days.

Take your daily outdoor exercise at midday, when pollen levels are at their lowest.