COVID-19, flu, strep or common cold? How to tell the difference

September 9, 2021

Mark L. Friedman, MD, FACEP, FACP

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With cold and flu season approaching during an ongoing pandemic, you might be anxious about what will happen if someone in your family gets sick. At the first sign of sniffles, you’re likely to wonder: “Do I have COVID-19? Or could it just be a common cold? Maybe the flu? And what do I do about it?”

It’s not always easy to tell, but with First Stop Health Telemedicine from your employer, you can get diagnosis and treatment via phone or video 24/7. Our doctors call back in 3 minutes (on average) to make sense of your symptoms and help you feel better, faster.

In the meantime, here’s what you should know about telling apart COVID-19, the flu, strep and common cold.



Understanding the cause of your upper respiratory symptoms can be a challenge. Not all patients with the same illness experience the same symptoms, and there’s also a good deal of overlap:

  • Cold symptoms include stuffy nose, congestion and sneezing.
  • Strep throat symptoms include white spots on your tonsils, swollen lymph nodes in your neck, fever, and lack of cough.
  • Flu symptoms include fever, chills, body aches, sore throat and headache.
  • COVID-19 shares a lot of symptoms with the flu, but loss of smell and taste are specific to COVID-19.


No matter who you are, diagnosis is important because it determines your treatment plan. But accurate and timely diagnosis is even more important for the elderly and very young, who are generally at a much higher risk of life-threatening complications.

Telemedicine doctors diagnose your illness based on your symptoms and medical history. COVID-19 and the flu are both epidemic in nature, which makes it reasonable for doctors to diagnose and treat patients who:

  • are located in the epidemic area and
  • have a fever and cough, and especially
  • live with someone who has tested positive.

In other words, you don’t need a positive test for COVID-19 or the flu to receive treatment via telemedicine.

There are also tests available for strep throat (throat swab), COVID-19 and the flu (nasal swab). Bear in mind that these tests are not foolproof:

  • There can be false positives or false negatives.
  • It can take 3 days or more to get COVID-19 test results; if you’re not isolating, this means you could still catch or spread the virus before you get your result.

If your First Stop Health doctor believes that you need a test for COVID-19, you’ll receive an email after your visit with information and next steps.



For COVID-19, the flu, strep throat, and the common cold, most patients simply need increased fluid intake, rest, fever-reducers (not aspirin!) and pain relievers. Other treatments include:

  • antiviral medications to shorten the course of (or even prevent) the flu.
  • antibiotics to treat strep throat (but not COVID-19, the common cold or other viral illnesses).
  • prescription cough medication (and even inhalers) if your diagnosis is bronchitis or asthma.
  • monoclonal antibodies (by IV infusion) for COVID-19 may be of value to patients at high risk of complications. Unproven treatments (like ivermectin and hydroxychloroquine) are NOT advisable.
  • over-the-counter medications and home remedies.

9 in 10 First Stop Health patients avoid an in-person visit. In rare cases, your telemedicine doctor might recommend that you seek in-person care at the doctor’s office, hospital or emergency room. 


We're here for you 24/7.

Whether the treatment is over-the-counter medication, chicken broth or Tamiflu, First Stop Health doctors are here to help you feel better, faster.

If your employer or school provides you with First Stop Health Telemedicine, request a visit to talk to a doctor in minutes.


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Questions about COVID-19? Visit our Coronavirus Resource Center

Originally published Sep 9, 2021 1:36:24 PM.