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News >  Health

Allergies don’t come with fever: Symptoms can cause fear of coronavirus as pollen hits peak levels

UPDATED: Fri., May 29, 2020

Here come seasonal allergies thanks to culprits such as tree pollens and that grass springing up tall.

Only this year, concerns about the coronavirus linger, as well. Sniffs and sneezes might get viewed with higher suspicion. Seasonal allergy symptoms, along with those for asthma, could raise alarms for sufferers worried about COVID-19.

However, there are key differences and ways to manage the conditions for better health, experts say. Dr. Steven Kernerman, an allergist with Spokane Allergy and Asthma Clinic, suspects Spokane is having a stronger pollen season this year.

“It seems we’re having a bit stronger pollen season just in terms of people mentioning it,” Kernerman said. But COVID-19 restrictions have meant no official pollen counts locally at least as of May 21.

“The triggers right now, just from historic information, we know as a general rule that the tree pollen is kind of declining right now, and the grass pollen is increasing as we speak.”

But don’t blame the yellow pine pollen, which is benign. Rather, common irritants are from trees such as alder, birch, cottonwood and sycamore. You might want to avoid fields of grass, too, especially if they’re uncut and showing those spikes where pollen rests.

Symptom differences

To tell if symptoms are worse than allergies, think about if there’s a fever, Kernerman said. Allergies cause sneezing, itchy eyes, a runny and itchy nose, as well postnasal drip causing throat irritation.

Conversely, COVID-19 can cause fever and often signs such as a dry cough, shortness of breath, muscle aches, intensive loss of taste and smell or gastrointestinal symptoms.

“The biggest differentiators between COVID and what would be allergies is really temperature,” Kernerman said. “The vast majority of people who end up diagnosed with COVID will have had a fever. Allergies do not cause a fever.

“Obviously, if you sneeze in a public place, people are going to turn their head around, but if you don’t have a fever or the other typical symptoms of COVID, it’s more likely going to be allergies.”

Dr. Jen Caudle, a New Jersey family medicine physician, knows much about seasonal allergies in treating patients and first-hand. She also makes a clear distinction.

Counter to allergies’ itchy-watery eyes, itchy-runny nose and other typical symptoms, COVID-19 often means fever, shortness of breath and perhaps breathing difficulties. Other concerns might be generalized body aches from flu or COVID-19.

“I would also say that allergy symptoms tend to come on more abruptly while colds and flu tend to come on more gradually – hours to days,” Caudle said. “With allergies, you get symptoms as soon as you’re put in contact with allergens” such as pollen.

“If you have a fever, you should be considering something other than allergies, something infectious. It could be a cold, it could be flu, it could be COVID or something else.”

Check in with a health care provider, she said.

Asthma concerns

Because of risks from COVID-19, people diagnosed with asthma should make sure their treatment is optimized, Kernerman said.

“You wouldn’t want to be undertreating or ignoring your asthma,” he said. “If you have airways that are irritated and inflamed, you might have a difficult course (if infected with the coronavirus) versus if you’re on medicine and correctly treating asthma.”

Asthma is a condition that causes airways to narrow and swell and produce extra mucus, says the Mayo Clinic. Inflammation in the airways and lungs would be concerning if there’s COVID-19.

“The news comes so fast, and every other day, it seems like there are different views, but I think it’s safe to say that if someone has uncontrolled asthma, it is never good,” Kernerman added. “It’s even worse when you have a wildcard like COVID out there.”

That scenario, to a certain degree, might apply for moderate-to-severe allergies left untreated, he said. If nose tissue is inflamed, irritated and impaired, “There would be a compromise to its usual protective barrier. You might be more susceptible to infection because the tissue is compromised.”

Sinusitis is another concern in both scenarios if the tissue is not as protective because it’s compromised, swollen and inflamed.

Better self-care

Here are other tips for better seasonal allergy and asthma care:

Take a shower. Wash off particularly at the end of a day if you’ve been outside to remove any pollen.

Regularly take medications. There are plenty of over-the-counter medications for seasonal allergies, and a primary care doctor can help guide you. Often, antihistamines, inhalers and nasal spays help.

“One of the reasons why people might not want allergies to be an issue is if you’re out and about and sneeze,” Kernerman said. “Right now, people are going to notice, and they’re not going to think grass pollen. They’ll think, ‘Great, I’ve just been exposed to COVID.’ It’s not unreasonable to think that way.

“If they can take something like an oral nonprescription antihistamine, that would help. It would decrease the likelihood they’d experience symptoms if they’re in Costco, where they do require you to wear a mask. Do you really want to have a runny nose and be sneezing while you’re wearing a mask?”

It’s the same for asthma treatment plans. Stay on top of managing it, he added, as health professionals still don’t know how COVID-19 might spread during the summer or this fall.

“If they have asthma, that is something under their control, to take appropriate medications that will help with the larger context of all the other stuff going on.”

Use social distancing and masks to full advantage. It’s perhaps one perk of nearly constant use of masks in public – as barriers from environmental triggers for allergy and asthma patients.

However, the mask part is tougher if you have asthma, Kernerman said.

“A year or two ago, it would be rare for people with allergies to wear a mask. Now everyone is wearing them, but they also have a benefit of filtering out the pollen. But people with asthma might find it more difficult to wear a mask.”

That’s another argument to make sure allergy or asthma is best controlled. “People with asthma might have shortness of breath as a baseline, and if they put a mask on, that might slow the velocity of the air getting in. They literally feel uncomfortable breathing.

“But the advice is to still wear the mask where you might be exposed to the coronavirus. There is a greater benefit to wearing the mask and feeling uncomfortable for that short time to the risk of potentially getting COVID.”

Consider untreated consequences. A lot of patients don’t realize that they don’t have to suffer with allergies, Caudle said. Seasonal allergies also can impact people in feeling fatigued and foggy.

Allergies, which impact millions of people, occur when a person’s immune system reacts to a foreign substance such as pollen or pet dander.

“Mostly seasonal allergies are what we are talking about, and they’re mostly triggered by pollen,” she said. “As a family doctor, I treat allergies all the time. I’m also an allergy sufferer myself.”

Caudle said she promotes and is a representative for a brand she uses, Xyzal, taken nightly to help for 24 hours, but many treatments exist.

“There are a lot of different choices for seasonal allergies – some are over the counter; some are prescriptions,” she said. “There are nasal sprays, pill-form medications, some come in liquid, and sometimes people even need allergy injections.

“Sometimes, if people don’t respond to one option, they need to try other options.”

She said children also should receive care if they have seasonal allergies, which can cause issues with concentration and breathing problems. A constant need to mouth breathe can affect growth of the teeth and some facial bones.

“The other thing with children is allergies can cause inflammation of the ear, which can cause increased fluid that actually can lead to ear infections or problems with hearing.”

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