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Telehealth care is available in Arizona, Florida, Illinois, Indiana, Kentucky, Michigan, Nevada, and New York. You must be in your selected state during the visit.
For general educational purposes only, not a substitute for specific medical advice. Consult with a licensed provider before implementing any adjustments to your treatment regimen.
A cold, the flu, COVID-19 and RSV can all cause a cough, sore throat and stuffy nose, so it’s hard to tell them apart by symptoms alone. A few clues help: how fast symptoms start, whether you have fever and body aches, whether you’ve lost your sense of taste or smell and whether you’re wheezing.
A test is often the only way to know for sure. Knowing which virus you have matters most for flu and COVID-19, because prescription antivirals for both work best when they are started early.
How the Four Viruses Compare
All four are respiratory viruses that spread through coughs, sneezes and close contact. Here is how they tend to differ:
- Cold: Symptoms start slowly. A stuffy or runny nose, sneezing and sore throat are common. Fever and headache are rare, and any aches are usually slight.
- Flu: Symptoms come on suddenly. Fever or chills, body aches, headache and feeling worn out are typical. Cough and sore throat are common too. Some people, more often children, have vomiting or diarrhea.
- COVID-19: Symptoms range from mild to severe and most often start about 5 days after exposure (anywhere from 2 to 14 days). Fever, chills, cough, muscle aches, headache, sore throat, congestion, nausea and diarrhea can all happen. A new loss of taste or smell is a known COVID-19 symptom, though many people never have it.
- RSV: RSV usually causes mild, cold-like symptoms such as a runny nose, cough, sneezing, fever and a lower appetite. Symptoms tend to show up in stages rather than all at once. Wheezing is a sign to watch, because RSV can inflame the small airways and lungs.
Why Symptoms Alone Can Fool You
These lists overlap a lot. A mild case of flu or COVID-19 can feel just like a cold. COVID-19 symptoms can also shift as new variants appear, and they may look different if you’re vaccinated. Some people with COVID-19 have no symptoms at all and can still spread it.
So a cough and a runny nose don’t rule out the flu or COVID-19. When your symptoms started, who you’ve been around and your own health history all help a clinician decide what is most likely and whether a test would change your care.
What Home Tests Can and Can’t Tell You
Rapid COVID-19 self-tests give results in minutes. They are useful, but one negative result doesn’t always mean you don’t have COVID-19. The FDA advises repeating most home COVID-19 tests after a negative result to lower the chance of a false negative. Many are labeled to be taken twice over three days when you have symptoms, so follow the directions on the box.
Rapid flu tests give results in about 15 to 20 minutes, but they are less accurate than slower lab tests. RSV testing uses a sample of nasal fluid and is usually done for people who are very sick. A clinician may not need a test result to decide on treatment, since timing and symptoms also matter.
If you tested at home, write down the date and the result so you can share them at your visit.
Who Is at Higher Risk
Many people recover from these viruses at home with rest and fluids. Some people are more likely to get seriously ill and should reach out early:
- Adults 65 and older
- Babies and young children
- People who are pregnant
- People with asthma, COPD, heart disease, diabetes, kidney disease or another long-term condition
- People with a weakened immune system
- People who have obesity or who smoke
If you help care for an older parent or a relative with a chronic illness, keep a close eye on them during respiratory season.
What Treatment Can and Can’t Do
Antibiotics don’t treat viruses. Colds, flu, COVID-19 and RSV are all caused by viruses, so antibiotics won’t help unless a clinician finds a bacterial infection, such as some sinus infections or pneumonia, as a complication.
Flu and COVID-19 antivirals are time-sensitive. Flu antivirals usually work best when started within 2 days of getting sick, and they can make the illness milder and shorter. Our post on getting Tamiflu online explains more. COVID-19 antivirals work best when given soon after infection, within about 5 to 7 days depending on the medicine. Some are pills taken at home, and they are mainly for people at higher risk of severe illness. They can interact with other drugs, so share your full medication list.
Colds and RSV have no specific cure. Most RSV infections go away on their own in a week or two. Rest, fluids and over-the-counter pain relievers can ease fever and aches. Don’t give aspirin to children.
A visit does not guarantee any specific medication. Your clinician will decide what is safe and likely to help you.
How a Video Visit Can Help
A video visit works well for many respiratory illnesses. A clinician can ask when your symptoms started and review your risk factors, medications and any home test results. Then they can decide whether an antiviral makes sense. If a prescription is appropriate, it is sent to your pharmacy.
Video has limits. A clinician can’t listen to your lungs or swab your nose through a screen. If you need a lab test, a chest X-ray or an in-person exam, your clinician can help you figure out where to go. Our guide to when respiratory symptoms need urgent care can help you choose. Wade’s Care First sees patients ages 5 and older, so babies and toddlers with breathing symptoms should be seen by their pediatrician or in person.
When to Get Care Right Away
Call 911 or go to the nearest emergency room if you or someone you care for has:
- Trouble breathing
- Chest pain or pressure that doesn’t go away
- Confusion or trouble waking up
- Bluish lips or face
- Any other symptom that is severe or frightening
In very young babies, RSV may show up only as fussiness, less activity and trouble breathing, which needs in-person care right away. Also get prompt care if a long-term condition such as asthma is getting worse while you’re sick.
The Short Answer
A cold usually starts slowly and stays mild. The flu hits fast, with fever and body aches. COVID-19 can look like either one and sometimes causes a loss of taste or smell. RSV often feels like a cold but can bring wheezing, especially in older adults and babies. Testing helps sort them out, and reaching out early matters for flu and COVID-19, because antivirals work best soon after symptoms start.
Learn more on our online urgent and sick care page.
Get Support
Wade’s Care First provides telehealth care in Arizona, Florida, Illinois, Indiana, Kentucky, Michigan, Nevada and New York, with same-day appointments when available. Visits are with Charles Wade, FNP-BC, a board-certified family nurse practitioner.
We accept many major insurance plans, including Original Medicare (Indiana only), Medicaid (Indiana, Illinois and Nevada only), UnitedHealthcare, Aetna, Humana and Cigna. Plan participation varies by state, and self-pay visits are available.
If your symptoms started in the last few days, reaching out now gives you the most treatment options.
Book at wadescarefirst.com.
Answers connected to this topic.
Do I need a test for flu or COVID-19 before an urgent visit?
Not always. We review symptom timing, risk factors and any available home results to determine whether testing or time-sensitive treatment is appropriate.
What if I have fever but do not know the cause?
We assess the pattern, associated symptoms and risk factors. Testing or an in-person examination may be necessary, especially if symptoms are severe or persistent.
Can you reassess an illness if my symptoms worsen after a video visit?
Yes, but rapidly worsening or severe symptoms should be evaluated promptly in person rather than waiting for a routine follow-up.
Further reading: medlineplus.gov (flu) · medlineplus.gov (COVID-19) · medlineplus.gov (RSV) · fda.gov · medlineplus.gov (common cold).
