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You’ve just coughed or sneezed. Now what? When they share similar symptoms, how can you tell if you have a cold, flu, or COVID? Learn the differences between the different viruses, and how to prevent these viral infections.

COVID vs. flu vs. cold
	COVID-19	Flu	Cold
Virus	Coronavirus	Influenza	Usually rhinovirus
Shared symptoms between 2+ virus	Cough Sore throat Runny nose or congestion Fever or chills Fatigue Muscle or body aches Headache	Cough Sore throat Runny or stuffy nose Sneezing Fever or chills Fatigue Muscle or body aches Headache	Cough Sore throat Runny or stuffy nose Sneezing
Suggestive symptoms	Loss of taste or smell Shortness of breath or difficulty breathing Nausea or vomiting Diarrhea	Occasionally vomiting and diarrhea (especially in children)	Generally feeling unwell
Severity	Mild to severe	Mild to severe	Mild to rarely severe
Treatment	Symptom relief medication, treatment of secondary illnesses Antivirals (Paxlovid, Lagevrio, and Veklury) for high-risk groups given up to 5-7 days after symptoms begin Immune modulators for qualifying hospitalized individuals	Antiviral (Tamiflu, Xofluza, Relenza) given within first 24-48 hours, symptom relief medication, treatment of secondary illnesses	Symptom relief medication
At risk groups	Older people, people who are immunocompromised, people with chronic health conditions	Young children, adults over 65, pregnant people, people who are immunocompromised, people with chronic health conditions	Young children, adults over 65, pregnant people, people who are immunocompromised, people with chronic health conditions
How it is spread	Close contact with infected individuals, touching contaminated surface

What causes colds, the flu, and COVID-19?

“All three are caused by viruses,” says Georgine Nanos, MD, an expert in epidemiology and the CEO of Kind Health Group in Encinitas, California. “The common cold is usually caused by a virus called rhinovirus. COVID-19 is caused by coronavirus. The flu is caused by the influenza virus.”

Within those types of viruses, there are variations. Influenza virus falls into two main categories labeled A and B. (There is also influenza C and D, but C is mild and not common and D is not known to occur in humans.) While COVID-19 is called “coronavirus” colloquially, it is really just one type of coronavirus.

“Coronaviruses are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV),” says Andrea Limpuangthip, MD, the medical director of quality of patient safety at Baltimore’s Mercy Medical Center. COVID-19 is labeled SARS-CoV-2.

What are cold vs. flu vs. COVID symptoms?

Common symptoms of a cold are usually mild and include a runny or stuffy nose, coughing, sneezing, sore throat, and generally feeling unwell.

The flu has the same symptoms as a cold, but infected individuals may also have a fever or chills, muscle or body aches, headaches, tiredness, and occasionally vomiting and diarrhea (especially in children).

Symptoms of COVID-19 can include fever or chills, cough, shortness of breath or trouble breathing, fatigue, muscle or body aches, headache, loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, and diarrhea.

“Common colds usually show upper respiratory symptoms; influenza and COVID-19 show both upper and lower respiratory issues with systemic involvement,” says Hamid S. Syed, MD, an acute care and primary care physician at Reagan Medical Center in Atlanta.

Is COVID worse than the flu or cold?

A cold is rarely serious and very unlikely to be fatal. Severity can depend on the particular virus causing the cold and the individual who is infected. Even a cold can become severe in certain individuals, with respiratory syncytial virus (RSV) infections in infants being a good example of that potential. The flu and COVID-19 affect people with varying degrees of severity. For some, the symptoms are mild and there are no complications. For others, particularly those in high-risk categories, these viruses can cause serious complications and even death.

Those at a higher risk for severe symptoms or complications from the flu, and to a lesser extent colds, are:

Children
Adults older than 65
People who are pregnant
People who are immunocompromised
People with other medical conditions such as diabetes, heart disease, and asthma or COPD

For COVID-19, those most seriously affected are:

Older adults
People who are immunocompromised
People with other health conditions like heart disease, lung disease, or diabetes

What are the treatments for these respiratory illnesses?

Antibiotics are only effective against bacterial infections—not viruses. Therefore, there is no treatment for the common cold except for symptom management. Rest, fluids, and if needed, over-the-counter symptom relief medicine such as Vicks Vaporub.

For the flu, an antiviral medication called Tamiflu can lessen the severity of the symptoms and length of the illness, but is only effective if given within the first 24 to 48 hours after symptoms develop. Rest and fluids are important for recovery, and symptoms can be managed with medications such as Advil or Tylenol for fever and muscle pain. The flu can cause secondary infections like pneumonia or other complications, which may require further medical care.

Mild cases of COVID-19 can be treated at home with lots of rest, fluids, and over-the-counter (OTC) medications like acetaminophen and ibuprofen. For individuals with mild to moderate symptoms who are at risk of severe illness, including hospitalization or death, the FDA has approved or authorized several treatments, including prescription antiviral drugs, such as Paxlovid or Veklury, and immune modulators, which are available for qualifying hospitalized individuals.

How do colds, the flu, and COVID-19 spread?

“The common cold and flu are usually transmitted via [having contact with] small or large droplets from coughing, sneezing, or close contact with an infected person,” says Dr. Syed. COVID-19 has a similar mode of transmission.

“Close contact” means within six feet of an infected person, where it is possible to breathe in droplets being expelled into the air, or to have droplets land onto another person. It’s also possible to contract the infection by touching surfaces contaminated with droplets containing the virus, and then touching the face (particularly the eyes, nose, and mouth)—but this isn’t thought to be the main way these respiratory viruses spread.

The flu is contagious for a day or so before symptoms appear and continues to be most contagious for the first few days of symptoms. Similarly, COVID-19 can be spread by infected individuals who are asymptomatic; they then remain very contagious in the early days of illness.

How can you prevent these illnesses?

Despite differences in severity and types of viruses, you can prevent all three of these illnesses in similar ways.

Wash your hands

You should wash your hands in warm water with soap for 20 to 30 seconds. Try singing “Happy Birthday” twice to keep the time. Make sure to include the backs of your hands and your nail beds. Washing your hands is the single best way to prevent the spread of many infectious diseases. It’s particularly important before eating or preparing food, and after using the bathroom. Of course, respiratory illnesses that are spread by airborne viruses, like colds, flu, and COVID-19, cannot be totally prevented by handwashing.

Soap and water are best, but if none are available, use an alcohol-based hand sanitizer that is at least 60% alcohol.

Don’t touch your face

You may not realize how often you touch your face until you try not to. “We touch our faces at least 200 times per day without noticing,” says Dr. Nanos. Touching your face after touching a contaminated surface can make you sick.

Disinfect commonly used objects and areas

Door handles, toilets, handrails, countertops, anything people touch regularly—and especially your phone. Dr. Nanos recommends washing your phones as often as you wash your hands. “They are usually the most contaminated item we have in our possessions,” says Dr. Nanos. “Phones present an extra risk because we keep them so close to our face as well, so I recommend using a Bluetooth headset as much as possible to keep it away from your face.”

Stay home if you are sick

The only place you should be going if you have or suspect you have the flu or COVID-19 is to see a healthcare provider—and even then, you should call ahead. Minimize your contact with others. Even if your symptoms are mild, you could infect someone for whom these illnesses could be severe or fatal.

“Catch your cough”

Cough or sneeze into a tissue, discard the tissue, then wash your hands. If no tissues are available, the inside of your elbow will do in a pinch. Try telling children (or adults) to “make an elephant” or a “vampire” as a way to teach them how to do this.

Take care of yourself

Get lots of sleep, eat well, exercise—do all those things you would normally do to stay healthy.

Get vaccinated

There is no single vaccine for the common cold, but there are vaccines available for COVID-19 and the flu. The flu vaccine helps slow the spread of the influenza virus. The COVID-19 vaccine helps slow the spread of the coronavirus. Both vaccines can help lessen the severity of each virus. Vaccines against RSV, which is one potential viral cause of the common cold, have recently been approved.

It’s never too late in the flu season to get vaccinated if you haven’t already. Remember you need a flu shot every year.

Ask a healthcare provider if you are eligible for a COVID booster shot if you’ve already been fully vaccinated.

For COVID-19, evaluate travel plans.

“I would highly recommend that people avoid unnecessary travel,” Dr. Syed says. If you must travel, “be diligent about following the previously noted preventive measures.” It’s best to avoid large gatherings of people as well.

RELATED: Coronavirus and travel

Check the Centers for Disease Control (CDC) website regularly.

Prevention recommendations and general information about both COVID-19 and seasonal flu are updated on the CDC website as information becomes available. Make sure you are up-to-date.

While the common cold, the flu, and COVID-19 may overlap in some ways, knowing the differences can help you know when to seek proper treatment, if needed.

Sources:

People at higher risk of flu complications, Centers for Disease Control and Prevention (2023)
People with certain medical conditions, Centers for Disease Control and Prevention (2023)
If you are sick or caring for someone, Centers for Disease Control and Prevention (2022)
Coronavirus (COVID-19) drugs, U.S. Food & Drug Administration (2023)
Show me the science – When & how to use hand sanitizer in community settings, Centers for Disease Control and Prevention (2023)

COVID vs. flu vs. cold