Is It A Cold, or Flu, or COVID-19? What To Do?

Guest Bio: Danielle Gong, MD
Danielle Gong, MD is an Emergency Medicine provider. 

Learn more about Danielle Gong, MD
    Is It A Cold, or Flu, or COVID-19? What To Do?
    Dr. Danielle Gong discusses what to expect this cold and flu season amidst of the pandemic. She discusses symptoms, similarities, the flu vaccine, and when you should see your doctor.
    Transcription:

    Scott Webb: This podcast was recorded on October 7th, 2020. I'm here today with Dr. Danielle Gong with VCU Health's Emergency Medicine Department and a telehealth provider to help answer some timely questions about the cold and flu season in the midst of COVID-19. This is Healthy with VCU Health. I'm Scott Webb. So Dr. Gong, thanks so much for being on today. We've got a lot to talk about specifically now, as we head into cold and flu season in the midst of COVID-19 in the midst of a pandemic, you know, how can we really tell the difference these upper respiratory illnesses all sort of manifest themselves in similar ways? So how can we tell the difference between cold, flu and COVID-19?

    Dr. Gong: Well, it really is almost impossible to tell the difference. Congestion, sore throat are common symptoms in all of the illnesses, including colds, flus, and COVID-19. Most likely with COVID-19, you will have a cough, fevers and body aches, but oftentimes you'll have those with the flu as well. Loss of taste and smell seem to be more common in COVID-19 compared with other upper respiratory illnesses. So maybe that would be an indicator for you. And then there is definitely a component of shortness of breath and fatigue. That seems to be pretty consistent across all individuals who get COVID-19 compared to other colds, but the flu also gives some people shortness of breath. So there really isn't a way to tell the difference between colds, flus, and COVID-19.

    Host: Well, that's particularly frightening, right, because we all, as we are in the cold and flu season, we all get a little cough here and a little body ache there, and it really is hard to tell the difference. So what can we do as we head into cold and flu season? And I'm sure a lot of people are thinking about the flu vaccine, and we're seeing that pop up at all the local stores and doctor's offices. So why is the flu vaccine particularly important this year?

    Dr. Gong: So, getting the flu vaccine will help many people avoid getting the flu. And because we don't really know completely how COVID-19 affects everybody, avoiding getting any type of respiratory illness, including the flu is a good idea. This winter, getting this flu vaccine will help us with that goal. Along with masking and social distancing. Getting the flu vaccine in October will allow everybody to be immune during the peak of flu season, which usually begins around November. And the only people who really should not get a flu vaccine are those who have had a severe allergies, such as anaphylaxis (or the inability to breathe) after getting a flu vaccine and babies under six months of age.

    Host: How does a person know when to seek care? As we've established here, you know, cold flu, COVID all pretty similar symptoms. So as to not seem like hypochondriacs and rush to the doctor, or rush to call our providers every time we have a little cough or something, or congestion or body ache, how do we know which symptoms are the ones we should really be concerned about?

    Dr. Gong: You should probably call a doctor, your doctor or another provider, if you have a fever greater than 104 degrees Fahrenheit accompanied with shortness of breath and severe coughing and extreme fatigue. If you have risk factors such as diabetes, high blood pressure, other chronic illnesses, then you should definitely, even if you have just one of those symptoms, call a physician,

    Host: That's good to know. So let's assume that we've we either have the risk factors and some or all of those symptoms. And we make that call. What levels of care are available to people?

    Dr. Gong: If you have a primary care doctor, that's a great first step. Usually if you have an existing relationship, then they will know your medical history. They will be able to do a risk analysis very quickly. And many practices will often offer you a video visit first. So you don't have to drive all the way across town to go see them, and they can kind of assess your risks and what kind of testing you would need. First over the video, virtual video visits are now becoming more and more popular. You should be able to find even a virtual visit through your health insurance carrier. Usually if you call the number on the back of your insurance card, they'll give you the ability to do a virtual visit with one of their providers as well. What to expect during the virtual visit, your provider will basically talk to you the way they normally do in the office. And while they're talking to you, they're going to watch you. And they're going to watch how you speak, how you finish your sentences, how fast you're breathing. They might ask you to give you them your heart rate. So whether or not that's from your Fitbit or Apple Watch or just you taking your pulse on your wrist, we'll have you count out loud and they will convert your counting into a heart rate.

    If you have your own thermometer, they might ask you to take your temperature during your visit. If you have your own blood pressure machines, we'll have you take your own blood pressure. And if it's a new provider, somebody that you've just seen through your health insurance card or through your primary care provider, but they're not available you're seeing somebody else in the office, they will probably ask you your previous medical history, just to kind of give your risk of whether or not you need to be seen in person. And then in Virginia, and probably in most other states, the Department of Health's website will give you testing sites for COVID-19 and other respiratory illnesses. And your provider can help guide you through where to go to get additional testing if you need additional testing. At VCU, if you use our virtual urgent care, we will have the ability to order COVID-19 testing and send you to our various testing sites, whether they are drive through, or you walk into a respiratory evaluation clinic, and then you see another provider to make sure that you don't need additional x-rays or anything like that.

    Then you can start off with this virtual visit. And then end with either a test ordered that you can take on your own time, or we will recommend that you see another doctor, or if you are severely ill we’ll tell you to come into the ER and reassure you and explain what will happen. A lot of people talk about going to urgent cares, and those are definitely an option. VCU doesn't have an urgent care option, but in the Richmond area, there are quite a few urgent care options, including Med Express, Patient First, and BetterMed. And after your primary care visit or your virtual urgent care visit, you may be referred to an urgent care. And then, obviously, we have the emergency room. So for those who are very ill, whether or not you use a video visit first, you're always welcome to be seen at the emergency room and evaluated. We have our main campus emergency room in downtown Richmond, as well as now, a new free-standing emergency center in New Kent. The Emergency Center at New Kent facility has the ability to do x-rays and stabilize people. It's very well equipped to handle sick individuals.

    Host: You know, as you mentioned about telehealth and televisits, and I had some experience with that myself during this pandemic where I needed to speak with my primary, and there was just no reason for me to drive over there and park and go into the office and deal with PPE. And so they sent me a link. I clicked on the link on my phone and all of a sudden my doctor was on my phone and we were having a video chat and I'm sitting in my kitchen having a cup of coffee, talking to my doctor, and it allows my doctor to kind of see my home, how I'm living. It allows us to, you know, refresh and renew prescriptions and things, and just go over some basic stuff that, you know, really doesn’t need to be done in person. So it's pretty fantastic. And if there are any positives that have come out of COVID-19, it's probably the telehealth and the televisits right?

    Dr. Gong: Definitely both as a provider and as a patient, I have loved the new telehealth options that are available. I also did not really enjoy having to drive 30 minutes to go see my doctor and get my prescription refilled.

    Host: Yeah. And of course, if there are some visits, you know, where the gold standard is still an in person visit, but for a lot of these things, as you say, just to renew your prescriptions, why can't we just chat on our phones? It's really fantastic. You know, Dr. Gong, as we wrap up here today, we all want to stay as healthy as possible during cold and flu season during a pandemic. So how do we do that? How do we stay as healthy as we possibly can?

    Dr. Gong: Eating well, exercising well, wearing a mask when you're out in public, social distance is very important this year, making sure that your plans for the holiday season, which are coming up, including Halloween, are with smaller groups and not large gatherings. And of course get the flu vaccine. They are starting to be widely available this year at, you know, all of the convenience stores and health care systems, your regular physician’s office, and wash your hands often. And once again, wear a mask, and socially distance, and if we all do all of these things, we could really reduce the rate of colds and flus and COVID-19 this winter.

    Host: Absolutely. With Dr. Gong, thanks so much for being on today. One of the great benefits of hosting podcast is I get to talk to the healthcare heroes. I get to talk to the doctors on the front line and I feel more prepared. Hopefully the listeners do as well. And of course you stay well. And go to VCUhealth.org/news for the latest updates on COVID-19 and flu season. And thanks for checking out this episode of Healthy with VCU Health. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library at VCUhealth.org/podcast for topics of interest to you. Thanks, and we'll talk again next time.