Tens of thousands of Canadians across the country are being hit with the flu, a cold or COVID-19, and with many symptoms overlapping, coupled with a lack of availability of COVID tests, it’s almost impossible to tell what they could be ailing from, doctors say.
“Clinically, the LeBron James of medicine can’t tell the difference between one or another,” said Dr. Sumon Chakrabarti, an infectious disease specialist at Trillium Health Partners.
With it being impossible to diagnose patients without a test, Chakrabarti advises anyone who is feeling ill to assume they’ve been infected with COVID-19, even if they cannot be tested for the virus.
“There’s so much Omicron going on in the community, chances are your symptoms are from COVID,” he said.
Family doctors are also in the same boat, where Ontario says publicly funded testing is only available to “high-risk individuals who are symptomatic and/or are at risk of severe illness from COVID-19 … and workers and residents in the highest risk settings, as well as vulnerable populations.”
“We’re all kind of waiting for guidance,” said Dr. Michelle Cohen, a family doctor in Brighton, Ont.
The province reduced the isolation period for those who are fully vaccinated and children under 12 years old, from 10 days to five days following the onset of symptoms.
Cohen, who talked about previous waves being a little easier to distinguish because of the availability of testing, said she’s still not fully prepared to tell patients what to do when they call her office seeking advice. She said she’s been crowdsourcing information from other doctors and trying to look at provincial and federal guidance, but there are no hard and fast rules.
“I’m at a loss, really, what to do in terms of what I’m going to be telling people who are going to be calling,” she said.
Symptoms to look for
Commonly reported symptoms of Omicron included cough, fatigue and congestion or runny nose, according to the World Health Organization. The symptoms, whether they’re chills, a cough or runny nose, are all a result of your body’s reaction to the different viruses and less about the virus, according to Chakrabarti.
“A lot of the symptoms that you get from viral infections, whether it’s COVID, whether it’s influenza, whether it’s the cold virus, are actually coming from the activation of your immune system rather than the virus directly,” he said.
Between the three different illnesses, it’s easy to misunderstand which one a person could be suffering from. At times with COVID-19, there could be additional symptoms like a loss of smell, but the same can happen with a bad cold as well. With nearly indistinguishable traits, there is no real way to tell what you’ve been infected with unless you take a PCR test or rapid test. Currently, there is a lack of availability across Canada and the U.S. for PCR and rapid tests.
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Despite Omicron being the most recent variant of concern, it carries all the same symptoms as its predecessor, the Delta variant, and the original strain.
“We haven’t seen a change in the symptoms that people present with Omicron compared to Delta,” said Dr. Maria Van Kerkhove, an epidemiologist and the COVID-19 technical lead at the WHO, in a podcast on Dec. 23.
What to do when symptoms escalate
Similar to the Delta variant and others, with Omicron, people with high-blood pressure, diabetes, or those taking an immunosuppressive drug could be at greater risk for severe illness. For those who are unvaccinated or vaccinated and still impacted, people can experience shortness of breath, body aches, abdominal pain, and gastrointestinal problems, which can depend on severity.
There are some signs for people who should be cautious if they’re experiencing a number of those symptoms, Chakrabarti said.
“If it gets to a certain point, you need to contact emergency health care,” he said.
According to Cohen, anyone experiencing something that lasts more than a couple days and that progressively gets worse should immediately check into a hospital, where diagnostic tests can be run to determine the infection.
“Go to the emergency room anyway, which is routine. If you’re sick enough that you can’t wait a few days to get a test, you need to go to the emergency room,” she said.
How to manage your symptoms
With COVID-19 transmission at an all-time high, Chakrabarti said Canadians who have any flu or cold-like symptoms that could also be COVID-19, stay at home and isolate for at least five days.
“I recommend that you just isolate — assume that you have COVID at this time and isolate,” he said. “We don’t need to know if it is COVID or the influenza.”
Up to December 2021, testing and contact tracing have been two of the major methods used to control infection and spread. Currently, testing in some provinces has been delayed more than two days and there is limited contact tracing given the large outbreaks.
As a result of these changes, Cohen, who said she’s often seeing patients with acute respiratory illnesses, said this year is particularly different if symptoms persist because, unlike last year, there is no way to know what people are dealing with.
“I don’t know what to do now with someone who has that cough that won’t go away. I can’t just tell them it’s a cold. I can’t just tell them to isolate because it’s been going on for a few weeks,” she said. “It’s complicated. … It’s quite confusing.”
She added that because most people have expanded their bubbles and are in contact with more people on a regular basis, it makes contact tracing on an individual basis a tougher task, too. So, Cohen said she plans to tell people to isolate for at least five days, but more importantly until symptoms are completely gone.
“Isolate until the symptoms are resolved, use the guideline of 24 hours of symptom resolution,” Cohen said.