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Cold, flu or COVID-19? What parents should know

With multiple viruses spreading at once, here's what to do if your child becomes ill.
photo collage of woman navigating flu/covid season
TODAY illustration / Getty Images
/ Source: TODAY

With the coronavirus continuing to circulate and flu season beginning, experts worry that the next few months will bring a "twindemic," with both illnesses causing serious complications around the country.

While it's likely to be a confusing time for many, experts spoke with TODAY Parents and shared advice to help moms and dads navigate the coming season. They described how to prepare, what to do if a child is exposed to the virus, and which symptoms are especially important to spot.

Have a plan for the season

Family practice physician Dr. Kristin Dean, who is also the medical director of virtual care provider Doctor on Demand, said that for a lot of families, the best thing to do is strategize together as a unit about how to approach the next few months as cold and flu season collide with the coronavirus pandemic.

"I think a lot of people are starting to feel some of the fatigue of just this ongoing social distancing," Dean said. "Talking as a family and deciding how you're going to manage this cold and flu season and what's going to work best for you as a group is really important to help minimize some of that stress and anxiety."

Dean stressed the importance of continuing to keep safe distances, wear masks and maintain proper hand hygiene. She also recommended planning for some worst-case scenarios. Working parents should try to speak to their supervisors about what time they can take off if a child is ill, and families should develop a backup plan for child care in case parents themselves become sick. It's also important to understand what will happen at school if your child has to miss days.

Dean also recommended devising a plan to get tested for coronavirus if necessary. Most importantly, Dean said, get your flu shot; the American Academy of Pediatrics advises that children get the vaccine by the end of October.

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Watch for unusual symptoms

A major concern in the coming months is that the flu, the common cold, seasonal allergies and coronavirus have similar symptoms. Dr. Eric Robinette, a pediatric infectious disease physician at Akron Children's Hospital in Ohio, said that if there's any concern about which condition might be afflicting your child, keep them home from school.

"It's pretty much impossible, honestly, to tell the difference (between flu and COVID)," said Robinette, who noted that even doctors struggled to diagnose the different illnesses without the help of testing. "Cough, runny nose, sore throat — those are all shared by both viruses, so without doing testing it's pretty hard to tell."

The only major difference between the two, according to Robinette, is the loss of taste and smell, which he said is fairly specific to the coronavirus.

If your child does start showing symptoms such as fever, dry cough or loss of senses, it's important to keep them home from school and get them tested as soon as possible — but don't panic.

"Remain calm, and look to the plan you made before," Dean said. "Know what you're going to do."

Know when and how to get tested

Testing rules, regulations and limits can all vary based on your area, so be sure you know what local options are available to you. Robinette said that if you're not sure whether your child has the flu or coronavirus, it can be better to try to get a coronavirus test first.

"COVID has a lot more implications for things like isolation and social distancing and contact tracing, all those public health pieces," Robinette said. "That would be the more important of the two, but I would tell folks that if they're getting tested in the first 24 to 48 hours of the illness, they're going to want to get tested for coronavirus and flu because there are treatments available for flu that can shorten the duration of symptoms."

If your child is exposed to the coronavirus through a classroom setting or because of time spent with a friend, Robinette said the recommendations for what to do can change based on where you are, how long it has been since the exposure occurred, and whether a patient is showing symptoms. Since coronavirus has a long incubation period, some patients may not start showing symptoms for up to 14 days.

"If I test you five days after you're exposed to somebody with COVID and you're negative then, I can tell you you don't have COVID right now, but I can't tell you that you're not going to have it tomorrow, because you could be incubating the virus," Robinette said.

In most cases, it's best to get the test when possible, but still maintain a two-week isolation period after the exposure.

"By the time 14 days has elapsed, it's likely that if even if you have had an asymptomatic infection, you're not likely to be contagious," Robinette said.

In the event of exposure to COVID-19, Dean recommended similar steps.

"Talk to your doctor first," she said. "Talking about your symptoms and determining when the best time to actually get tested would be better than just jumping in to get the test right away."

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Keep track of relevant details

If your child does start showing symptoms of the coronavirus, make sure to keep track of what symptoms they have and when they started appearing. It can also be helpful to figure out their contacts over the past few weeks. All of this information can be helpful to public health officials and medical experts who work on contact tracing.

If your child is diagnosed with the flu, not coronavirus, it's likely not necessary to alert people in the way you might report coronavirus exposure, Robinette said. While you're waiting for test results, though, anyone who may have been exposed should quarantine.

"(Contact tracing) is not a routine practice with seasonal flu, just because it's such a common infection, it's not super practical," he said. "But at first, you're not going to know if you have the flu or coronavirus."

The timeline of your isolation period might change depending on when a child starts showing symptoms.

"If the child becomes sick, that sort of resets the clock," Dean said. "Then we think about the timeline in a different way ... and we start a 10-day clock for symptoms. ...

"Ten days after the onset of symptoms, you have to be without a fever for at least 24 hours, and you have to be feeling better. Those are the criteria that we look for" to confirm the end of illness.

Be prepared for potential quarantine periods

Whether it's just a brief period of isolation while waiting for test results or a full two-week quarantine, it's important to be prepared to spend some time at home, especially if a child is ill.

"The treatment for both (illnesses) is really supportive care," Robinette said. "Maintain good hydration, keep them comfortable by managing nasal congestion — that sort of thing."

Dean said it's important to stock up your medicine cabinet with the basic remedies for cold and flu symptoms.

"Having things like Tylenol, or anything with acetaminophen, is great," she said. "That's a fever reducer, and it can help with the headaches, body aches and muscle aches that you might experience with any of those illnesses."

Dean said it can also be good to stock up on cough medicine, but be sure to talk to your pediatrician before administering anything to young children.

If only one family member was exposed or ill, try to keep them isolated from the rest of the household. Be sure to have masks and cleaning products on hand. If possible, try purchasing a pulse oximeter to monitor oxygen levels, which can be affected by the coronavirus.

"If you have another child at home who maybe hasn't been exposed, having those face masks, hand sanitizers, even disinfectants to clean surfaces off at home ... can be very helpful," Dean said.

Know when to seek medical help

While most cases of flu and coronavirus are mild, especially in children, it's important that parents monitor the situation.

Robinette said that "difficulty breathing, high-grade fevers, and the inability to keep fluids to the point where kids are becoming dehydrated" are all major symptoms that caretakers should take seriously.