Is It a Cold? The Flu? COVID? Or RSV?

Disorientation could point to COVID-19, especially in older adults, says Kenneth Koncilja, M.D., a geriatrician at the Cleveland Clinic. “I’ve seen more of my older patients present with symptoms of confusion [and test positive for COVID-19], where you might think it’s a urinary tract infection,” he says.

Sneezing a lot? That’s typically a symptom that’s more common with a cold or RSV than with the flu or COVID. And chances are, if you have a cold, you won’t experience the body aches and fever that accompany an influenza or coronavirus infection. (RSV can cause a low-grade fever, though.)

Keep a COVID test — or two — on hand

It’s still important to keep an at-home COVID test (or two) on hand — especially during the fall and winter seasons. That way, if you start to feel sick, you can check to see if your symptoms are due to COVID-19 in a matter of minutes. Don’t have any tests? The federal government reopened its program, and each U.S. household can order four free tests.

“Particularly given the nonspecific nature of a lot of COVID symptoms and the fact that there can be a diminished fever response and other kinds of atypical symptoms, I think the safest thing would be to definitely test,” Shaw says.

If you’re positive for COVID-19, your doctor may prescribe an antiviral pill, like Paxlovid (nirmatrelvir/ritonavir) or Lagevrio (molnupiravir), both of which can significantly lessen your chances of severe illness.

However, it’s important to start these treatments early in the disease course. So talk to your doctor right away if you find out you have COVID-19. Some pharmacists can also prescribe the pills.

If you test negative for COVID but symptoms persist, your health care provider may conduct a flu test. As with COVID-19, prescription antiviral treatments taken early on can help you feel better if you have the flu.

Antivirals usually aren’t prescribed for RSV, although some bad cases may require hospitalization. Often with RSV, care calls for fluids, rest and symptom management with over-the-counter medications, according to the Centers for Disease Control and Prevention (CDC). The same goes for a cold.

Stay up to date on your vaccines

One way to lower your likelihood of getting the flu, COVID-19 and RSV in the first place is to get vaccinated against each disease. Not everyone who gets vaccinated will be able to completely avoid an infection, but the separate shots can blunt the severity of symptoms and help to keep you out of the hospital.

When it comes to COVID-19, health experts recommend that everyone 6 months and older get the recently updated coronavirus vaccine; adults 65 and older should plan on getting a second shot in the spring.

For the flu, adults 65 and older should ask for a high-dose vaccine, CDC recommendations say. There are three options to choose from, but experts say the differences among them are minimal. For most people, the best one to get is the one your doctor or pharmacist has available. There’s no need to space out your flu and COVID-19 shots, so if it’s more convenient to get them at the same visit, the CDC says that can be done.

There’s also an RSV vaccine available, and it’s recommended for all adults 75 and older and for those ages 60 to 74 with certain risk factors, such as heart disease, lung disease and diabetes.

While there is no vaccine to help prevent a cold, there are several steps you can do to avoid one: Wash your hands often, stay away from people who are sick, and disinfect frequently touched surfaces. These measures can also help you avoid many other illnesses swirling about this cold-weather season.

Editor’s note: This story, first published Sept. 27, 2022, has been updated to include new information.