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Was That Sneeze Caused By Allergies Or COVID?

A man sneezes and holds his other hand up in a stop motion.
Allergies and COVD-19 have many symptoms in common, including sneezing.
(Photo by Towfiqu barbhuiya
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We’re in the middle of tree pollen season in Southern California. That means thousands of people will sneeze, cough or wake up with a scratchy throat and wonder — is it allergies or COVID-19?

It’s an important distinction. Allergies are caused by your immune system overreacting to normal things in your environment such as pollen, dust and pet dander. Allergies are not contagious and can be treated with over-the-counter medication, or allergy shots for more serious cases.

COVID-19 is a highly contagious respiratory disease caused by infection with the virus SARS-CoV-2. The virus spreads through respiratory droplets released when someone breathes, coughs, sneezes, talks or sings.

L.A. County is still considered to have substantial transmission of the virus, according to the Centers for Disease Control and Prevention.

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So how do you know if that tickle in your throat is COVID-19 or just a reaction to tree pollen?

“Both omicron and allergies can cause nasal congestion and sneezing, and both can also cause an itchy or scratchy throat,” said Dr. Elisabeth Ference, an otolaryngologist with Keck Medicine of USC.

“Omicron often has additional symptoms such as fever, headaches, malaise, body aches, and even gastrointestinal issues as well,” Ference said.

But some people who test positive are completely asymptomatic. Fully vaccinated people often experience milder COVID symptoms, making it hard to differentiate. Complicating the picture is the range of symptoms, already broad, that shift with each variant.

“Sneezing is definitely increased with omicron," Ference said. "Also, there are more people who have come to me with sore throats which turned out to be COVID. Having a sore throat wasn't really highlighted as a symptom in the initial surges."

The only real way to know the answer is to test. Ference says treat any possible symptoms as COVID and stay home, away from other people until you get the results. If you don’t want to wait for a PCR test result from a lab, you can use rapid over-the-counter tests that give results in a few minutes.

“If you continue to have symptoms, repeat the test 24 hours or more later, to make sure that you have a second negative test,” Ference said.

You can get tested for free at county sites, or have rapid tests mailed directly to your house.

It’s important to get tested as soon as possible — treatments such as antiviral pills are becoming more widespread, but they work best when taken early.

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What questions do you have about the pandemic and health care?
Jackie Fortiér helps Southern Californians understand the pandemic by identifying what's working and what's not in our health response.