With the approaching fall season, we typically witness flu and viral season quickly arrive as well. Simultaneously weed pollen, dust mite, and mold allergy sufferers are preparing for an intense time of year. This year however, the ongoing spread of COVID-19 and reputable variants adds an additional concern to patients’ minds. There is quite a lot to navigate!

Currently, the recommendations continue to spend time outdoors or hold event outdoors where social distancing is easier and coronavirus transmission is less effective. For fall allergy sufferers, however, the recommendation to spend more time outdoors can sound like a no-win situation. Not to mention a cough, runny nose, or sneeze seems to send the average person into a state of anxiety, concern, and confusion these days, and those around you running for cover. This fall, more than ever, we have the opportunity to assist providers in determining if their patients’ symptoms are typical for this time of year or signs of something more serious.

Allergy symptoms can occur seasonally or continuously year-round when someone is sensitive to particles such as pollen, animal dander or dust mites. When allergies are to blame, symptoms commonly include itchy, watery eyes, itchy, runny nose, sneezing, nasal congestion, post-nasal drip, and itchy throat or ears. Did I mention itching was common for allergy sufferers? I absolutely mentioned itching, however what I made sure not to mention was fever. Fever, muscle aches, and weakness are three big differentiators as they are absent with allergies. Similarly, as differentiators, sneezing, itching, and clear, watery nasal discharge are always present with allergies but not flu or COVID19.

Some other overlapping symptoms can be fatigue, headache, or sore throat. Again, focusing on time of onset is important. Coronavirus (COVID-19) signs and symptoms tend to be more sudden or rapid than allergies and result in rapid onset fatigue coupled with fever, chills, muscle pain, headache, weakness and potentially also dry cough, sore throat and loss of taste and smell. Allergies can be associated with a cough and can make breathing difficult, and trigger wheezing and/or shortness of breath. Unfortunately, these symptoms can also be associated with COVID-19. However, with allergies expect that these symptoms will come on slowly, and respiratory symptoms will be “wet” in nature. If mucus is being produced, especially clear mucus, and onset is slow allergies are likely the culprit.

Patients that have already been diagnosed with allergies and asthma may be concerned with whether they have a greater risk of contracting COVID-19 or if it is safe for them to continue immunotherapy at this time. It is important to support your provider in assuring these patients there is currently no data to support that patients with allergies are at an increased risk for contracting COVID-19, and similarly there is no data demonstrating that concomitant allergen immunotherapy poses any risk.

Patients with allergies should continue wearing a protective face covering, however if they have been outside for significant time periods or during high pollen or mold count days there are some important mask recommendations to consider. A onetime use, disposable, non-cloth mask is the best option for outdoor pollen sufferers. If allergy sufferers are wearing a cloth mask, please make sure to recommend the mask is washed in the sterile or sanitation cycle after a day’s use. Also, those with allergies can more commonly have sensitive skin or history of contact dermatitis may need to wash the mask more frequently than non-allergy sufferers. One final reminder, if coughing or sneezing strikes- make sure that you encourage patients to carry additional masks, change their masks frequently, however, do not remove masks in public when a cough or sneeze occurs.