In the beginning of the coronavirus pandemic, we felt sure we could tell the difference between this new virus and the flu, strep or another virus like the common cold.


Now it’s not as clear. We’ve added symptoms to COVID-19, including sore throat, diarrhea, nausea and vomiting. Those also can indicate flu or strep. It’s also possible to have more than one disease at a time.


Dr. Gaurang Shah, emergency medical director at St. David’s Medical Center, says the coronavirus can have a wide range of nonspecific symptoms, especially in people who are younger.


"It is always a challenge in this current environment to get an accurate diagnosis," he says.


The first question Shah would ask is, "Do you have a fever?" He also would do an exam and ask questions about exposure to people who have had coronavirus, as well as whether a patient has had a loss of taste and smell, which he says is a "strong indicator" for the coronavirus. He’s also going to look inside the throat. Strep throat comes with an "angry" throat that is distinguishable.


Coronavirus also comes with shortness of breath, but not always, and flu can have that as well.


Based on symptoms and history, doctors like Shah decide which tests to order: flu, COVID-19, strep, some of the above, all of the above or something else.


What is a little easier to tell is whether it’s allergies or COVID-19. With allergies, think itchy — itchy eyes, itchy nose, itchy throat. Also, think sneezing and watery eyes. Sometimes, though, allergies confuse with a loss of smell or taste that is also found with COVID-19.


In Central Texas, we’re about to hit our unique and intense allergy season: cedar fever, which typically starts in December and runs through February.


Shah recommends that people who have allergies, including cedar fever, start taking their allergy medications such as an antihistamines or a nasal steroids.


Allergies can increase your risk for other illnesses, Shah says.


"Because you have more mucus, you’re more likely to catch and hold onto viral particles, which increases the risk of developing an infection," he says.


Shah is starting to see some flu patients come into his emergency room. This year, the flu has been pretty classic, Shah says: high fever, body aches, runny nose, congestion and cough.


Shah and doctors like him are encouraging everyone to get their flu shot by Halloween for the most protection. Get your flu shot even if you haven’t left your home in months just in case you do need to leave home.


The worry is that flu patients might fill up our hospitals, which also could be filled with people who have coronavirus. As well, if you have one followed by the other, it will be hard for your body to fight both.


One bright spot of the pandemic: Because many kids are still at home and because people are physically distancing, using masks and washing their hands, Shah has not been seeing as much strep as he normally would by now. He also thinks we might have less of a flu season this year.


Experiencing some of the milder symptoms of any of these diseases means you can call your doctor and schedule an appointment. More serious symptoms, such as difficulty breathing, not being able to urinate, or dizziness and dehydration caused by vomiting or diarrhea, warrant a trip to the emergency room.