Thomas S. Bottiglieri, D.O.

The recent weather & springtime blooming of trees & grasses has lead to an allergen response that has people confused as to an appropriate course of action.  How can you know if the symptoms you have are allergies or COVID?

The symptoms of COVID, caused by the SARS-CoV-2 virus, include headache, muscle aches, fevers, and cough.  While that is not a comprehensive list, it can help to guide your decision to seek further medical care.  When in doubt jump on a telehealth encounter.  If you have experienced allergies before you will be able to self-assess to a certain degree.  Are the symptoms you currently have in line with what you have previously experienced with seasonal allergies? Your primary care doctor can help you to come to a diagnosis and treatment plan if you are not sure.

That being said, the common symptoms of allergies are itchy, watery eyes, nasal congestion (stuffy nose), itchy throat, and dry cough.  I use a strategy for myself of topicals preferred to oral medications.  While the antihistamines (fexofenadine, loratadine, cetirizine) by mouth have a certain benefit, topicals (eye drops and nasal spray) are basically all I need for maintenance. If your symptoms are uncontrolled, start with oral medications and topicals together. However, maintenance with topical medications is all I need in my own self-care for seasonal allergies.

Eye drops such as ketotifen are very useful and I use these when I know allergies are approaching and until symptoms are clear for more than two consecutive days.  Although you can use these up to twice per day, once my symptoms are controlled and allergens decrease, I often use them only as needed at the first sign of allergies – itchy eyes. Do not rub your eyes.  This will only worsen the symptoms.  Cold water to help flush the eyes before treatment is sometimes helpful.  Throughout the day that practice can help to abate any itching that occurs.  Zaditor OTC is my favorite brand as it burns a bit less that other brands.  During heavy allergen days, which you can anticipate by checking most weather apps available on your phone, I use these drops morning and night – 2 drops each eye.

Nasal congestion can be treated with a combination of medications.  If you have allowed your symptoms to get out of control, start with a steam shower or warm mist to help loosen secretions. Then use Simply saline or equivalent to flush the allergens and mucous from your nose.  This should flush all the way through and will often accumulate in the back of your mouth which can be quite nauseating, but this helps to restore flow of mucous and removes allergens from your nasal airway.  Second to this, and ONLY FOR A MAXIMUM of three days, you can use oxymetazoline (afrin is a common brand) to decrease swelling. DO NOT USE THIS MEDICATION FOR MORE THAN THREE DAYS, and follow other warning advisories on the label.  This is not meant to scare anyone, but there is a potential for this medication to cause harm if overused.  When used appropriately it works wonders to open the airways.  Lastly, five minutes or so after flushing and opening the airways, use an inhaled steroid for the nose (fluticasone propionate, mometasone furoate).  The way in which you use this medication is absolutely essential for it to work.  I have explained this to people for years that do not like these nasal medications due to side effects, but there is invariably incorrect usage of medication in these cases.  Please watch the following video and come back to this page for the wrap up at the end of this post.

Allergen avoidance is important to establish control. When allergies are uncontrolled stay indoors with filtered air when possible until the symptoms abate.  When you do go outdoors change your clothes, shower, & wash your hair to remove pollen upon return home.  While outdoor activity is important during this time be aware that windy days are particularly problematic for allergy sufferers.  The wind will pick up dust and that will get into your eyes and respiratory tract. If you can avoid spending time outdoors when the wind is blowing that is good.  If not wear glasses and a bandana or mask to decrease exposure.

KEY TAKEAWAYS:

1. COVID is a respiratory illness that presents with headaches, fever, cough, body aches, chills, loss of smell & taste, as well as fatigue. If you are unsure about the symptoms you are experiencing get a telehealth visit ASAP.
2. Allergy symptoms occur seasonally.  Ask yourself if the symptoms you are experiencing are the same as allergy symptoms that you have experienced before.
3. Use a combination of medications including antihistamine, allergy eye drops, nasal inhalers (see specific medications above) to control symptoms and maintain control with topicals.
4. Allergy avoidance during windy days and high pollen counts can help to restore control.

https://healthmatters.nyp.org/how-to-tell-the-difference-between-covid-19-and-seasonal-allergies/