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Allergies ... or Coronavirus Symptoms?

The pandemic, plus this year's especially early allergy season, brings added stress

woman with pollen allergies standing outdoors under blossoming trees sneezing into a tissue

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En español | Did the person next to you at the grocery store just sneeze? It may not be what you think.

The spring allergy season kicked off early this year, with symptoms such as coughing and sniffling bringing unwanted attention to those affected by the abundance of tree pollen.

"Every time I sneeze, people seem to get very nervous and kind of move away,” says Jacquie Hume, 72, of Tallahassee, Florida. “I just want to tell them, ‘Hey, I'm not sick. I have allergies.’ “

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Hume, who has a lung issue that puts her at higher risk during the pandemic, says her allergy symptoms have also made it harder for her to avoid touching her face — a key step that public-health experts recommend to prevent the spread of the coronavirus.

"I try to be conscious about not rubbing my eyes, but it's something I tend to do without thinking,” Hume says, noting that allergy season seemed to arrive earlier than ever this year in her corner of Florida.

What's kicking off your allergies

It's not Hume's imagination. In some parts of the country, spring arrived earlier this year than at any point in the past 39 years, which is how long such records have been kept, according to the USA National Phenology Network, funded primarily by the U.S. Geological Survey.

The appearance of the first tiny leaves on trees was three to four weeks early across the South, Southeast and mid-Atlantic regions, the network reports. Washington, D.C., and New York City, for example, were both 24 days early. Spring also came early in the far west, affecting cities including Portland and Seattle.

It's part of a continuing trend in recent years of longer and more intense allergy seasons caused by climate change, explains Ronald Saff, M.D., an allergist in Tallahassee, Florida. A 2019 study, reported in the journal Lancet Planetary Health, found that airborne pollen counts increase as average temperatures climb.

"Warmer weather tricks the trees into thinking it's an early spring, so they start pollinating,” Saff says. Because tree pollen is so fine, wind can carry it for miles. For allergy sufferers, it can cause itchy, swollen eyes, a dry cough, congestion, sneezing and wheezing. From 10 to 30 percent of the adult population suffers from seasonal allergies (also called allergic rhinitis).

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Older adults are not immune. Allergies often develop in middle age, says Milwaukee allergist Gary Steven, M.D., who serves on the board of regents of the American College of Allergy, Asthma and Immunology. In one study about 15 percent of women and 13 percent of men over age 60 reported they have some type of seasonal allergy. Once you reach age 70, however, allergies often tend to decrease, along with the responsiveness of your immune system.

Coronavirus vs. allergy symptoms

So how can you tell the difference between seasonal allergies and COVID-19, the disease caused by the coronavirus? COVID-19 usually causes a fever and a cough, and only about 5 percent of patients experience nasal symptoms, according to a World Health Organization report. Allergies, on the other hand, almost always cause a runny or stuffy nose and are rarely associated with a fever, Steven explains. Dry, itchy eyes are another classic allergic reaction.

Steven recommends paying attention to what makes your symptoms worse. “If you're fine when you're indoors and the windows are closed, but then you go out on a dry, windy day and start sneezing your head off, yes, that's an allergy.”

The good news is that over-the-counter allergy medications are effective for many people. If you're experiencing symptoms, doctors recommend the following steps.

Reduce your exposure

• Keep windows closed and filter indoor air. When driving, set the controls to “recirculate” so your car isn't pulling in outside air that's filled with pollen.

• When outside, wear glasses and a hat, as they keep pollen from striking your face and eyes.

• Reduce pollen cling. Change your clothes after being outside, and take a shower if you can, to wash the pollen grains off your hair and body. Leave your shoes outside the door.

Try over-the-counter remedies

• Nasal steroids: The American Academy of Allergy, Asthma and Immunology considers these sprays (such as Flonase, Nasonex and Nasacort) “the mainstay of treatment” for seasonal allergies. They have few side effects, and just a spritz or two dramatically relieves symptoms in most people, Saff says. The sprays are most effective if you start them before the beginning of allergy season and use them every day.

• Oral antihistamines: These drugs are designed to counter the effects of histamine, the chemical your body releases during an allergic reaction. To prevent drowsiness, Steven recommends “second-generation” antihistamines, such as Allegra, Claritin and Zyrtec, rather than a first-generation medication like Benadryl. “The first-generation antihistamines slow down reaction times, especially in older adults,” he notes. “They can have an impact on your driving."

• Antihistamine eye drops: Drops made with an antihistamine called ketotifen will help relieve itchiness, redness and puffiness, Saff says. These drops last for up to 12 hours.

• Sinus rinse: A rinse at the end of the day can “wash out all of the allergens and gunk that accumulates in your nostrils and sinuses during the day so you feel better,” Saff advises. Make sure you use distilled water, sterilized water or tap water that has been boiled, and then cool when used; in a few rare cases, regular tap water that wasn't boiled caused dangerous infections.

See an allergy doctor

Whether your symptoms are severe or not, it's a good idea (when possible) to consult an allergy specialist before you self-treat, Saff and Steven suggest. Allergists can do tests to find out what you're allergic to and offer access to stronger prescription medications, such as antihistamine sprays, which Steven says are extremely effective.

If you have a severe case, an allergist may recommend “allergen immunotherapy,” which exposes you to increasing amounts of an allergen, usually through a series of shots, to build up your immune system.

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