Is it a cold, the flu, or COVID-19?

That will be a common question for employers and HR managers this fall and winter as the cold and flu season meets a potential second wave of the coronavirus.

Sources: World Health Organization, U.S. Centers for Disease Control and Prevention.

Considering that COVID-19 is recordable under OSHA regulations and could impact your entire workforce, employers will want to know the differences.

COVID-19 is a recordable illness under OSHA recordkeeping requirements if:

Another important reason to distinguish among these illnesses is that the federal Families First Coronavirus Response Act provides for extended paid leave benefits for workers absent due to COVID-19.

Applying Benefits

CBIA's Mark Soycher cautions against applying these paid leave benefits too broadly.

If a worker’s illness is not properly documented by a healthcare professional, the paid leave will not meet U.S. Department of Labor or IRS criteria as qualifying and recoverable through the payroll tax credit provisions of the FFCRA.

If an illness is not documented, employee leave will not meet federal qualifying criteria for paid benefits.

Further, Soycher says, a worker given paid leave under the FFCRA—despite having only a cold, or the flu but not COVID-19—might later need paid time off for a documented COVID-19 situation.

The employee could claim the prior paid leave was not qualifying, so it didn’t count, then demand the paid leave they’re entitled to under the law.

That’s why the illness must be properly diagnosed.

Symptom Progression

A new study from the University of Southern California that identifies the order in which symptoms associated with COVID-19 arrive could help determine which of these respiratory diseases a person may have.

USC researchers found that COVID-19 symptoms appear in this order: fever followed by cough and muscle pain, then nausea and/or vomiting, then diarrhea.

“This order is especially important to know when we have overlapping cycles of illnesses like the flu that coincide with infections of COVID-19,” said USC professor Peter Kuhn.

The flu has many similarities to COVID-19, including fever/chills, cough, shortness of breath or difficulty breathing, fatigue, sore throat, runny/stuffy nose, muscle pains, a headache, and some people may have vomiting and diarrhea, although this is more common in children.

Unlike the flu, COVID-19 often results in an additional symptom, loss of taste and/or smell.

“Some of the symptoms of flu and COVID-19 are similar, making it hard to tell the difference between them,” according to the Centers for Disease Control.

“Diagnostic testing can help determine if you are sick with the flu or COVID-19.”

Comparing Symptoms

The USC study found that COVID-19 symptoms tracked similarly to two related coronaviruses—the Middle East Respiratory Syndrome and Severe Acute Respiratory Syndrome.

But unlike MERS and SARS, COVID-19 tends to produce nausea and vomiting before diarrhea.

There are also differences between a cold and a flu.

A cold comes on gradually and a fever is rare. There are slight body aches but chills are uncommon.

A cold can induce fatigue and weakness, but a headache is rare. Other common traits of a cold include sneezing, a stuffy nose, and sore throat.

The flu comes on abruptly and often includes a fever that lasts three to four days.

Body aches can be severe, chills and weakness are common, and sneezing can occur, although it’s not common.

Chest discomfort and headaches are common, and a stuffy nose and sore throat can also happen with the flu.

While symptoms of seasonal allergies can include a runny or stuffy nose, cough, shortness of breath or difficulty breathing, allergies do not cause a fever or gastrointestinal problems.

'Stay in Your Lane'

It can certainly confuse an employer trained to manage a business and people, but not trained in medicine, Soycher said.

“HR people and other company managers need to stay in their lanes of expertise, and not attempt to substitute their judgment for the expertise of health professionals,” Soycher said.

“Similarly, as reflected in the FFCRA, an employee’s self-diagnosis or decision to self-quarantine without input from a healthcare professional would not qualify for FFCRA paid leave.”

Soycher said employers shouldn’t be overly suspicious of employees who exercise caution and stay home from work when ill.

“We don’t want employees infecting others at work, whether it’s COVID-19, SARS, MERS, the flu, or just a common cold,” he said.

The length of isolation or quarantine, treatment protocols, and applicable leave and protection laws vary from ailment to ailment.

“But the proper length of isolation or quarantine, effective treatment protocols, and applicable laws regarding paid leave and job protections vary from ailment to ailment.

“And, of course, there are some workers who unwisely and irresponsibly anticipate that the mere mention of COVID-19 will allow them a two week off with pay.”

Soycher recommends managers consider the phrase “trust, but verify” when a worker calls out sick.

“Seeking documentation from a healthcare professional will serve the common interests of the company’s health and legal compliance and sustained operations, as well as the well-being of the involved worker, coworkers, and their loved ones,” he said.


For more information, contact CBIA’s Mark Soycher (860.244.1900) | @HRHotline