Maybe COVID, Maybe Allergies, or Maybe Both

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March 23rd, 2021

Spring: grass growing, flowers blooming, trees growing new leaves… but if you suffer from seasonal allergies, this explosion of new life probably stimulates more fear than joy.

For millions of people, it’s seasonal allergy time; it is estimated that 40% of the world’s population has some kind of allergies.

Some people step outside and within minutes they are sneezing and dealing with a congested nose. Some could also have watery, swollen eyes and watery throat that itches.

Chief of the Allergy Division at UNMC, Dr. Jill Poole, says that this year, allergy season will be different and people should be vigilant.

“Well I think it’s complicated and it’s confusing to patients. The allergies have actually hit hard the last week or two now and so the tree pollen has come out strong and it’s not getting press because of COVID, and so I think there has… there’s kind of been a lack of awareness this year. We had, actually, a very bad fall pollen season as well,” Dr. Poole said.

What’s behind this attack of mucus? The answer lies within our immune systems. Allergies, sometimes also known as hay fever, is a hypersensitive immune response to something that’s not harmful but presents itself with a negative effect for some.  

Pollen from trees and grass along with mold spores from tiny fungi find their way into our mucus membranes. Our bodies attack these tiny agents the same way they would attack infectious bacteria.

The immune system has a memory, so when a foreign substance gets tagged as threatening white blood cells, our body will produce customized antibodies that will recognize the agent next time around.

Allergies usually (but not always) show up for the first time during childhood, but why do some people get allergies and others don’t? Sometimes it can be genetic, and the environment people grow up in matters.

Being exposed to an allergen as a baby or growing up on farms might make some people less likely to develop allergies than people in urban environments.

So, is it COVID or allergies?

“The symptoms are overlapping and sometimes it’s very hard to tell the difference,” Poole said.

Poole said that this year it will be a little difficult to distinguish between allergies and COVID symptoms.

“What I’ve seen actually during this pandemic is people with allergies have really wanted them well controlled so they’re not being as symptomatic and being confused about having COVID,” Poole said.

Every year after a hard freeze, the tree pollen starts to travel, and Poole says we’re seeing high counts this season that will only continue to get higher. April tends to be the peak time for tree pollen in Omaha.

“Because it was such a hard winter we didn’t get any whiffs of allergy in January because of all of the snow, so now with melting our pollen counts are high,” Dr. Poole says.

Allergies usually (but not always) show up for the first time during childhood, but why do some people get allergies and others don’t? Sometimes it can be genetic, and the environment people grow up in matters.

Being exposed to an allergen as a baby or growing up on farms might make some people less likely to develop allergies than people in urban environments.

A group of people is most susceptible to allergies, but anyone is at risk. Allergies can strike anytime and it depends on the levels of contact and the severity of the season.

“Well allergies are super common and the peak time in one’s life for getting allergies is really in your 20s and then in your 30s. I mean you can get allergies at any point in your life. Now these 20 something year old into the 30s, they’re having allergies for the first time and that’s just not unusual to start experiencing allergies in your 20s and 30s although I’ve diagnosed new allergies in 70-80 years old’s,” Poole said.

From the beginning of March to May, it is the season for tree pollen, May and June grass pollen. August, September, and October bring weed pollen.

“Our area, Omaha, I mean Nebraska, Kansas, Missouri tend to be high in ragweed but that’s and that’s really locations like California the Pacific Northwest that they don’t have any ragweed,” Poole said.

Tree pollen travels the longest distances, so this season Omaha will have high levels of pollen because winds have brought pollen from everywhere, even all the way from Oklahoma.

So, is it COVID or allergies?

“The symptoms are overlapping and sometimes it’s very hard to tell the difference,” Poole said.

Poole said that this year it will be a little difficult to distinguish between allergies and COVID symptoms.

“What I’ve seen actually during this pandemic is people with allergies have really wanted them well controlled so they’re not being as symptomatic and being confused about having COVID,” Poole said.

So what are the differences? More itching nose and eyes are more likely to be allergies. Sneezing is also more likely to be allergies, but it is also is a COVID symptom. With other symptoms is where it gets a bit tricky.

The nasal congestion and postnasal drip, that is tough, you know that with allergies and you can have that with COVID. I mean, throughout this year people have called me thinking of sinus infection then I make them get COVID tested and they’ve been positive. The sinus symptoms are very overlapping,” Dr. Poole said.

Clear and colored drainage can be found with allergies and COVID, but fever with allergies is rare, and it is more likely with allergies one will not lose a sense of smell or taste.

So what can you do about it? If you think you have allergies, over-the-counter medications can help reduce the symptoms. The most common ones stop the inflammation and steroids can help the immune system.

Another, more permanent option, is immunotherapy, which is slow controlled exposure to an allergen.

If you take your seasonal allergies medication in the spring, your allergies will be decreased by mid-summer – just in time for ragweed season.

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