Reviewed by GPhC Pharmacist Ashley Cohen at Halton Pharmacy Clinical Team, Leeds , GPhC No. 1039734
Quick answer
Colds, flu, COVID-19 and RSV share many symptoms, so it can be hard to tell them apart. A cold usually starts gradually with a blocked or runny nose and a sore throat. Flu tends to come on suddenly with a high temperature, an aching body and exhaustion. COVID-19 can feel like a cold or flu and may change your sense of taste or smell. RSV usually causes cold-like symptoms but can be serious for babies and older adults. Most people recover at home with rest and fluids, and your local pharmacist can advise on easing symptoms. Get urgent medical help if you are struggling to breathe.
Cold, flu, COVID-19 and RSV all circulate at the same time through autumn and winter in Leeds, and they can all begin the same way – a scratchy throat, a tickly cough, a shivery evening. Comparing cold, flu, COVID-19 and RSV symptoms side by side is the quickest way to work out what you’re likely dealing with, and whether you can sit it out at home or need to be seen.
This is the comparison we run through at the counter on Selby Road most weeks between October and March. It’s a guide, not a diagnosis – but it tells you what to watch for, what helps, and exactly when to pick up the phone.
Symptoms at a glance
Flu tends to hit hard and fast. A cold creeps up on you. COVID-19 now often looks like a cold in most people, and RSV in a healthy adult is usually indistinguishable from one. The differences show up in how quickly symptoms arrive, how wiped out you feel, and who is most at risk of a serious infection.
| Symptom | Cold | Flu | COVID-19 | RSV |
|---|---|---|---|---|
| How it starts | Gradually, over 2 to 3 days | Suddenly, often within a few hours | Can be gradual or sudden; symptoms have shifted over time | Within a few days of becoming infected |
| High temperature | Sometimes | Common, and often sudden | Common, sometimes with chills | Common |
| Cough | A cough, usually mild | A dry cough | A continuous cough is common | A cough, which gets worse if the infection becomes more serious |
| Runny or blocked nose, sneezing | Very common | Possible, but not the main feature | A blocked nose is often reported | Very common |
| Sore throat | Common, sometimes with a hoarse voice | Common | Common; some recent variants cause a very painful throat | Not listed among the main NHS symptoms |
| Aches and tiredness | Feeling tired and unwell, sometimes aching muscles | An aching body and exhaustion | Body aches and tiredness | Tiredness |
| Loss of taste or smell | Can happen | Not listed among the main NHS symptoms | A change in sense of taste or smell is often reported | Not listed among the main NHS symptoms |
| Breathing | Unaffected, though a blocked nose makes it feel harder | You may feel short of breath – get urgent advice if so | Shortness of breath is a known symptom | Wheezing or difficulty breathing if it leads to bronchiolitis or pneumonia |
| Who tends to get hit hardest | Anyone; usually mild | Older adults, pregnant women, people with long-term conditions or weakened immunity | People aged 75 and over, and people who are immunosuppressed | Babies under 6 months, premature babies, adults over 75, people with lung or heart conditions |
Not sure it’s just a cold? Get protected this winter
Halton Pharmacy on Selby Road (LS15) offers NHS flu and COVID-19 vaccinations with no GP appointment needed.
How each illness usually starts
A cold builds slowly. You notice a blocked or runny nose, sneezing, a sore throat or a hoarse voice, then a cough and a general feeling of being tired and unwell. A high temperature, aching muscles, a loss of taste and smell, and pressure in your ears and face can all follow. Children often get it worse and for longer – they may be irritable, breathe through their mouth, feed and sleep badly, and be sick after coughing.
Flu arrives like a switch being flipped. Within a few hours you can have a sudden high temperature, an aching body, a dry cough, a sore throat, a headache, and be too exhausted to sleep or eat properly. Children get much the same picture, plus ear pain, sore eyes and swollen glands, and they tend to go quiet and inactive.
COVID-19 is the one that keeps changing. Many people now get cold-like symptoms, alongside fever or chills, a continuous cough, shortness of breath, tiredness, body aches, headache, sore throat, a blocked nose, loss of appetite, nausea, diarrhoea, or a changed sense of taste or smell. Recent variants have been linked with a hoarse voice and a particularly painful sore throat – what the press dubbed “razor-blade throat”.
RSV starts much like a cold: a runny or blocked nose, a cough, sneezing, tiredness and a high temperature. Babies may be irritable and take less milk than usual. The reason we take it seriously is what it can turn into – bronchiolitis in infants and pneumonia in older adults, with a worsening cough, shortness of breath, faster breathing or long gaps between breaths, noisy wheezing, difficulty feeding, and confusion in older people.
When to get help
Call 999 or go to A&E
What helps at home
Most colds, flu, COVID-19 and mild RSV infections clear up without treatment. A cold usually settles over 1 to 2 weeks, flu in about a week, and mild RSV in 1 or 2 weeks. What actually helps is boring and effective:
Do
- rest and sleep as much as you can
- drink plenty of water – your pee should be light yellow or clear
- take paracetamol or ibuprofen to bring down a temperature and ease aches; give children the children’s versions and check the leaflet first
- try saline nose drops from a pharmacy for a blocked nose
- breathe in steam from a hot shower to ease a blocked nose
- gargle salt water, or drink a hot lemon and honey drink, for a sore throat
- stay at home and avoid other people while you have a temperature or feel too unwell for normal activities
Don’t
- give aspirin to children under 16
- take paracetamol alongside cold or flu remedies that already contain paracetamol – it’s far too easy to double up
- use decongestants for children under 6, or nasal sprays for more than a week
- give honey to children under 12 months, or hot drinks to small children
- let children breathe steam from a bowl of hot water – scalding risk
- smoke, or smoke around your child
- sponge a child with cool water or strip their clothes off to bring a temperature down
Antibiotics don’t touch any of these four, because they’re all viral. If you’re reaching for a remedy, bring the box to the counter and we’ll check what’s in it before you add anything else.
Come and see us on Selby Road
Halton Pharmacy, Selby Road, LS15 – no GP appointment needed.
Walk in and ask us about coughs, colds and winter bugs any time we’re open. We can tell you which medicine suits you, check for interactions with what you already take, and say plainly whether you need to see a GP. If you’re eligible for an NHS flu, COVID-19 or RSV vaccination this season, we can talk you through that too, and Pharmacy First consultations are available for the conditions it covers.
Prefer to plan ahead? Book online and pick a time that fits around work or school runs.
If you’re in Halton, Leeds and you’re not sure whether it’s a cold, flu, COVID-19 or RSV, don’t sit at home guessing – call in at Halton Pharmacy on Selby Road (LS15) and ask at the counter, or book online if you’d rather have a time to yourself. We’ll help you work out what it is and what to do next.
Useful sources
- NHS: Common cold
- NHS: Flu
- NHS: Respiratory syncytial virus (RSV)
- UK Health Security Agency: Do I have flu, COVID-19 or a cold?
- NHS 111 online symptom checker
Frequently Asked Questions
It can be hard to tell them apart because the symptoms overlap. A cold usually starts gradually with a runny or blocked nose, sneezing and a sore throat. Flu tends to come on suddenly with a high temperature, aching muscles and exhaustion. COVID-19 can cause a cough, fever, tiredness and sometimes a change in your sense of taste or smell. RSV often feels like a cold but can cause wheezing or breathlessness, especially in babies and older adults. The only way to know for certain is a test.
Yes. Not everyone with flu, COVID-19 or RSV gets a high temperature, and older adults in particular may have milder or less typical symptoms. If you feel unwell, especially with a new cough, unusual tiredness or shortness of breath, it is worth taking care and avoiding close contact with people who are more vulnerable.
The NHS advises trying to stay at home and avoiding contact with other people if you have a high temperature or do not feel well enough to go to work, school or your normal activities. You can usually go back once you feel better and no longer have a high temperature. Take extra care to avoid people with a weakened immune system, older adults and young babies.
Contact NHS 111 or your GP practice if your symptoms are getting worse, have not improved after a week, or you are worried about a baby, an older person or someone with a long-term condition. Call 999 if someone is struggling to breathe, has blue or grey lips or skin, is very drowsy or confused, or a baby is not feeding or is having pauses in their breathing.
Yes. A pharmacist can recommend medicines to ease symptoms such as a high temperature, sore throat, blocked nose and aches, and check they are safe with any other medicines you take. They can also tell you if your symptoms need to be seen by a GP. Antibiotics do not work for colds, flu, COVID-19 or RSV because they are caused by viruses, but vaccines can help protect people who are eligible.