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There’s no doubt that spring time is most certainly hay fever time. But when it comes to diagnosis this spring, public health requirements and community concern regarding COVID-19 complicate matters. Should patients be using their atopy as an excuse to avoid public health guidelines regarding COVID-19 screening and isolation?

Let’s delve a little deeper into diagnosing hay fever.

Hay fever is common

Almost 18% of Australians have hay fever, with more than one in six individuals affected.

This presents a clear dilemma for registrars, GPs and patients as some upper respiratory symptoms (eg snuffy nose, rhinorrhoea and headache) are similar to those with COVID-19. As a doctor, do you recommend testing and isolating, or simply using antihistamines? The right clinical judgement is required, especially as symptoms may not be clear cut.

The distinction between hay fever and COVID-19

Allergic rhinitis (aka hay fever) is more likely if there is concurrent sneezing and itchiness. There is often a past personal or family history of hay fever, asthma or atopy. Symptom onset is usually slower, unless there has been recent exposure to a particular allergen (eg Granny’s cat).

New presentations may occur when people have relocated, which is more common since people have moved away from metropolitan areas during the pandemic.

Symptoms will respond promptly to oral antihistamines, and symptom prevention strategies include intranasal steroid sprays, sinus rinses, allergen exposure reduction and desensitization.

URTI or COVID-19 is more likely if there are other respiratory symptoms, for instance sore throat, cough, anosmia or systemic symptoms like fever, myalgia, malaise, nausea, vomiting or diarrhoea. COVID-19 screening, isolation and symptom management are indicated.

Here’s hoping this information has help to clear concerns you might have diagnosing hay fever versus COVID-19.

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