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The falling leaves and cooler temperatures are a grim signal that winter is coming, with cold and flu season is on its heels.

Meanwhile, COVID-19 cases are surging across Ohio, with Cuyahoga and other Northeast Ohio counties back in the 'red' category of the . Hospitalizations are also increasing statewide.

With COVID-19 now tossed into the mix of viruses expected to circulate this winter, medical experts are even more worried about crowded hospitals and protecting the most vulnerable. Cleveland-area doctors are encouraging people to prepare as much as they can before the season is in full swing.

Spot the difference: flu, COVID, minor cold

While colds and influenza can spread year-round, incidences of these illnesses tend to increase during the fall and winter, generally peaking sometime between the months of December and February, according to the U.S. Centers for Disease Control and Prevention.

Many symptoms of colds, the flu, and COVID-19 are very similar, said Dr. Neha Vyas, a family physician at the Cleveland Clinic.

The flu and COVID-19 often present chills, body aches, and fever, while colds generally do not come with a fever, Vyas said.

A unique identifier of COVID-19 is the loss of smell or taste, she added.

鈥淭he rest of the symptoms can actually cross different respiratory pathogens, and that鈥檚 where it gets a little more complicated,鈥� Vyas said.

Because it is often difficult to tell the difference between these infectious diseases, Vyas recommends calling your primary care physician if you start feeling cold or flu symptoms, especially if you have underlying medical conditions or know you have been exposed to COVID-19.

Her office is already fielding many calls from patients with symptoms trying to determine what illness they have.

鈥淯p until now, people could kind of sense that 鈥榳ell, it鈥檚 just a cold, and I鈥檓 not going to call my doctors鈥� office for several days until I鈥檓 worried about a sinus infection or something more serious,鈥欌�� she said. 鈥淣ow, what we鈥檙e seeing is people who have had a day or two of symptoms and, of course, they鈥檙e obviously concerned about COVID, and I would be too, so they call us a little bit earlier.鈥�

Flu shot more important than ever

It鈥檚 a good idea to get the flu shot as soon as you can because if a COVID-19 vaccine becomes available in the U.S., doctors will likely have to pivot to meet the demand to administer it, said Andrew Heffron, the clinical supervisor at the Cuyahoga County Board of Health.

鈥淎 lot of our infrastructure is going to be moved to that, and so to get the flu vaccine while you can now before that complexity is added to it, and the demand, is just a good move right now,鈥� he said.

Doctors point to pharmacies and drive-thru clinics as places where you can receive your flu shot if you are not going to places where you would normally get it, such as the doctor鈥檚 office, school, or work.

Not much is known yet about the strain of flu that circulated in countries with earlier flu seasons than the U.S., such as New Zealand. However, early data shows the flu vaccine seems to be a pretty good match, said Dr. Christine Alexander, chair of family medicine at MetroHealth.

One promising observation is that these countries had milder flu seasons this year, she said.

Some speculate that because people were already taking precautions for COVID-19, such as masking and social distancing, it helped slow the spread of the flu as well.

The U.S. could possibly see a similarly mild season because of COVID-19 safety measures already put in place, said Alexander.

鈥淚f people really follow the recommendations of masking and handwashing and socially distancing, I do think we have a really good chance at decreasing the spread of influenza,鈥� she said.

However, in the U.S., there has been greater pushback to wearing masks and other safety precautions than in other countries, Alexander said.

In Ohio, Gov. Mike DeWine has recently expressed concern that cases of the coronavirus seem to be surging because residents have let their guard down and are not wearing masks in public as much as they were at the beginning of the pandemic.

Alexander said she is not sure if the U.S. will be able to contain the flu, as well as other countries, did this year.

鈥淲e have freedom of choice. The downside of that freedom is that when we say, 鈥榟ere鈥檚 what you should be doing,鈥� there will be a piece of the population who, very legally and lawfully, can say, 鈥榯hat鈥檚 not right for me, and I鈥檓 not going to take those steps,鈥欌�� she said. 鈥淭hat may keep us from keeping the flu as contained as we could.鈥�

Still, those who are taking safety precautions and following the guidelines are helping to prevent the spread of both the flu and COVID-19, Vyas said.  However, people should not have a false sense of security, she said.

鈥淭hat鈥檚 the thing about cold viruses 鈥� sometimes, it鈥檚 just your own immune system, that you might be under the weather. You might have picked something up, and it鈥檚 not that you鈥檙e not following all of those things,鈥� she said. 鈥淚 get that question a lot 鈥� 鈥榳ell how did I pick this up, because I did everything right?鈥� and those are the times where I鈥檓 not able to give an answer," she said.

Doctors continue to advise the public to take general precautions, such as disinfecting surfaces and washing your hands frequently, to protect against all of these viruses.

Plan ahead

There is no need to panic and stockpile groceries or supplies at this point, Vyas said. People should, however, have common cold medications on hand, as well as items that help relieve symptoms, like popsicles, Pedialyte, and water bottles, Alexander said.

For people who pick up their prescriptions in-person, it might be a good idea to start getting refills through the mail, Heffron said.

鈥淚 think my brother said it best, where he said 鈥� we鈥檝e been preparing for COVID for the last 20 years, by moving to shipments and home delivery for everything,鈥� he said. 鈥淚 think, if you can get mail-order prescriptions, that鈥檚 definitely the way to go.鈥�

Alexander recommends getting established with a primary care physician now so that you can give them a call with any questions or concerns when the sick season hits full swing.

鈥淭ry to stay on top of your medical care because if the health concerns that you have are not well-managed heading into this season, they can only be made worse by you getting influenza or COVID,鈥� Alexander said.