Is there any way to distinguish coronavirus from other infections based on symptoms alone

Since there is a shortage of tests, is there any realistic or validated way to distinguish the coronavirus from other infections like flu, bronchitis, cold, etc based on symptoms alone and without a test?

For example, I read the cold causes a runny nose but coronavirus generally does not.

Bronchitis causes productive cough, coronavirus generally causes a dry cough.

I know at certain locations they are taking everyone’s temperature and sending people away with a fever. But wouldn’t a fever just narrow it down to one of those 3-4 likely illnesses (coronavirus, flu, bronchitis, common cold)?

First of all, bronchitis is not an infection; it’s a condition caused by infections such as flu or coronavirus.
And to answer your question, since symptoms for coronavirus, flu, and even the common cold are similar and overlap so much, there is no way you can distinguish one from the other without testing.

The most dominant element seems to be breathing difficulties. But if you have a mild case, that may not be all that apparent.

I have been sick recently, only one day off work. Had some body ache, but that went away a while ago. Some dry cough. Also runny nose, which isn’t a symptom, though some say you can have cold and coronavirus at the same time. So if it’s mild, you do probably need testing.

My son and I have had runny noses since early February, when there was some warm weather. It’s most likely allergies. In the morning, I have a cough, which cough medicine does 0 for, so it is probably post-nasal drip. Neither my son nor I have had fever in the slightest, shortness of breath, or fatigue, which are the top three symptoms of Covid-19.

To cover all the bases, I called my doctor. She said that with no fever or shortness of breath, I did not merit a test, and if my symptoms really began that long ago without getting better or worse, they were very likely allergies. She asked if OTC allergy meds helped. I said they did indeed. She said, don’t worry, and keep taking them.

At that point, there had not been a case in Indiana, but I had been in CA with my son from Dec. 28-Jan. 3. I told her that too. She said I still shouldn’t worry.

So apparently the big 3 symptoms are 1) fever; 2) shortness of breath & 3) fatigue; in that order. If you don’t have at least one of those along with your runny nose and cough, they won’t test you.

Albeit, it may be different if you have a KNOWN CONTACT, or if you can’t claim your symptoms have persisted for weeks unchanged.

However, you might, at this point, get told that if you have allergies, they make you vulnerable, now that the virus is more common.

Here is a chart published on Daily Kos that shows comparative symptoms. Hope it is of some use.

At the prison my son works at, they had severely ill inmates with all of the symptoms of COVI19. The physician at the prison thought they had it and the Florida Department of Health thought they had it. Testing was negative for COVID19, positive for influenza.

A positive test is really necessary.

My daughter had the fever and dry cough, no nasal congestion. She tested negative, but was told that the test has a 30% false negative rate. Is the testing really that bad?

A family I know (mom, dad, 3 year old) was very sick with fever, dry cough, exhaustion, etc for most of March. They asked various doctors at various times about testing and were told they did not qualify. Mom and kid have gradually improved but dad is still sick.

Dad’s cough is still a problem so he sought a second opinion. That doctor, when he heard about all the family symptoms said they should have been tested. So dad got a test. The test comes back negative for COVID19 and the doctor explains that he’s no longer infectious, but likely had it.

On all the other hands, I’ve lately seen articles also saying that covid can present with gastronomic symptoms in addition to, or instead of respiratory symptoms: Nausea and diarrhea.

Clinical viral testing is hard - period. You have to get a good sample (nasopharyngeal, in this case), which is a non-trivial issue. There has to be enough virus present (some advanced cases have multiple negative NP swaps but positive with more invasive testing lower in the respiratory tract).

The virus has to be processed and extracted carefully and correctly. The amplification has to work correctly. And, remember, this is a new virus so every step of the process works but hasn’t been optimized yet.

Also a factor: the long prodrome period and significant patient variation means the hitting the perfect testing window where all of the above works out is…hard.

A 30% false negative is higher than I’ve seen (10-15% is more typical) - though that may be biased by the populations we’re testing, but I can easily see how that would be possible.

I’m thinking that the answer to the OP is “typically, no.” The disease has such a broad range of possible symptoms, including “none.” In addition, the various symptoms can be caused by any number of other things.

Here’s an excellent little table comparing the symptoms of Covid-19, Cold, Flu, and Allergies:

Thanks! I guess when they develop an accurate anti-bodies check, she can tested again and, if she had it, donate plasma or something. She seems to be on the mend.

I saw an interview with the Dr in charge of efforts in South Korea, and he said those presenting with symptoms would sometimes be asked to smell something strong, if they couldn’t, and had lost their sense of smell/taste they would assume a positive. He said it was remarkably reliable.

(Google AsianBoss, covid, SKorea)

The Pakistani National Institute of Health in their case definition for COVID19 instruct Doctors to consider patients with fever and acute respiratory distress as probable Covid cases in the absence of testing if no other diagnosis can explain the clinical presentation.