A sick student leans their chin against their notebook while writing and cradling a mug.

Back to School: What’s the Difference Between COVID-19, Flu, and Colds? Using Schmitt-Thompson Protocols to Evaluate Student Symptoms

As students return to the classroom, it’s common for a certain percentage to contract and spread diseases. Students recognize this fact, and — up until COVID-19 — probably gave it little thought. Now, three years into the pandemic, more parents and students are concerned about knowing the difference between COVID-19, flu, and colds. We’ve discussed before how Schmitt-Thompson protocols are valuable to college campus health clinics in addressing behavioral health. The same applies here. 

Read on to learn how these nurse triage protocols can help schools, nurse lines, and students understand their symptoms.

A Word About Schmitt-Thompson Protocols

As you may be aware, these nurse triage protocols were developed by Drs. Barton Schmitt and David Thompson. They cover all types of medical symptoms affecting pediatric to geriatric patients, and come in daytime and after-hours versions. 

Protocols are updated annually, after major medical events, and on a case-by-case basis when requested by a certified medical professional. 

Telephone and telehealth triage nurses can use these protocols to evaluate patient symptoms based on severity, including those related to cold and flu, and guide those patients to the appropriate providers for care.

Addressing the Spread of COVID-19, Flu, and Colds

Generally speaking, there are common steps that students can take to prevent the spread of COVID-19, flu, and colds. Washing hands periodically, taking steps to maintain general health (plenty of rest, hydration, eating well, exercise, and stress-reducing activities), as well as wearing N95 face masks where deemed appropriate can all contribute to mitigating the spread of viruses and bacteria. 

In cases of the flu and COVID-19, getting annual vaccinations is also highly encouraged. Even when experiencing possible breakthrough infections, students have symptoms that are typically milder compared to those who are unvaccinated. 


The common cold is still very prevalent — the average adult will come down with it three to four times a year. While it lacks a cure, there are steps that students can take to avoid contracting it, as well as lessen their symptoms if infected. 

While colds are rarely a cause for concern, cases of it that do become serious often affect older adults or those who are immunocompromised, and have the potential to lead to medical conditions like bronchitis or pneumonia. 

Students with colds often have symptoms including:

  • A dry cough that lasts two to three weeks.
  • A low-grade fever that can last two to three days.
  • Headache.
  • Muscle aches.
  • Postnasal drip.
  • Nose congestion.
  • Sneezing.
  • A sore throat.

Because these symptoms are typically mild, a triage nurse would likely advise a student to manage their care at home and only call back if:

  • Their fever is over 104 °F, or continues for more than three days.
  • Their runny nose lasts for more than 10 days.
  • They experience shortness of breath or difficulty breathing.
  • Their cough lasts over three weeks, or persists two hours after taking a cough treatment.


The flu is caused by the influenza virus that affects the nose, throat, trachea, and bronchi. It’s highly contagious, often needing only two to three days to incubate, with symptoms showing in one to four days after infection. 

Symptoms that students may exhibit, although resembling those of a cold, tend to be more pronounced in the case of the flu:

  • A fever of 100 °F or higher.
  • Cough.
  • A sore throat.
  • Runny nose.
  • Muscle or body aches.

A test is the only way to determine if a student has the flu. Based on symptom severity, they may be advised to use at-home treatment, or talk to their primary care physician about medication options other than OTC. As previously noted, students are encouraged to get yearly flu shots to prevent spread.


Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2), the strain that causes COVID-19, has mutated several times over the course of the pandemic. The Omicron variant now appears to be the most dominant. Due to a combination of vaccination, spread, and immunity, the virus was deemed “an established and ongoing health issue and no longer constitutes a public health emergency of international concern (PHEIC)” back in May of this year. However, it still poses a risk to those with preexisting health conditions (for example, heart disease) or those who are immunocompromised.

While a new vaccine is being developed to address the current variant, there are concerns that this fall will see a new wave of transmission and illness. 

After infecting the lower respiratory tract, symptoms of COVID-19 can include:

  • Chills.
  • A fever.
  • Cough.
  • Fatigue.
  • Loss of taste or smell.
  • Muscle pain.
  • Shortness of breath.
  • Anorexia.

COVID-19 cannot be confirmed without a lab test. Because specific symptoms and their severity can vary based on the individual who is infected, a student could easily think they have the flu or a cold instead. This also means that nurses must look at symptom severity when using Schmitt-Thompson protocols to determine if a student should stay at home or seek care from a provider.

If symptoms are mild, the student may be advised to self-isolate until an at-home test can confirm that they have COVID-19. Or, if they choose to meet with a physician for diagnosis and treatment, they will likely be advised to wear a mask to mitigate spread of the virus.

Triage Services That Use Schmitt-Thompson Protocols

These protocols are available for purchase on their own, but they’re often more effective when integrated with nurse triage software like myTriageChecklist. This intuitive solution allows triage nurses to document all interactions with student callers and share that information directly with any referred providers, thus improving continuity of care and reducing provider liability.

For those health providers that may not have the ability to implement their own dedicated nurse triage line, we have an outsourced medical call center that can serve as an extension of their practice. Nurse Triage On Call is staffed by registered nurses who are available to answer student health concerns 24/7, use protocols to evaluate their symptoms, and make sure that they receive the proper types of care in the appropriate windows of time.

Let’s Discuss a Program

We want you to have the tools and capabilities to help students get the care they need. When you’re ready, contact us to discuss how you can empower your organization with our customized protocols and services.

About TriageLogic

TriageLogic is a URAC-accredited, physician-led provider of top-quality nurse telehealth technology, remote patient monitoring, and medical call center solutions. Founded in 2007, the TriageLogic Group now serves more than 22,000 physicians and covers over 42 million lives nationwide.

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