How Not to Mistake Lyme for Coronavirus

It’s tick season again.

Flu-like symptoms, fever, malaise, fatigue. Sounds familiar, right? These are often the base symptoms for Lyme disease, a tick-borne illness that effects outdoor enthusiasts in unfortunate numbers. Coincidentally, these are also symptoms that mirror COVID-19.

Chart for identifying the most common ticks. Photo courtesy of

Each year, hikers head to the trails and are exposed to ticks. Many people are spending more time exercising outdoors this year a way to relieve stress during the coronavirus lockdown. This year, on top of the risk of Lyme, we have added the layer of COVID-19. Typically, when flu-like symptoms develop in anyone who spends time outdoors where ticks are common, tick-transmitted diseases like Lyme come to mind.

Learn the difference, and interaction between COVID-19 and Lyme disease so you can reduce your risk.

Lyme Puts You at Greater Risk for COVID-19

Lyme disease can make you more vulnerable to complications from coronavirus. Post-Treatment Lyme Disease Syndrome (PTLDS) is a complication of Lyme disease, whereby patients continue to suffer from pain, fatigue, cognitive impairment, and poor function. “Lyme Disease should be classified as another co-morbidity when it is associated with coronavirus. Lyme as a chronic infection requires your immune system to be working overtime and therefore leaves you more vulnerable to complications to a virus like COIVD-19,” says Jason Stein, a functional medicine practioner who specializes in tickborne illnesses.

What happens in those individuals struggling from coronavirus is a cytokine storm—  the body’s immune response going wild. The cytokines that raise immunity activity become too abundant and the immune system goes out of control, attacking healthy tissue and blood cells. Doctors are only recently coming to understand this negative response and how to treat them. “Interestingly, the cytokine storms or inflammation that create havoc in people who are struggling with COVID-19 also occur with Lyme disease and co-infections,” Stein adds. “There are some lessons we can take from the treatment of Lyme—There have been documented cases of patients who have benefited from using the same treatments that manage cytokine storms with both Lyme and COVID-19.”

If you contract Lyme disease this year, or have already had it, be hyperaware of these potential risks.

Learning the Different Symptoms

Graphic by Effie Drew.

The characteristic bull’s-eye rash is sometimes the telltale sign of Lyme disease, but it doesn’t always show up. It can take up to 30 days to appear, and does so in only 70% of cases.

When it comes to detection, the virus and Lyme can cause confusion because the symptoms can mirror each other.

The base symptoms for both are fever, fatigue, chills, muscle aches, headaches, and shortness of breath. Since it attacks the respiratory system, any signs of congestion, sore throat, or trouble breathing suggest coronavirus. If you experience achy or swollen joints, a stiff neck, dizziness or a rash, signs point to Lyme.

Preventing Tick Bites and Lyme

The highest number of Lyme disease cases are in the Northeast and Mid-Atlantic. Photo courtesy of CDC.

The highest number of cases are in the Northeast and Mid-Atlantic, but Lyme cases  in the Midwest have been on the rise. Lyme cases are found from Virginia to Maine and reaching into Eastern Canada, with outside hot spots in California, Texas, and Florida. In 2019, the ATC reported one out of every 20 AT thru-hikers will contract this tickborne illness. If you’re hiking in these areas, it’s important to take precautions.

Ticks are most active during the warmer months, April through October. The ticks most likely to transmit the disease are in the nymph stage, the size of a poppy seed, which makes them very difficult to find.

Graphic by Effie Drew.

The best way to avoid contracting Lyme disease is by taking preventative measures when you’re outside.

  • Treat clothes and gear with permetherin. Use the mix to spray items yourself, or use the soaking method. You can also buy pre-treated clothing.
  • Wear light-colored clothing so ticks are easy to spot
  • Wear long pants and sleeves in tick territory
  • Apply DEET-based sprays to exposed skin

    Graphic, but this is what an engorged tick on a dog looks like. Use tweezers to remove it by the head. Photo courtesy of Just Birding.


  • Do nightly tick checks on the trail. If you’re hiking with a partner, have them check the areas you can’t see. (Pro tip: if you’re alone, use your phone on reverse camera – it’s like using a mirror to check tricky areas)
  • If you’re day hiking, shower and do a tick check as soon as you get home. The water will wash off any unattached ticks.
  • If going out for an extended time in tick country, ask your doctor to prescribe a course of Doxycycline or Amoxicillin prior to your hike. If you develop symptoms, you can take the antibiotics to avoid the hassle of going to a doctor who will simply prescribe the same medication.
  • If you have dogs, ticks can hitch a ride home on them and later attach to you. Conduct a thorough check when you return home at the end of the day. If your dog sleeps in your bed or tent with you, it’s important to be extra vigilant about this. (Pro tip: if there’s swimmable water nearby, have your dog jump in; this will wash off any unattached ticks).


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