From common colds to COVID-19-Respiratory infections update 2020

This year’s cold/flu season is complicated by a new player- COVID-19, caused by the SARS-CoV-2. If you get sick, please do not assume your illness is “just the flu” ; this could have serious, perhaps fatal consequences for you and your loved ones.

Where I live, North America, we’ve just observed the first day of fall, also known as the autumnal equinox. And especially in healthcare, we unofficially view it as the start of the “cold and flu” season. To those of you in the southern hemisphere, happy spring. You also have a respiratory illness season during fall/winter.

Respiratory infections

By “cold and flu” we means acute respiratory infections caused by a variety of viruses including

  • influenza
  • respiratory syncytial virus (RSV)
  • adenovirus
  • rhinovirus
  • coronavirus

and less commonly several bacteria, most commonly

  • Streptococcus
  • Mycoplasma
  • Haemophilus
  • Legionella
  • Pertussis (whooping cough)

These cause diseases called by various names including

  • colds/flu
  • influenza
  • pharyngitis (throat infection)
  • otitis media (ear infection)
  • bronchitis
  • sinusitis
  • pneumonia
  • laryngitis
  • COVID-19
  • whooping cough
  • bronchiolitis-infants and children
  • croup-mostly children

This year’s cold/flu season is complicated by a new player- COVID-19, caused by the SARS-CoV-2.

Acute vs chronic

We call these illnesses acute because they (usually) come on fairly suddenly, run their course within a few days to sometimes a few weeks, and then resolve. Sometimes they don’t resolve and become chronic.

Some underlying factor may prevent healing. There may be a chronic condition that is out of control, or has not been previously diagnosed. You may need a doctor’s evaluation to determine whether it’s “just a cold” or perhaps asthma, COPD ,or allergic rhinitis.

Many of these illnesses tend to occur seasonally, such as influenza and RSV. Others can occur year round. So far we don’t know if COVID-19, due to the SARS-CoV-2 , will be year round or seasonal. Unlike influenza, it did not abate during the summer this year.

What are respiratory symptoms?

Symptoms of respiratory illness involve some combination of the nose, sinuses, ears, throat, larynx (voice box), trachea, bronchus, and lung

  • Sneezing, stuffy  or runny nose,
  • Sinus pain, pressure
  • coughing, wheezing, shortness of breath
  • sore throat, hoarseness
  • ear pain, fullness

often along with systemic symptoms such as

  • fever and/or chills
  • body aches, fatigue, 
  • nausea, vomiting, diarrhea 
  • headache
  • loss of appetite


Coping with respiratory illness

Although these infections make us miserable and can temporarily disable us from work and school, most otherwise healthy people recover uneventfully, even from COVID-19. Nevertheless, we should take them seriously.



Don’t panic.

Fever ,especially in children, alarms parents. Don’t ignore it but don’t panic either. Reading this post should help you keep calm about fever .

a woman taking her temperature
This photograph depicted a woman who was using a modern, battery-powered oral thermometer, in order to measure her body temperature. In order to return an accurate reading, this particular type of thermometer needed to be placed beneath the user’s tongue, for a set amount of time, beeping when the ambient, sublingual temperature was reached. Photo credit-James Gathany, CDC, public domain

Some  people are at risk of developing  severe symptoms and serious complications from respiratory illnesses, so seek medical help sooner, rather than later. These include

  • Infants, especially under one month old
  • Older adults,starting at about age 50, with risk increasing with age, especially combined with chronic disease
  • Those with chronic lung disease, like asthma, COPD, emphysema, cystic fibrosis
  • People who smoke cigarettes or vape
  • People on medications or with diseases that suppress the immune system
  • Serious chronic diseases – diabetes, liver disease, kidney disease, heart disease, cancer 
  • Obesity (a risk factor for COVID-19 complications)
  • Pregnancy

If you are not sure if you fit into one of these categories, ask your doctor.

Stay home.

These illnesses spread person to person, so minimize contact.

Keep your kids home from school and stay home from work, at least the first few days, when you are  the most contagious. When  there is widespread illness in your community, avoid crowds and public gatherings.

Resting, getting extra sleep, drinking fluids and staying warm and dry  make staying at home therapeutic.

Wash hands.

Speaking of person to person contact, the best way to avoid getting or giving germs is to wash your hands often, but especially after being with others ,using a restroom,  and before cooking or eating. Cleaning household surfaces helps too, as well as clothing and linens. Don’t forget to clean your cell phone, tablets, and keyboards too. Use hand sanitizer if hand washing can’t be done.

Wear a mask

You probably remember that early on in the pandemic, the CDC did not recommend wide spread wearing of masks. I suspect this was to prevent hoarding of masks (remember toilet paper? ) and because they did not know how widely the virus was circulating in the United States.

But that has changed; when experts learn new information they reassess and update recommendations. Whenever you expect to have close contact with people outside your household wear a mask that covers your nose and mouth. In some situations, eye coverings are also warranted but that is not universally recommended now.

Use medication wisely.

Some of these illnesses have a specific medication that clear it faster- strep throat, influenza, pneumonia. The others will “run their course” and meds are used to help relieve symptoms.

Many people assume that any illness with fever, sore throat and cough will improve with an antibiotic. The fact is, most will not. Antibiotics only treat infections caused by bacteria, and most of these are caused by viruses. To learn more read about

These illnesses cause the greatest overuse of antibiotics, contribute to the cost of health care, and the development of antibiotic resistance. Please do not insist on an antibiotic if the doctor says you don’t need it; if offered an antibiotic, ask why.



6 smart facts about antibiotic use


 Be patient

The “24 hour virus” is for the most part a myth. Expect to be ill anywhere from 3 to 10 days; some symptoms, especially cough, can linger for weeks. If you are a smoker, this is a great time to quit. 

But if after 7-14 days you are not getting better or are getting progressively worse, something more may be going on, so it’s wise to seek professional medical help.

Is it flu or is it COVID?

The arrival of COVID-19 this year creates a dilemma since symptoms overlap other respiratory infections and the possible outcomes run the gamut of no symptoms to death.

So this year, if you develop respiratory symptoms, healthcare clinicians will likely test you for COVID-19 , both to guide your care and to protect your family, co-workers, and healthcare workers.

Please do not assume your illness is “just the flu” ; this could have serious, perhaps fatal consequences for you and your loved ones.

Prevention of respiratory infections

Respiratory infections don’t have to happen. We know that they are mostly spread person to person, so what we each do matters. So what can you do?

  • Stay home when you are ill.
  • Observe physical distancing when disease is spreading in your community.
  • Wear a mask when recommended by public health professionals.
  • Practice careful hygiene on hands and surfaces.
  • Get available vaccinations.




exploring the HEART of respiratory illness

I would love for you to share this  information (but not your germs) on your social media pages.

FLU VACCINE: We all have a role in protecting each other.
used with permission CDC

Thanks for following this blog. If you’re visiting, I would love for you to start following Watercress Words : use the form to get an email notification of new posts. Don’t worry, you won’t get anything else from me. I also want you to find and follow me on Facebook, Pinterest , Instagram, and LinkedIn .

                              Dr. Aletha 

How can we safely worship at church in a pandemic?

Many types of gatherings are important for civic and economic well-being; religious worship has particularly profound significance to communities and individuals, including as a right protected by the First Amendment.

in whom the whole structure, being joined together, grows into a holy temple in the Lord.  In him you also are being built together into a dwelling place for God by the Spirit.

Ephesians 2:21-22, ESV

The Holy Bible, English Standard Version. ESV® Text Edition: 2016. Copyright © 2001 by Crossway Bibles, a publishing ministry of Good News Publishers.

(Although this post addresses the Christian faith, I hope other communities of faith find this useful.)

San Fernando Cathedral, San Antonio, Texas

 “Closing” our churches

Many of us have not attended a religious service in person since March, when almost every activity outside our homes ceased in order to limit spread of SARS CoV-2 infection.

Unfortunately churches were lumped into the category of “non-essential”, although we all realize how essential our religious establishments are. But in the context of a serious viral pandemic, our public health professionals believed it was necessary to prohibit all large public indoor gatherings.

Of course, the “Church” never closes; people who consider themselves the Church practice their faith in places other than a designated building-in their homes, in a park, at work, online. My local church already had an online presence so we’ve never missed a week of having teaching and prayer.

My state opened relatively early, and my church reopened soon after. They arranged the sanctuary for social distancing, performed extra cleaning, and now require masks. However, due to our age, my husband and I have chosen to continue worshiping from home.

St. Hedwig Church in Chicago Illinois
St. Hedwig Church in Chicago Illinois

“Reopening” our churches

The CDC, state, and local health departments have issued guidelines for reopening public facilities of all kinds, including churches, and I encourage you to consult those. A private association of Christian physicians and dentists also developed guidelines specific to the needs of churches. (Although these guidelines are directed toward those who practice the Christian faith, I believe that others can apply them to their worship practices.)

7 recommendations for church gatherings during COVID-19
7 recommendations for church gatherings during COVID-19 from the Christian Medical and Dental Associations

The Christian Medical and Dental Associations, CMDA, had a specific purpose in writing their guidelines. As stated-

Part of the mission of CMDA is to glorify God by caring for all people and advancing Biblical principles of healthcare within the Church and throughout the world.

With that in mind, CMDA has enlisted several expert members to provide guidance to church leaders as they wrestle with the problem of re-opening their services within the ongoing COVID-19 pandemic.

Members of the association are all physicians and dentists-students, residents, clinicians, teachers, missionaries, and retired. And they are active members of churches all over the world. So they are in a unique position to consider both the needs of the Church and the needs of public health and safety.

CMDA Guidelines For Reopening Churches

  • Consider size of the area for enclosed gatherings to accommodate social distancing.
  • Offer communion using single use, prepackaged supplies.
  • For baptism, use heated and disinfected water .
  • Limit choir participants and assure adequate social distance , especially if unmasked.
  • Use extra precautions for congregational singing if not done outdoors.
  • For instruments, ensure social distance and limit sharing of equipment.
  • Social distancing, hand hygiene, and masks are recommended for all attendees.

I encourage you to follow the link to the full document which explains the reasons for the recommendations and includes links to pertinent references.

a simple white church flanked by autumn trees
a church in Talulla Falls Georgia

There is no guarantee that even with these measures cases of COVID-19 will not occur due to transmission at a church. Ohio has had several COVID-19 outbreaks recently, many of which the Ohio Department of Health traced to bars, restaurants, churches, and day care centers. Outbreaks in other states have been linked to attendance at church events, including weddings and funerals.

the purpose of these guidelines is to provide evidence-based recommendations for Christian communities who wish to reopen safely.

Though evidence-based, however, these guidelines are not intended to replace government ordinances or health regulations and should be considered in light of local guidance which account for the community prevalence of SARS-CoV-2/COVID-19 and available resources.



The Constitution and the CDC

Does closing churches for health reasons violate the Constitution? According to the First Amendment (the first ten amendments are called the Bill of Rights)

Congress shall make no law respecting the establishment of religion, or prohibiting the free exercise thereof; …

Amendment 1, the U.S. Constitution

I suppose it depends on your definition of “the free exercise” thereof.

  • Have we been told to renounce our faith?
  • Are we prohibited from owning or reading our Bibles and other spiritual writings?
  • Can we watch or listen to religious programs on television, radio, and the internet?
  • Can our clergy and teachers continue to preach and instruct?
According to the Centers for Disease Control and Prevention

“This guidance (about church activity during a pandemic) is not intended to infringe on rights protected by the First Amendment to the U.S. Constitution or any other federal law, including the Religious Freedom Restoration Act of 1993 (RFRA).

The federal government may not prescribe standards for interactions of faith communities in houses of worship, and in accordance with the First Amendment, no faith community should be asked to adopt any mitigation strategies that are more stringent than the mitigation strategies asked of similarly situated entities or activities.

while many types of gatherings are important for civic and economic well-being, religious worship has particularly profound significance to communities and individuals, including as a right protected by the First Amendment.

State and local authorities are reminded to take this vital right into account when establishing their own re-opening plans. “

Here’s another post you may enjoy reading
an open Bible next to a world globe

The place where God lives

And in him you too are being built together to become a dwelling in which God lives by his Spirit.








sharing the HEART of health, faith, hope, and love

Thanks for following this blog. If you’re visiting, I would love for you to start following Watercress Words : use the form to get an email notification of new posts. Don’t worry, you won’t get anything else from me. I also want you to find and follow me on Facebook, Pinterest , Instagram, and LinkedIn .

I took all of the photos in this post on vacations over several years. They are for illustration only, and do not represent CMDA or the guidelines described in this post. I am a member of the Christian Medical and Dental Associations but had no part in writing the guidelines,with which I agree.



FAITH LOVE HOPE- words created with letter tiles
These three remain, faith, hope and love, and greatest of these is love. 1 Corinthians 13:13

                              Dr. Aletha