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 often 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 


6 things you need to know to get through the flu season-update

When I first published this post, I didn’t know these same basic recommendations would also be helpful to fight a new and possibly deadlier infectious disease-COVID-19, caused by a different respiratory virus, the Coronavirus, which has spread all over the world beginning in December 2019 and now into the spring of 2020.

Influenza vs Coronavirus

When I first published this post, I didn’t know these same basic recommendations would also be helpful to fight a new and possibly deadlier infectious disease-COVID-19, caused by a different respiratory virus, the Coronavirus, which has spread all over the world beginning in December 2019 and now into the spring of 2020.

At this time, most of these points also seem to apply to COVID-19, except unfortunately, number 3; there is no vaccine and probably won’t be for many more months.

1. If you think you have the “flu”, you probably don’t.

To many people “the flu” is any respiratory illness characterized by  fever, cough, congestion, fatigue and aches. That term has become so nonspecific even we doctors use it that way. But flu should refer  to influenza,  one of many viruses that cause respiratory illness.

The other viral respiratory illnesses  are

  • rhinosinusitis, aka “colds”, upper respiratory infections-URIs,
  • bronchitis,
  • pharyngitis,
  • pneumonia.
The human respiratory system
The respiratory tract including the nose, sinuses, mouth, throat, trachea, bronchi in blue and the lungs (pink). Infections can involve the breathing organs from the nose all the way down to the lungs. (photo complimentary from Pixabay

2. If your doctor thinks you have “the flu”, you probably do.

Prior to the  “rapid flu” test, we doctors diagnosed influenza by the characteristic symptoms,  exam, and knowing there was an outbreak in the community. The test is helpful for confirmation but not 100 % accurate, and likely the Coronvirus test is not either.

3. The best way to prevent influenza is by vaccination.

The World Health Organization (WHO), Centers for Disease Control and Prevention(CDC) ,the National Foundation for Infectious Disease and  other reputable medical organizations recommend vaccination against influenza.

People refuse vaccination because they believe it is ineffective, unnecessary, dangerous, toxic, unnatural, subversive, and who knows what else.  I don’t think I or anyone else are going to change their minds.

My family and I always get vaccinations which have successfully protected us without side effects or adverse reactions. There are risks, just like there are with any medical procedure, or lots of other things we do in life. In this case we have decided the benefit outweighs the risk.

If you don’t want a “flu shot”, just say no. Your doctor doesn’t need or want to hear a speech; we’ve already heard them all.

4. Stay away from others if you are sick.

It’s not a coincidence that influenza outbreaks coincide with the American holiday season (approximately November through January). So to protect us all,

  • Stay home if you are sick, and ask your family, co-workers and employees to do the same.
  • Cover your nose and mouth when coughing or sneezing; use your sleeve, not your hand.
  • Keep your hands away from your eyes, nose, and mouth.
  • Wash your hands frequently, thoroughly, and long enough.
  • Wash frequently touched surfaces with disinfectant.
Hand hygiene saves lives.
a common sight now in public restrooms

5. If you do get sick, don’t ask your doctor for an antibiotic. It will not help. 

Antibiotics attack bacteria. Influenza and 99% of all respiratory illnesses are due to viruses.

There are antiviral drugs that will “shorten the duration and severity of symptoms” by 1-2 days, if started early. The effectiveness is uncertain for an illness that will resolve within 10-14 days regardless. But if it gets you back to school or work a day earlier, it may be worth the cost-they are not cheap drugs.

Otherwise, the treatment is“symptomatic” or “supportive” care:

  • Rest; eat and drink as normally as possible; extra fluids if running a fever 
  • Non-prescription cough/congestion /pain/fever meds

Acetaminophen for aches and fever

Lozenges for sore throat, cough, and congestion

Breathing moist air with the use of a humidifier  helps with cough and congestion

(the previous are affiliate links. )

6. You can die from influenza, but you probably won’t.

People die from complications of influenza, and infants, young children and the elderly have greatest risk.The most common fatal complication is bacterial pneumonia, infection in the lung. Influenza can also attack the nervous system causing brain inflammation (encephalitis and/or meningitis) and paralysis in the form of Guillain Barre syndrome .

an xray of healthy lungs with no signs of pneumonia.
Healthy lungs with no signs of pneumonia.

Persons with chronic illnesses like diabetes, lung disorders, depressed immune systems and cancer are at greater risk of complications and should always consult a physician if feeling ill. If you are not sure if you fall into that category, ask your doctor.

what you really need to know

We should all take influenza and COVID-19 seriously; consider my suggestions, talk to your personal doctor, keep up with recommendations from your local public health professionals, and do your part to keep your family and community well.

Here are some previous posts about infections .

Get Smart About Antibiotics

“Most common infections, such as colds, flu, most sore throats, bronchitis, and many sinus and ear infections, are caused by viruses and do not respond to antibiotic treatment. “

6 smart facts about antibiotics

“You may think of antibiotics as safe, harmless drugs with no potential for serious effects.  Usually antibiotics are well tolerated and safe. But serious side effects are possible, though infrequent.”

Sorting out sinusitis

“If you have a bacterial sinus infection with more than mild symptoms, an antibiotic may relieve symptoms and help you recover sooner. “

exploring the HEART of health

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 

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