Cold Season Primer
by Dr. Wanda Filer M.D. updated by Dr. C.H. Weaver M.D. 10/2020
2020 Will create new challenges as the "common cold" the "flu" and COVID-19 infections all have some common symptoms and will be occurring at the same time. Read on for cold season coping strategies and guidelines for diagnosis and treatment.
We’ve all heard the bad news: there is no cure for the common cold. But how do you know if you have a run-of-the-mill viral cold or something more serious like COVID-19 or Influenza? When should you seek medical attention? And what are the best treatments for the symptoms.
Defining A Cold
When we talk about a “common cold,” we’re talking about a virus (most often a rhinovirus), which triggers symptoms that may start with a sore throat and runny nose and can include coughing, sneezing, watery eyes, headaches, and body aches.1 These symptoms last about seven to 10 days, and most adults average two or three colds per year (children can have more).1 While the symptoms can be annoying and may result in a few missed days of work, most adults who come down with a cold will recover within that 10-day window.
If you have a viral cold, there is no miracle remedy, but there are steps you can take to feel more comfortable. Wanda Filer, MD, MBA, FAAFP, president of the American Academy of Family Physicians, says the best approach is to treat symptoms and get adequate rest. Though the most effective strategies will vary depending on the severity of your various symptoms (see chart on page 46), maintaining adequate hydration should be a primary objective.
“Dehydration can come with a cold or flu because you’re congested, it hurts to swallow, or you’re stuck in bed,” Dr. Filer says. Though you may think that because you’re not active you’re not in need of as much water, the opposite is true. Symptoms of a cold can result in “insensible losses” of fluid, Dr. Filer says: “When you’re sick with a low-grade fever, you perspire more; when you’re congested you breathe faster and lose fluid by more rapid inspiration and expiration; when you’re sick you lose fluid more rapidly than is typical.”
Maintaining hydration in these cases is important because it helps move mucus through your sinuses and chest, allowing you to clear the congestion and avoid more-serious infection. To help ensure that you are getting enough liquid, Dr. Filer advises, “Keep an eye on your urine; if it’s dark yellow, you’re dehydrated.” Clear liquids (water and tea) are ideal, she adds, though sports drinks can also be helpful.
Hydration and rest are important steps regardless of your symptoms, as is patience, Dr. Filer says. A cold can last as long as 10 days, and a cough from a cold can linger longer—up to several weeks. Ultimately, she says, “there is no magic answer—time is the treatment for most common viral cold symptoms.”
To See The MD Or Not To See The MD, That Is The Question
There is no doubt that a nasty cold can lay you low, and we’ve all had that moment of wondering if what started as a cold has progressed to something that requires a visit to the doctor. Dr. Filer says that, as a general rule, if you’ve been sick for less than two weeks, your fever has remained below 102 degrees, and you haven’t developed shortness of breath or severe body aches, managing your symptoms and getting rest is likely a good call.
If, however, you develop a high fever, significant aches, shortness of breath, or very localized sinus or headache symptoms, a call or visit to your provider is a good idea. And if you have a compromised immune system or any existing chronic condition, such as asthma or chronic obstructive pulmonary disease, it is always better to play it safe and seek medical care at the onset of symptoms.
Cold Versus Flu or COVID-19
In some cases, symptoms that you might initially think are related to a cold may actually be the beginning stages of an influenza virus, or the flu. It could also be COVID-19. The difference in symptoms, Dr. Filer says, is the severity: “If you’re running a fever higher than 102 degrees, accompanied by intense body aches (especially in the back, arms, and legs) and significant discomfort in your chest (influenza is a lung infection), you may have flu or COVID-19.”
This Flu season it will be especially important for individuals to know if they have COVID-19. If individuals develop any symptoms that should assume they have COVID-19 and act accordingly until they can get a test. This includes distancing, hand washing, and staying away from "at risk" individuals. There are several rapidly available tests and individuals with symptoms should get tested promptly.
The key to treating the Flu and COVID is getting to the doctor early on in the progression of the illness—ideally within the first 48 hours. Both anti-flu medications, and anti-COVID mediations work best when administered within the first 48 to 72 hours.
The most effective strategy to avoid being hit by the flu is to get a flu shot—a dose of flu vaccine. While it’s ideal to get a flu shot early on in the fall when the vaccine first becomes available, Dr. Filer notes that it’s never too late in flu season to get the vaccine.
Cold Medicine Is Not Recommended For Young Children
It is hard to see your child come down with cold symptoms. Stuffy nose, cough, sore throat—all symptoms we know are uncomfortable and get in the way of kids’ school schedules and activities. But while it may make a parent feel better to offer up fruity cough syrup or similar over-the-counter medications, Dr. Filer says that consensus among physicians is that the potentially harmful side effects of these medications, which are often overdosed by parents wanting to alleviate their children’s discomfort, outweigh their benefit.
“There is no evidence to show that over-the-counter cough and cold medicines are good for kids; in fact, there’s advice against giving kids these medicines,” she says. “We generally don’t recommend them for children.”
Antibiotics Will Not Cure A Cold
Antibiotics are not an effective treatment for a cold virus. “The majority of head colds are viruses, and we know that antibiotics do not work on viruses,” Dr. Filer says. Antibiotics treat bacterial infections, which can develop as secondary infections in the wake of a cold but are not the same.
Dr. Filer says that often a red flag in determining whether a cold has become a bacterial infection is “double sickening”—when you feel your health was actually improving but are then hit hard again by worsening symptoms. “That sequence tells me you may have moved from a viral infection to a secondary bacterial infection,” she says. In that case, antibiotics may be prescribed after a thorough examination and, sometimes, lab tests to confirm the bacterial diagnosis.
Natural remedies can provide relief from uncomfortable symptoms.
Cold season is in full swing. Unfortunately, there is no cure for the common cold—it just has to run its course. When you’re sidelined by the sniffles, it’s tempting to race off to the drugstore for an over-the-counter drug that promises relief—but there are several natural remedies that can provide relief without side effects. These remedies won’t “cure” what ails you, but they can make you more comfortable and they might even shorten the duration of your cold.
If you’re tired of sniffling, sneezing, and coughing, try one of these natural remedies and see if you can find some relief from your nagging symptoms.
Use a humidifier. Winter air is cold and dry, which is especially irritating to sore throats and nasal passages. If you’re feeling congested, a humidifier can help clear that congestion. Place a humidifier in your bedroom so that you can breathe easier while you sleep. Even after the cold has run its course, you may want to consider making the humidifier a habit during the winter months. For an extra dose of relief, add a few drops of eucalyptus oil to the humidifier.
Just add garlic. Garlic has many antiviral, antibacterial, and antifungal properties. It has been used in medicinal practices in Asia for centuries. While garlic won’t “cure” you, it can boost the immune system. Some evidence indicates that mega-doses of garlic at the first signs of a cold can reduce the severity and duration of symptoms. One to two garlic cloves a day may help alleviate the symptoms of a cold. Chopping the garlic will help activate the allicin, which is the ingredient that combats colds. Steep the chopped garlic with hot water, lemon, and honey for an immune-blasting tea. If you’re not a fan of garlic, garlic supplements are available
Drink tea. Tea won’t make your cold go away, but it might make you feel better. There are several herbal teas on the market that promote relaxation. Furthermore, tea is a great way to warm up when you’re suffering from the chills associated with colds and flu. To make a homemade cold-fighting tea: boil water, fresh ginger, lemon, cinnamon, and a dash of cayenne. Sweeten with honey or maple syrup.
Steam shower. A steam shower or steam room is an excellent way to ease the congestion associated with a cold. A steam room is sort of like a supersonic humidifier—the heat and steam can loosen up the mucus and provide some relief. Some steam rooms even add eucalyptus or peppermint oil for further relief.
Homeopathics. There are several homeopathic remedies on the market that target specific cold-related symptoms. Consult a holistic practitioner to find the homeopathic remedy that matches your specific symptoms.
Neti Pot. A neti pot is a small pot that can be filled with warm saline water and used for nasal irrigation. Neti pot enthusiasts swear by this method as a way to both prevent colds and reduce congestion when a cold has set in. You can find neti pots in many health food stores.
Rest. Let’s not forget the most important remedy of all—sleep. Once you’ve been afflicted by a cold, the only thing to do is stop and rest and let your immune system do its job.
Remember, this too shall pass. Here’s to a healthy winter!