Feeling sick? Here’s what to take and what to avoid, according to a doctor

People are getting sick with acute respiratory illnesses and visiting health care providers at high levels, according to data from the US Centers for Disease Control and Prevention. Seasonal flu levels are elevated across the country and increasing in many parts, while Covid-19 has also increased in most areas of the country.

Since many people are dealing with viruses in their households, I wanted to ask a physician what to do. Who should get tested and for which diseases? At what point should people see a health care professional for their symptoms? What over-the-counter treatments are helpful, and which ones are not? And before people get sick, what steps can they take to reduce their risk of contracting these diseases?

To learn more, I turned to CNN wellness expert Dr. Leana Wen. Wen is an emergency physician and clinical associate professor at George Washington University. She previously was Baltimore’s health commissioner.

CNN: When should someone who is sick get tested to learn what’s causing their symptoms? 

Dr. Leana Wen: Most people with symptoms of respiratory illness do not need be tested. That’s because there are hundreds of viruses that can cause the common cold, and most healthy people with run-of-the-mill symptoms like a runny nose, congestion and fatigue don’t need testing to identify the type of virus or to distinguish between these viruses from the flu or Covid-19.

There are two instances where people should consider testing. The first is if they would qualify for antiviral treatment for Covid-19 or influenza. These are individuals at high risk for developing severe illness from these two viruses, including older individuals and people with significant underlying medical illnesses.

For them, early diagnosis is essential, as antiviral treatment should be started as soon after symptom onset as possible. People can take home tests, and they can also visit a health care provider to get tested.

The second is someone who is very ill. That’s because a patient who is very sick with influenza may be recommended for antiviral treatment, even if they are otherwise generally healthy. Also, a person who has persistent fevers, severe coughing and trouble catching their breath may need additional medical treatment to help stabilize them. They may also not have a virus — or perhaps they had a virus initially, but then they also developed a bacterial infection that may require antibiotics. Such individuals should visit a health care provider, and further testing may be recommended.

 

CNN: What are other reasons that people should see a health care professional?

Wen: One is to receive antiviral treatment if someone is in the category of individuals eligible for antivirals. Two is if they have severe or persistent symptoms. I’d add here, too, concerning and unusual symptoms.

For instance, while a cough and fever are expected as part of respiratory infections, it is unusual if someone has abdominal pain and starts vomiting. It’s concerning if someone is coughing up blood or develops chest pain. These symptoms should prompt a visit to a health care professional.

Moreover, people with serious underlying medical conditions should consider contacting their providers early. Someone who has cancer, who has undergone an organ transplant, who has heart failure, who is pregnant or has a young infant — these are all individuals in need of having a plan in advance of getting ill.

Those individuals for whom viral illnesses can trigger underlying problems should also make a plan with their provider for what to do if they become sick. Some patients with asthma or chronic obstructive pulmonary disease, for instance, may preemptively increase their inhaler dose or start using a nebulizing machine if they contract a respiratory virus. Again, these plans should be discussed with their provider, ideally before they fall ill, and certainly as soon as they start having symptoms.

CNN: What over-the-counter treatments are helpful? What should be avoided?

Wen: If someone has a fever and body aches, acetaminophen and ibuprofen are effective over-the-counter oral medications that can be taken to reduce these symptoms. They are different medications and can be taken together for maximal effect.

Make sure to always read the label and follow instructions for use. Children need to use the right doses for their body weight. Adults should also use the right dose, which means not taking too much but also not taking too little. I have seen quite a few patients who claim that these medications do not work but in fact are using a much lower dosage than is appropriate for them.

For people with cough and congestion, there are a number of over-the-counter remedies available. For instance, dextromethorphan can suppress coughing, and oxymetazoline and pseudoephedrine can be used to reduce congestion. These products may help some individuals, but they must also be used with caution. Some of these ingredients have significant interactions with other prescription medications. They may also be included with other ingredients, like acetaminophen, and it’s important to make note of the ingredients so that you don’t accidentally take too much of something.

The US Food and Drug Administration advises that children younger than 2 years old do not use over-the-counter cough and cold medicines. They can, though, use acetaminophen and ibuprofen at the right doses as fever-reducers. Other treatments that can help are humidified air, lots of hydration and, of course, rest.

CNN: Finally, what steps can people take to try to reduce their risk of contracting these diseases?

Wen: Good hand hygiene can reduce the risk of spreading contagious diseases. That means everyone should wash their hands regularly with soap and water, and if this is not available, should use hand sanitizer.

Individuals who have a fever and active respiratory symptoms should stay away from others, especially those most vulnerable to severe illness. Vulnerable individuals should also consider taking additional precautions during winter respiratory virus season, including masking in indoor crowded settings.