Everyday care
Cold, flu or COVID? And when it needs a doctor
Most respiratory infections get better on their own, and most do not need antibiotics. The useful question is not which virus it is, but whether you are the sort of person, or at the sort of point, where it needs looking at.
The short version
- A cold builds slowly and stays mostly above the neck. Influenza tends to arrive suddenly with fever and aching all over.
- You cannot reliably tell COVID-19 from influenza by symptoms alone. A test is the only way to know.
- Antibiotics do not work on viruses. Most of these illnesses need rest, fluids and time.
- Breathlessness, chest pain, confusion, or a child who is difficult to rouse mean urgent care, not an appointment next week.
Every winter the same question comes across the desk: is this just a cold, or is it something else? It is a reasonable question, and the honest answer is that the label matters less than most people think.
What tends to distinguish them
A cold
Comes on gradually over a day or two. Mostly above the neck — sneezing, a blocked or runny nose, a sore throat, a cough. You feel unwell but usually well enough to get through the day. Fever is mild or absent in adults. It typically settles within a week, though a cough can linger considerably longer.
Influenza
Tends to arrive suddenly, often within hours. Fever, shaking, aching muscles, headache and exhaustion that is out of proportion to anything else. People frequently describe being unable to get out of bed, which is not typical of a cold. Recovery takes one to two weeks and the tiredness outlasts everything else.
COVID-19
Varies enormously. It can be indistinguishable from a cold or from influenza. Loss of taste or smell is more suggestive but is far less common than it once was. You cannot tell reliably from symptoms — a rapid antigen test is the only way to know, and it matters mainly because it changes what you should do about protecting other people.
When to book an appointment
Ring us if any of these apply:
- Fever that persists beyond three or four days, or that settles and then returns
- Symptoms improving and then getting clearly worse again
- A cough producing discoloured phlegm alongside fever and feeling unwell
- Ear pain, facial pain over the sinuses, or a sore throat that is severe and one-sided
- Wheeze, or asthma or COPD that is harder to control than usual
- You are pregnant, over 65, or have a chronic heart, lung, kidney or immune condition
- It has simply gone on longer than you would expect
Go to an emergency department or call 000 for difficulty breathing or breathing that is getting worse, chest pain, confusion or unusual drowsiness, blue lips, an inability to keep fluids down, or a child who is floppy, will not wake properly, or has a rash that does not fade when you press a glass against it.
Why antibiotics usually are not the answer
Colds, influenza and COVID-19 are all viral. Antibiotics act on bacteria and do nothing at all to a virus. Taking them when they are not needed brings side effects with no benefit, and contributes to resistance that matters for everybody.
Your GP will prescribe them when there is a genuine bacterial infection, and will explain why when there is not. Being told you do not need antibiotics is a clinical judgement, not a brush-off — and it should come with a clear account of what to expect and what would mean coming back.
Antiviral medication for influenza and COVID-19 does exist and can help certain people, particularly those at higher risk of becoming seriously unwell. It is most effective started early, so if you are in one of those groups, ring on day one rather than day four.
What actually helps
- Rest, and more fluid than you feel like drinking
- Paracetamol or ibuprofen for fever and aches, if they suit you
- Saline nasal spray or rinses for congestion
- Honey for cough in anyone over twelve months old, which has better evidence behind it than most cough syrups
- Staying home while you are infectious, which is the single most useful thing you can do for everyone else
A note about coming in
If you have a cough, cold, sore throat or fever, ring us and ask about a telehealth appointment rather than sitting in the waiting room. Plenty of respiratory illness can be assessed over the phone, and it keeps the waiting room safer for the people in it who are least able to cope with catching something.
The other thing worth doing before winter: influenza vaccination, each year, ideally before the season gets going.
This article is general information. If you are worried about a symptom, book an appointment. In an emergency, call 000.
Questions we get asked
Do I need a test to know what I have?
Not always. If you are otherwise well and at low risk, the treatment is the same regardless. A test matters more if you are at higher risk of becoming seriously unwell, if antiviral treatment is being considered, or if you are around vulnerable people.
Can I get a telehealth appointment for this?
Often, yes, and it is preferable to bringing a respiratory infection into the waiting room. Medicare has eligibility rules about having been seen in person in the previous twelve months, so ring reception and they will check.
How long should a cough last?
A cough after a viral infection can persist for three to four weeks, which is longer than most people expect. Book an appointment if it lasts beyond that, if you are coughing blood, or if it comes with fever, breathlessness or weight loss.
General information only. This article is general health information for people in the Port Stephens area. It is not advice about your individual situation and it does not replace a consultation with a doctor. If you are worried about a symptom, book an appointment or call us on (02) 4008 4400. In an emergency, call 000.
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