A quick and dirty guide to survive this winter

Cartoon by Megan Stewart

The respiratory bugs are piling up.

Last month, it was RSV; now it’s flu. COVID is surging again. But they’re just the leaders of the pack; there are many others. People, especially with young children, may feel like they’re chasing one runny nose after another.

To make our lives easier:

First, I want to put one question to rest, “Can you tell what infection I have based on symptoms?”


And COVID is the only virus you can test at home. You need to call doctors to get tested for flu or RSV. At-home flu tests are not FDA approved.

Knowing which virus you have matters if you belong to the high-risk group (see cdc.gov/flu/symptoms for CDC definitions of “high-risk group” and “emergency warning signs" for flu). The treatments for COVID and flu are different, and the earlier you start the better the outcome.

COVID can be treated effectively by Paxlovid (free pills). When it came out last year, I was a believer: data showed Paxlovid reduced COVID hospitalization by 90% in the unvaccinated and 50% in the vaccinated. These are good outcomes.  

Weeks ago, COVID struck my family. My 89-year-old mother, who has frailty, stroke, dementia, and high blood pressure, came down with the sniffles and tested COVID-positive. She was started on Paxlovid within the hour. Mother suffered congestion for a day – and woke up the next day like nothing happened. (For full disclosure, she’s fully vaccinated.) Since then, I’ve been a rabid devotee of Paxlovid.

For flu, we have four drugs. The least expensive, Oseltamivir, is generic Tamiflu (GoodRx price for a 5-day treatment starts $14). All require prescriptions and are best taken within 2 days of symptoms. Drugs can cut your symptoms by a day – and might reduce the incidence of severe complications.

Next, about the flu vaccines, there’s good and bad news.

Good news first: During the flu season, different types of flu viruses hit at different times. A flu vaccine typically covers 3 to 4 strains. So far this year, the vaccine hit the bullseye for the first two flu strains, which are responsible for 99% of infections. Data shows it reduces hospitalization by 50 percent. This may change in the next weeks or months, but today is a good day.

More good news: For those over 65, CDC recommends any of three hyped-up flu vaccines that provide additional immunity.

Bad news: Vaccine lethargy is affecting flu vaccination. Those over the age of 65 account for 90% of hospitalization from flu, yet only 1 in 6 have received the flu vaccine.

When is a good time to get the flu vaccine?


Flu season is in full swing. After vaccination, it takes over 2 weeks for our body to develop combat-ready immunity. That said, if the flu season is going and you’re going, it’s never too late.

Finally, if you’re sick – stay home. CDC recommends those with certain warning signs (see the website above) for immediate medical care. If you belong to the high-risk group where early treatments matter, test yourself for COVID first, then call your doctor. It saves a step.

I have a new way of saying “I love you” – "I’ll drive you to get your COVID booster and flu shot today.”

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Volume 14, Issue 24, Posted 11:27 AM, 12.20.2022