MARA GORDON, HOST:
This is NPR's LIFE KIT. I'm Dr. Mara Gordon. I am a family doc. And right now we are in the middle of cold and flu season, right in the middle of - wait for it - an international pandemic. There are all sorts of ways people are getting sick right now. And here to talk with me about how to stave off all of the many viruses circulating with a vengeance is Dr. Amanda Davis. She's a pediatrician in Philadelphia, and her patients are kids - very germy kids.
AMANDA DAVIS: Kids especially get colds pretty year-round, but it certainly picks up in the fall-winter season. I would say around October is when we start seeing a usual uptick in the common cold and then eventually in the flu as well.
GORDON: So lots of runny noses these days - is that fair?
DAVIS: Tons of runny noses these days, yes.
GORDON: That's runny noses, which get wiped with little hands, which then touch everything around them. No wonder kids and their teachers and their friends and their families are always getting sick. So Dr. Davis has some ideas for getting little kids to wash their hands.
DAVIS: You can get a kid to do most things as long as you make it fun - so things like singing a song while they wash their hands.
GORDON: So I'm going to put you on the spot, Amanda.
GORDON: I saw in your bio that you are in a choir. Can you sing for us your song of choice...
GORDON: ...For the duration of hand-washing in order to make sure that kids are washing their hands long enough?
DAVIS: Oh, my God. I was not expecting this. All right.
(Singing) Happy birthday to you. Happy birthday to you. Happy birthday. Happy birthday. Happy birthday to you.
GORDON: Dr. Davis, you have a beautiful voice. And just as a PSA to make sure your kid's washing their hands long enough, you would do that twice. But that was lovely. You have a gorgeous voice (laughter).
DAVIS: Thank you.
GORDON: So this episode we've got for you - how to not get sick - tips from a multitalented pediatrician.
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GORDON: Let's dive in. We've got two doctors here full of advice that's good for both adults and kids.
Dr. Davis, what is the common cold? Please enlighten us. There's so many myths.
DAVIS: So the common cold is a little bit interesting to define. It's basically a constellation of symptoms. There's, you know, the runny nose, the coughing, the sneezing, the stuffy nose, sometimes sore throat. Oftentimes in kids, they can even have a little bit of fever with the common cold. But the interesting thing about the common cold is, actually, it can be caused by a number of different types of viruses. There are numerous different species and strains of viruses that can produce very similar symptoms that we all know as the common cold.
GORDON: So how is it different from the flu or strep throat?
DAVIS: Sure. So the flu is an illness that is similar in some ways to the common cold in that you do have some of that runny nose, the coughing, the sneezing. But the flu can often have more severe symptoms as well - fevers that can get pretty high, body aches that can be pretty bothersome. And then the other major difference between the flu and the common cold is that the flu is caused by one specific virus, although there are different strains of that virus. But the flu, as we know it, is caused by influenza, which is the name of the virus. The common cold is different than strep throat in that strep throat is really caused by one particular bug, one bacteria known as strep. And that bacteria can infect the throat, cause pain, cause pus in the back of the throat, certainly can cause fever. But typically with strep throat, you don't get the same coughing, sneezing, runny-nose-type symptoms that you can get with the common cold and with the flu.
GORDON: How do you get the common cold? And more importantly, how can you avoid getting the common cold?
DAVIS: So the common cold really is passed from person to person, and that can happen one of two ways, generally. It can happen with direct contact with somebody who is carrying the common cold, either through being too close to them when they sneeze or when they cough and inhaling those particles that they've just propelled into the air. And the other way you can actually catch one of the viruses that causes the common cold is by contact with an object that has been contaminated with somebody carrying a virus that causes the common cold.
So we call those objects - they're inanimate objects that can carry viruses. We call them fomites, and fomites can be anything from a door handle to a pencil. So if somebody is sick and, you know, sneezes on their hands and then opens a door, and then a healthy person comes behind them and opens that same door knob and then rubs their eyes or rubs their nose, they can introduce those viral particles into their body and then subsequently get the common cold.
GORDON: That sounds gross. Viral particles hang out. They hang out in the air, on our hands. They hang out on those fomites, like doorknobs and pens and keypads. It would be great if we had some sort of X-ray vision to identify them and steer clear. But alas, science has not advanced far enough yet for us to see viral particles with the naked eye.
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GORDON: Just as an FYI, researchers think that the virus that causes COVID-19 doesn't act in exactly the same way, and you're less likely to get COVID-19 than the common cold from surfaces. But even though every virus is a little different, our advice can help you with colds, influenza and COVID-19 alike. There are a few things that we can do to reduce our chances of getting sick. Spoiler alert - it's nothing you haven't heard before.
DAVIS: You have to maintain practices that almost assume that the cold viruses could be anywhere. And so what we encourage patients to do is wash their hands quite frequently just in case they come into contact with the viral particle on a surface. We also recommend patients to try to avoid touching their face as little as possible so that they don't introduce viral particles into their eyes or into their nose or into their mouth.
GORDON: That's really, really good advice. But of course, I'm thinking, you know, you're a pediatrician. You're seeing kids. It's so hard for kids to sort of adhere to these measures that you're recommending, which is probably one of the reasons that we see kids get sick all the time. So what's going on? Why is it that kids get sick constantly?
DAVIS: Yeah. There's only so much you can do in terms of counseling, particularly the younger kids. With the older kids, we can teach them a little bit about hygiene. But with, you know, toddler age, even going into middle school age, it is very challenging for those kids to have the self-awareness to make sure that they're washing their hands often or make sure that they're not touching their faces. And honestly, that's one of the reasons that kids get so sick so often.
Kids can have, you know, multiple common colds a month, and that can be completely normal and doesn't mean that there's anything wrong with their immune system. It just means that they're kids, and they're often exposed to viruses and other bugs that can make them sick.
GORDON: We definitely know that kids transmit the common cold. But researchers still don't totally understand what role kids play in transmitting the virus that causes COVID-19. There's some evidence that suggests COVID-19 might be totally different than the common cold when it comes to children and babies. But there's definitely going to be more research on this topic in the coming years. And remember that big push to encourage people to sneeze and cough into their elbows? That is totally real. It makes it less likely that you'll reach out and touch something with your hand covered in cold viruses.
And you know what else gets in the way of viral particles floating around after a sneeze? Masks. Dr. Davis and I talked about all the public health measures we put into action during this pandemic. How will mask-wearing and social distancing and all the regular hand-washing affect our likelihood of getting the common cold? Nobody knows for sure, but we agreed that it makes sense that these things could really help.
One question I get a lot is how somebody might know if they have the common cold versus something more serious. And when would you know if you need to see a doctor or not, or if you could just kind of tough it out at home?
DAVIS: Initially, that distinction might be a hard distinction to make. When it becomes apparent is when someone's symptoms aren't in line with what we would expect for the natural progression of the symptoms of the common cold. So typically, we often expect symptoms to last anywhere from five to seven days. We expect some, especially in kids, low-grade fevers every now and then. But if the child seems to be worsening over the course of five to seven days instead of getting better or the symptoms seem to be really prolonged or passing seven, upwards of 10 days, those things would be concerning as well. Particularly with children, we also expect that the fever typically wouldn't last more than five days. At five days of fever, I do like to have my patients come into the office so we can evaluate and make sure there's nothing else going on.
GORDON: And as a doctor who sees both kids and adults, I will add that this advice basically stands for grown-ups, too. If the symptoms are prolonged, give your doctor another call, come back in for another visit, and we'll see what's actually going on.
The thing about the common cold, which is this constellation of symptoms, as Dr. Davis puts it, is that we don't have a cure. And to create a vaccine, scientists would have to target hundreds or thousands of different strains, which could be really, really difficult. But even with no cure to speak of, we have another way to help you feel better.
DAVIS: Supportive care - care that is directed at treating symptoms, as opposed to care that is directed at eliminating the cause of the symptoms. So there's no treatment to eliminate the virus or the viruses that cause the common cold, but we certainly can make somebody more comfortable and treat those symptoms.
So what I recommend, especially for kids, is maintaining hydration. When kids feel bad, they tend to stop eating, and they tend to stop drinking. So your body is designed to be able to go a certain amount of time without eating. That's typically OK. But what we can't do for a very long period of time is go without drinking. And so I have my parents focus very much on pushing fluids, making sure the child is drinking. They don't have to be too worried about eating for the time being, but certainly giving them fluids. Now, if the child's not eating at all, sugar-containing fluids like Pedialyte or juice are probably a better option than water, but water is also a great option as well.
GORDON: So it sounds like fluids are really important. What medicines can help our patients feel better?
DAVIS: So I typically try to minimize medications for children in general. Certainly, I recommend things like Tylenol or Motrin to control fevers not because the fever itself is dangerous or is going to harm the child, but it can be really uncomfortable to have a fever. And other than that, I typically try to go towards more natural, less medication-type interventions for their other symptoms.
There have been a good amount of studies recently looking at the efficacy of honey and comparing it to certain cough medications. And cough medications, while they can help, can often come with side effects that we just don't like. And so I do prefer my parents to use honey to suppress some of the coughs that can be so disruptive, especially at night, for kids with colds. I will note that children under the age of 1 should not receive honey, but children over the age of 1 can safely receive honey for cough.
GORDON: Yes, and adults, you, too, can enjoy the natural benefits of honey as a cough treatment. In my professional opinion, cough syrups are pretty much a waste of money. Some of them have acetaminophen or ibuprofen in them, which will definitely make you feel better, and you can buy those medicines on their own. But the other active ingredients in cough syrup can have all sorts of unpleasant side effects, ranging from insomnia to excessive drowsiness.
Let me bust another myth while we're at it. A lot of my patients come in asking for antibiotics to treat cold symptoms. Here's the thing. Antibiotics are medicines which target bacteria. And colds - you got it - they're caused by viruses, which are a whole different ballgame. Prescribing antibiotics for cold symptoms won't help you feel better, and it might even make things worse. They can cause some really nasty side effects, like diarrhea and nausea. And the more we use antibiotics without good reason, the more bacteria become resistant to those antibiotics, which really hurts everybody.
But, OK, what about those immunity boosters and all those different potions and pills and vitamins in the drugstore cold aisle that claim to prevent colds?
DAVIS: There is very little data to support the usefulness of those types of products. Most of the products that are sold over the counter have not been studied, have not been shown to improve immunity in any way or shape. Things like vitamin C and zinc have been studied in the data. And what they have found is that vitamin C, in the average person, does not prevent the cold. Vitamin C, given on a daily basis at certain doses, can actually shorten the duration of colds, and zinc, taken daily at certain doses for a very long time, has actually been shown to be able to prevent colds and also shorten the duration of colds as well. But again, you would have to take zinc for at least five months on a daily basis, which could also predispose you to having things like nausea to experience those benefits. Other than those two things, there really hasn't been much data to support any immunity boosters.
GORDON: I'm curious, Dr. Davis. Does going out in the cold cause the common cold?
DAVIS: So that is a myth I think all of us have heard at some point in our lives. I think all of us heard from a parent not to go outside because we would get sick. And we're not exactly sure why people tend to get sicker in the colder months. That certainly is true that the common cold, the prevalence of it, seems - and flu - the prevalence of those two illnesses certainly goes up in the colder months. What people think is happening is that during the colder months, people are congregating inside in closer quarters with each other, and the spread of illness happens faster. And there's also some thought that perhaps some viruses are more likely to survive in colder and in less humid weather conditions. But there's not any strong evidence that being cold as a human predisposes you to getting the common cold.
GORDON: I would say that remembering to go outside and exercise is incredibly important in the colder months. Getting enough exercise and sleep - it might help you fight off colds. The research isn't totally clear on this. But it's good for you anyway, so I say, go ahead. It definitely has my stamp of approval.
Another thing to note - if you do get sick, please don't go into work and expose your colleagues to your cold. If you have sick days, please take them. And if you happen to be working from home, it can be tempting to just power through. After all, you aren't going into work, and you're not going to contaminate your colleagues. It's a personal choice, but I encourage you to feel empowered to take some time off. Don't push your body harder than feels comfortable. This is a tough year. Take some time off to rest if your body needs it.
One question that I get a lot from patients is that they think getting the vaccine for influenza is going to make them sick or give them a cold, and I'm curious how you counsel families about that.
DAVIS: That is actually one of the most common things that I do hear from my parents, especially those who are timid about getting the flu shot for their children. And the flu shot can have a number of side effects for certain people. Certainly, people can get some fever from the flu vaccine. And there are people who do have a response, kind of like an immune response, where you feel as if you have cold-type symptoms. It is important to note that the flu shot does not give you the actual flu. And so when you do hear stories of people saying, you know, I got the flu shot, and then I got the flu, that is most likely either coincidental, or the other option is that they had a reaction to the flu shot that made them feel kind of icky for a few days.
The flu shot is not perfect because there are multiple strains of the flu. You can sometimes still catch the flu even after being vaccinated. But typically what the science says is that when you do get the flu after getting a flu shot, that illness is typically less severe than it would've been had you not been vaccinated.
GORDON: Yeah, I totally agree. Get your flu shot. We love flu shots in primary care (laughter).
DAVIS: I adore flu shots.
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GORDON: OK, let's recap. The common cold is a set of symptoms, including runny nose, coughing, sneezing and body aches, and you get it...
DAVIS: From interacting with somebody who has it or from touching a surface that has been contaminated with it.
GORDON: With a cold, there's a normal trajectory, usually between three to 10 days, and there's an expected way that those symptoms will play out and eventually ease up. But...
DAVIS: If your symptoms are quite severe or if they're prolonged, those are potential signs that there's something else going on.
GORDON: And that's definitely a reason to go talk to your doctor.
We do have a few doctor-approved things that you can do to feel better - hydrate, rest, take acetaminophen or ibuprofen to treat your fevers and body aches. But please don't fall for the many tricks in your pharmacy's cold and flu aisle.
DAVIS: The typical immunity boosters that you would find in the drugstore have not been shown to be helpful for preventing or shortening the duration of the common cold.
GORDON: Immunity boosting, sadly, is not really a thing. You can keep your immune system in fighting shape by washing those hands and avoiding people who are sick.
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GORDON: For more LIFE KIT, check out our other episodes. I hosted one all about choosing the best birth control for you. You can find that at npr.org/lifekit. And if you love LIFE KIT and you want more, subscribe to our newsletter at npr.org/lifekitnewsletter. If you've got a good tip, leave us a voicemail at 202-216-9823 or email us a voice memo at email@example.com.
This episode was produced by Sylvie Douglis. Meghan Keane is our managing producer. Beth Donovan is our senior editor. Special thanks to Dr. Nancy Aitcheson. Our digital editors are Beck Harlan and Clare Lombardo, and our editorial assistant is Clare Marie Schneider. I'm Mara Gordon. Thanks for listening.
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GORDON: Researchers think that the virus - oh, dog. Bernie, stop it. (Laughter) OK.
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