So far, winter 2023-2024 has been a rough season nationwide for respiratory viruses. While it’s common for illness to ramp up right after the holidays, when travel and lots of indoor gatherings cause the spread of viruses, the U.S. Centers for Disease Control and Prevention (CDC) is reporting the amount of respiratory illness causing people to seek health care is still elevated around the country. During the first week of February, respiratory illness levels classified as high or very high in 25 states, including North Carolina and South Carolina, the CDC stated.

What to do when you have a cough that just won’t seem to quit? Here Dr. Austin Sherman, a family medicine doctor in Novant Health New Hanover Regional Medical Center’s Family Medicine Residency Program, offers tips.

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1. Get a proper diagnosis early on, before you stretch into weeks or months.

With coughs, colds, flu, COVID-19 and RSV all circulating, it can be hard to tell what’s what. (This Healthy Headlines story can help you tell the difference based on your symptoms.) Receiving a diagnosis early on can help you receive the correct treatment to lessen the severity and duration of your illness, and also arm you with the information you need to make sure you keep others around you safe.

Dr Austin Sherman
Dr. Austin Sherman

“Regardless of the patient – whether it's young adults, children or elderly individuals – a lot of these diseases are easily spreadable,” Sherman said. “So even if you yourself don't have high risk factors for being someone who is going to have a poor bout of COVID or the flu, I think it's good to come in and get checked out with your physician.”

If you’re uncertain as to whether you should go to a clinic when you’re sick or feeling bad, Sherman recommends calling your primary care clinician’s office to ask, or scheduling a telehealth appointment. He frequently sees patients at Novant Health Family Medicine Wilmington, where established patients can walk in for a sick visit without an appointment.

An in-person visit will likely involve a swab test for the flu and COVID-19, which, Sherman emphasizes, is quick and painless, taking just about 5-10 seconds per nostril. An on-site lab makes swab results and a diagnosis available the same day.

2. Stay home from work, and keep your sick child home from school, for the first 5-7 days.

Evidence shows that during a viral respiratory illness, an infected individual may shed the virus in exhaled droplets and aerosols, and may contaminate nearby objects and surfaces. In other words, if you have a cough or cold, you can easily spread it to someone else around you.

“For anybody who is concerned they could have an infection, it’s important to try to limit the spread of that infection,” Sherman said. “If you're feeling ill, try to isolate as best you can.”

If you can’t take time off responsibilities, like taking care of children, while you are sick, Sherman recommends wearing a mask while you’re around others.

For coughs that last for weeks or even months, Sherman reassures, you’re not contagious for the entire duration of your symptoms. (But if your cough reaches the two-month mark, when it’s now identified as chronic, you should see your doctor.)

When isolating really matters is during the first 5-7 days of symptoms, a lesson we learned during the COVID-19 pandemic. Past about 10 days, you may still be coughing, but you’re not likely to be shedding the virus and spreading it to others. And at that point, you can just focus on soothing your symptoms, which are caused by remaining mucus and irritants that stimulate the cough reflex.

3. Soothe a lingering cough with honey.

When a cough drags on and on, “the unfortunate thing is, there's really not much that we can do outside of the symptomatic treatment,” Sherman said. But on the upside, one of the most effective cough suppressants is something widely available at any grocery store.

“Honey is potentially one of the best cough medications that we have,” Sherman said. He said he personally prefers it in hot tea with a little bit of ginger root.

There is plenty of evidence that shows honey is effective at reducing coughing and mucus secretions because of its antioxidant and antimicrobial properties. This study shows it’s particularly helpful for helping a coughing child sleep. The CDC recommends honey to treat cough and cold symptoms, and emphasizes it is recommended only for children over the age of 1 (because of the risk of botulism).

Other common at-home treatments for coughs and colds, like orange juice to get an extra bit of vitamin C, probably won’t hurt, but Sherman said they might not help much, either.

“It’s not something that I will generally recommend that you should go for orange juice,” Sherman said. “The thing with orange juice that people have to think about is a lot of those juices have a lot of sugar in them.”

4. Get enough sleep and fluids.

When you’re sick and bored at home, it may be tempting to watch Netflix or scroll on your iPhone until the wee hours of the night. But it’s very important to prioritize proper sleep when you are sick with a respiratory illness.

“When you're going through any sort of illness, your body's kind of ramped up,” Sherman said. “It's trying to fight an infection. Your body is almost exercising, in a way, behind the scenes.”

The CDC recommends at least 7 hours of sleep each night for adults and you may find you need more while recovering.

If it’s difficult to breathe at night, place a cool mist humidifier nearby. Sleeping on your back can worsen postnasal drip, which in turn can make a cough worse at night, so try switching to your side and propping some pillows underneath your head and neck to keep them elevated.

Sherman also said drinking plenty of fluids is important.

“You want to stay hydrated because you're going to get dehydrated more quickly while your body's trying to fight these infections,” he said. He recommends good ol’ water, and warm liquids like tea and broth.

5. Follow your clinician's prescription recommendations.

If you’re diagnosed with influenza (the flu) or COVID-19, your clinician may prescribe you with an antiviral medication to help shorten the duration of your symptoms. Tamiflu, an antiviral medication for the flu, is shown to be most effective when taken within the first 48 hours of the flu; while Paxlovid, an antiviral medication for COVID-19, is most effective when taken within the first five days.

Antibiotics are effective at treating bacterial infections only. So unless your doctor diagnoses you with a bacterial condition, like strep throat, you won’t benefit from taking antibiotics, and they can even be harmful.

There is no prescription treatment for rhinovirus, the most frequent cause of the common cold, but your physician may recommend over-the-counter products like antihistamines and/or cough suppressants to help relieve your symptoms.