Q: Can you explain the differences between viral and bacterial infections, especially with colds and the flu?
A: During the fall and winter, we often experience illnesses like colds, flu and COVID-19. Viruses typically cause these illnesses, which lead to symptoms such as runny nose, cough and congestion. Common viruses include:

  • Common Cold (e.g., Rhinovirus): Typically, there’s no fever or body aches, just congestion and runny nose.
  • Flu and COVID: These tend to make people feel more unwell, often with a fever of 100.4°F or higher. You may have body aches, chills, headaches and no appetite.
  • RSV (Respiratory Syncytial Virus): A common winter virus causing cold-like symptoms.

We can test for COVID and the flu if you’re unsure which virus you have. If neither is present, it’s likely another virus.

Bacterial infections often develop after a viral infection when your immune system is weak. Here are the signs that a bacterial infection might be present:

  • New fever, thick nasal discharge or worsening cough after a few days.
  • You start feeling better but suddenly worsen.

For example, you could have the flu or a cold that starts to improve, but then symptoms get worse — maybe a return of fever or severe cough. These could signal a bacterial infection, such as pneumonia.

Q: Why is it important to know when you need antibiotics and when you don’t?
A: It’s important for patients to understand the role of antibiotics because they’re helpful when used appropriately. Antibiotics fight bacterial infections. However, they don’t work against viruses like the common cold, flu or COVID. In fact, taking antibiotics for viral illnesses won’t make you feel better any faster.

This is something I try to remind all my patients: for viral infections, time is what helps you heal. Whether or not you take antibiotics, most people start feeling better in about five days. Your body just needs that time to recover. So when you think of antibiotics, think of them as a tool for specific situations, like bacterial infections. If we use them when we don’t need to, they won’t be as effective when we do need them.

Here’s why that matters:

  • Antibiotic resistance: Overusing antibiotics can lead to resistance, meaning bacteria become smart and learn to evade the medication. This makes future infections much harder to treat. Think of it like this: the more we use antibiotics when we don’t need them, the more chances we give bacteria to figure out how to outsmart them.
  • Side effects: Antibiotics can have side effects, even when they’re necessary. People often think antibiotics are harmless, but I’ve seen patients experience rash, liver issues, and even serious diarrhea infections triggered by antibiotic use. So, I always tell my patients that we only want to use them when they’re going to help.

I want my patients to know that I’m here to help them navigate this decision, and we will always make the best choice together. If you’re feeling unwell and wondering if antibiotics are necessary, it’s important to talk to your provider so we can keep you safe and healthy in the long run.

Q: When should patients talk to a medical provider before requesting antibiotics?
A: If you’re feeling sick and wondering whether you need antibiotics, it’s better to reach out sooner rather than later. We’re here to help guide you through the decision and make sure you get the right treatment. Here are some clear signs that you should contact your provider:

  • You experience severe coughing or difficulty breathing.
  • You have thick, pus-like nasal discharge or an ongoing fever, and your symptoms worsen.
  • Your symptoms have lasted more than ten days.

When it comes to viral infections, antibiotics won’t help, but there are antiviral medications that can shorten the illness. Medicines like Tamiflu (for flu) and Paxlovid (for COVID-19) can help. But you generally need to start within the first 72 hours of symptoms. If you’re within that window and experience symptoms like fever, body aches and chills, don’t wait.

Q: How can video visits help manage common winter illnesses, and what symptoms are best for video consultations?
A: Video visits are a convenient option for many winter illnesses. For instance, if you’ve already tested positive for COVID-19 at home, it’s a great way to touch base with your provider and get personalized advice without an office visit.

Video visits are perfect for:

  • Cough (without fever or breathing problems).
  • COVID-positive patients who feel unwell but not seriously ill.
  • Getting a professional opinion on what over-the-counter remedies might help.
  • Managing mental health concerns, particularly during the winter months when seasonal depression or holiday stress kicks in.

Routine check-ins when you’re managing mild symptoms like runny nose, congestion or mild cough.

In-person visits are perfect for:

Winter sports injuries.

Fever, difficulty breathing or persistent coughing.

When you need your ears, throat or lungs examined.

Sometimes, seeing a patient on camera — how they’re breathing, talking and moving — gives me valuable information about a condition. Even though I can’t physically examine the ears, throat or lungs over video, there’s still a lot we can learn through a telehealth check-in.

Q: How does the Nurse Now service guide patients who aren’t sure if they need medical care?
A: Nurse Now is a resource, especially when you’re unsure if you or your loved ones need to see a doctor. It’s available 24/7, so even if it’s late at night and your child wakes up with a fever, you have questions about medication dosing, or if you’re unsure whether to go to the ER, you can call and speak with a registered nurse immediately.

Here’s how Nurse Now helps:

  • Get reassurance: The nurse can guide you through your symptoms and help you decide whether you can manage things at home or if you need medical attention.
  • Receive practical advice: They can provide real-time guidance on what medications to give, how much and how often.

Q: What can patients do to stay proactive and healthy during winter?
A: Staying healthy during winter involves a few key steps:

  1. Stay up to date on vaccinations: Get your annual flu shot and the updated COVID-19 booster. These vaccines can reduce the severity and length of illness.
  2. Keep your hands clean: Especially after family gatherings or traveling, wash your hands frequently to avoid spreading germs.
  3. Get enough sleep: A good night’s sleep helps boost your immune system and improves your ability to fight off illness.
  4. Manage stress: Winter can be stressful, particularly with busy schedules and holiday obligations. Try to manage your stress levels to avoid feeling run down.
  5. Stay active: Regular physical activity strengthens your immune system, heart and muscles, helping your body recover quicker if you get sick.

Q: What about other immunizations like RSV, Tdap or shingles vaccines
A: In addition to flu and COVID vaccines, there are other vaccines to consider, especially for specific age groups:

  • RSV vaccine: We recommend this vaccine for infants, people 60 and older or those with chronic illnesses.
  • Tdap (Tetanus, Diphtheria, Pertussis): Adults should get a Tdap booster every ten years to avoid spreading whooping cough to young children.
  • Shingles vaccine: For adults 60 and older, this vaccine prevents painful shingles outbreaks. You receive two doses, spaced two to six months apart.

Q: Is there anything else that patients should keep in mind this winter?
A: COVID is still present, so remember the five-day isolation rule if you test positive. After five days, I recommend wearing a mask for an additional five days, especially if you’re around others. This helps limit exposure and keeps everyone safer. Also, if you think you have the flu, it’s important to stay home for at least 24 hours after your fever subsides to avoid spreading it to others.

By following these guidelines and knowing when to seek care, you can keep yourself and your loved ones healthier during the colder months.