Stay Well This Winter
Expert advice to help you avoid COVID-19, colds, and flu this season
Winter is on its way, and “there’s a real concern that our hospitals will be overflowing with both flu and COVID-19 cases,” says Dana Mazo, MD, an infectious disease expert in the department of medicine, Division of Infectious Diseases & Immunology, at NYU Langone Hospital-Brooklyn.
One reason: Australia has had more flu cases this past season than it has since at least the 2017-2018 season, and what happens in the Southern hemisphere is usually a harbinger of what’s to come here. Also, “the United States saw high levels of both flu and COVID-19 at the end of this spring, which shows they can circulate at the same time,” Mazo says. “And if you’re over 65, you’re at highest risk for hospitalization and death for both.”
Fortunately, we’ve learned a lot about how to stay healthy throughout the season. Consider these steps.
Your Vaccine Checklist
Consider vaccines as your first line of defense. They’re not available for all seasonal respiratory viruses, including many that cause the common cold. But you can be vaccinated against two of the riskiest viruses that will be circulating, influenza and SARS-CoV-2.
All are now quadrivalent, which means they protect against four strains of the flu virus, not just three. And research suggests that they may be more effective at preventing infection and flu-related hospitalizations than the standard flu vaccine. There’s not good evidence comparing them with each other, “so in general, we recommend older adults get whichever one of these three vaccines are available at their doctor’s office or local pharmacy,” says John Swartzberg, MD, clinical professor emeritus of infectious diseases and vaccinology at the University of California, Berkeley. If you can’t find one of these vaccines, get the regular flu shot.
Get the updated COVID-19 vaccine. The updated COVID-19 Moderna and Pfizer boosters—which target the original strain along with the BA.4 and BA.5 omicron subvariants—have both been shown to be highly effective. In fact, research suggests that if you mix and match, you may even get a more potent immune response, Swartzberg says. But so far, only about 10 percent of U.S. adults aged 18 to 65 have gotten the updated shot, known as a “bivalent booster.”
Go for a pneumococcal vaccine if you haven’t yet. The bacteria Streptococcus pneumoniae is one of the most common causes of bacterial pneumonia. Vaccines are available against this bacteria, which can also cause sinus infections and meningitis. The CDC recommends that everyone 65 and older receive a dose of PPSV23 (Pneumovax 23).
Don’t forget shingles. A third vaccine should also be on your radar if you are 50 or older: Shingrix. Shingles can be excruciating and lead to long-lasting nerve pain, and the two-dose vaccine is 97 percent effective in preventing it for people ages 50 to 69 and 91 percent effective for those in their 70s or older, according to the CDC. This vaccine is recommended even if you’ve had shingles before or received the older shingles vaccine, Zostavax. More reason to get both Shingrix doses and keep up with COVID-19 vaccines: A study published online earlier this year by the journal Open Forum Infectious Diseases found that people 50 and older who receive a COVID-19 diagnosis have a 15 percent higher risk of developing shingles than others in that age group.
Other Important Steps
With COVID-19, the flu, and colds likely to circulate together this winter, you’ll need to practice some additional virus-fighting habits.
Hang onto your mask. Many people shed their face masks during the summer. But remember that wearing a mask can help protect you from COVID-19—including breakthrough infections—and may shield you from other respiratory viruses. (Even with a mask, keep a distance from anyone coughing or sniffling.)
While the flu can spread through surfaces and large droplets (as from a sneeze), it can also be transmitted via small particles in the air, just like COVID-19. The CDC doesn’t actively recommend mask use for preventing the flu, but if you have any respiratory symptoms or are headed into a crowded environment—an airplane, a busy store, a big event—wearing a mask is a reasonable precaution to take, says Seema Lakdawala, PhD, an assistant professor in the department of microbiology and molecular genetics at the University of Pittsburgh School of Medicine, who studies flu transmission. That’s especially true if you’re at higher risk for severe disease because of your age or an underlying condition. Mask quality is important, so opt for N95s if you can, Mazo says.
Wash your hands. Cleaning your hands regularly with soap and water for at least 20 seconds helps prevent a wide range of diseases, not only those caused by respiratory viruses. When you don’t have access to a sink, use hand sanitizer with at least 60 percent alcohol.
Stay home when you’re sick. Many people developed at least one very good habit during the pandemic: staying home the minute they had any respiratory symptoms, Lakdawala says. That meant not going to work, visiting friends, or even stopping in a store. This probably helped limit the transmission of many viruses in addition to SARS-CoV-2, she adds.
If You Get Sick
Ask your doctor how to get tested for both flu and COVID-19. “Some offices, like ours, offer the combination test, which checks for both,” says Cleveland Clinic geriatrician Kenneth Koncilja, MD. Your doctor’s office can also schedule a virtual appointment if needed.
Consider taking an antiviral. If you test positive for either COVID-19 or the flu, an approved antiviral medication such as Paxlovid or Tamiflu may reduce your risk of severe illness when they are taken within 5 days (for Paxlovid) or 2 days (for Tamiflu) of your first symptoms appearing.
Rest and hydrate. And see our earlier guide on what works and what doesn’t to ease cold and flu symptoms.
Know when it might be urgent. Call your doctor immediately or head to the emergency room if you experience any of the following symptoms: trouble breathing, persistent chest pain or pressure, unusual confusion, an inability to wake up or stay awake, or pale, gray or blue-colored skin, lips, and/or nail beds.
Stock Up on These Supplies
- Home COVID-19 tests. “It’s very difficult to differentiate between COVID-19, the flu, and the common cold, which is where having a home antigen test can be helpful,” says Scott Kaiser, MD, geriatrician with the Pacific Neuroscience Institute in Santa Monica, Calif. If possible, a 30-day supply of the prescriptions you may take, and anything else you require for medical needs, such as oxygen supplies or blood glucose strips.
- Electrolyte replacement drinks, such as Pedialyte.
- An over-the-counter fever and pain reliever like acetaminophen (Tylenol and generic), along with an OTC cough syrup that contains guaifenesin. Kaiser recommends avoiding products with pseudoephedrine or phenylephrine because they can raise blood pressure, and the antihistamine diphenhydramine, which can cause confusion, constipation, and trouble urinating.
- A pulse oximeter, to measure your blood oxygen level and your heart rate.
- A digital thermometer.
- A cool-mist humidifier. Moist air can help reduce cough and nasal congestion. Saline nasal rinses can help alleviate nasal congestion.
Editor’s Note: A version of this article also appeared in the October 2021 issue of Consumer Reports On Health. Updated information was added from an article that appeared in the November 2022 issue of Consumer Reports on Health.
