Coughing for weeks: Why won't the doctor give us anything for this flu?

Help to get rid of a lingering winter bug seems to be hardest thing in the world to get right now. Dr Sam Hay explains why. 

Australians have a unique lingo for just about anything.  We’ve got sangers and snags; cossies, and togs; even potato scallops and potato cakes. And whilst terms like cold and flu are pretty universal, Aussies are far more likely to feel bloody crook with their bug, lurgy, or wog.

But it doesn’t really matter what we colloquially call them, "upper respiratory tract infections" ruin our week and we’re all desperate for the quick fix. 

And the most magical of all has to be the ‘antibiotic’ doesn’t it? So why is it the hardest thing in the world to get out of your GP?!?

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Why is everyone so sick this winter? 

Winter 2024 has seen a return to pre COVID-19 times.

We seem to have a pretty standard rate of presentations into our general practices of colds and flus, caused by a splattering of the usual circulating cold and influenza viruses; but there’s also a handful of rarer ones such as RSV out there.

Common cold viruses infect the upper respiratory tract, which lines the sinuses, ears, nose, throat, tonsils, larynx, and large airways of the chest. That’s why everyone gets a combination of runny and congested nasal passages, sneezes, earaches, sore throats, hoarse voices, and coughs. 

Being milder infections, they only trigger a milder total body immune response - known as "systemic" symptoms - including aches, pains, fevers, and sweats to name a few. They generally come and go over three to five days.

RELATED: Is it RSV, the flu or just a head cold? Here’s the difference

Not all colds and flus need medication, Dr Sam Hay insists. Image: iStock

Cold viruses are cleared by our body’s immune system. Mostly there’s no need for antiviral medications; or we don’t have any effective ones that are worth the time, cost, and hassle.

Treating COVID-19 with available medications in vulnerable patients is an obvious exception.

Influenza is like a common cold on steroids. It’s a more ‘potent’ virus, so it tends to cause more dramatic systemic symptoms, which means more aches, pains, and fevers; plus, it takes longer for the body to recover: seven days usually. There are some targeted medications available, but they’re not overly effective, which means we are still largely relying on the body to fight off the infection.

Whilst bacterial infections can infect any part of the respiratory tract from the sinuses to the lungs, they tend to hit just one area at a time. This means we complain of a really sore ear, or throat, or sinuses at the front for example. They usually come along as a secondary infection after a virus, which means patients complain of an initial basic cold for a few days, then they started feeling worse, with one ‘location’ becoming unbearable. 

It is also possible for bacterial infections to pop up of their own accord. Regardless, many of these infections will be dealt with adequately by the body, so just because they are ‘bacterial infections’ doesn’t always mean we need antibiotics.

RELATED: Health experts warn parents against natural common cold and flu remedy

So how do you know when you need antibiotics? 

I’m sorry to say it, but there’s no ‘one size fits all’ answer to this question - and that's why you need to find yourself a good GP that you have an ongoing relationship with. 

In a nutshell, for us, it’s a scientific art form! We are weighing up every individual case, thinking about things like:

• How long you’ve been sick for. A short time is more likely viral.
• Where the main symptoms are. If they’re mainly in one spot that might mean bacteria.
• How sick you are. More ‘unwell’ may mean influenza; or, getting worse after a few days of a mild cold may point to that secondary bacterial infection.
• Your general health. Your age and other medical conditions govern how vulnerable you are to each infection, and hence how critical treatment may be.
• Social factors. At the end of the day, sometimes we have to make a judgement call. We weigh up the pros and cons and risks based on what’s going on in someone’s life at the time. Sometimes, the risks are worth it, even if you only get better half a day earlier.

What are the risks of overprescribing antibiotics?

Taking an antibiotic when you just don’t need it exposes you to numerous risks.

Firstly, there are side effects from the medications. Whilst they might be mild like a headache or a simple rash; they can include a complete change-up in your ‘good’ gut bacteria and bowel habits, through to even life-threatening allergic reactions.

Next, there’s drug resistance. Every time you take an antibiotic, there are a handful of bacteria left behind that showed no effects from the drug they were ‘resistant’. Now, if the body’s immune system doesn’t clean them up, they can multiply and spread. They could mutate. They could turn into ‘drug-resistant super bug strains’.

Without any antibiotics to treat these super bugs, they can cause catastrophic infections. They become resistant to every known antibiotic, leading to completely untreatable deadly infections.

By the fourth daycare cold of the year, many parents don’t care about the ‘drug resistance’ argument, but they should.  Because if the common bugs become completely resistant to the common antibiotics - then we're all doomed!

Want to know more about the virus that has made so many kids sick this winter? We discuss all of it on Kidpsot's podcast, Mum Club! Listen and subscribe wherever you get your podcasts so you never miss an episode.

But we're just not getting any better! What can we do? 

We are relying on our immune system, so we have to do the best we can to support it.

REST. I mean proper rest - flatten yourself. It's bed, couch, do nothing time. Think about making your body put all of it’s energy into fighting the infection. Avoid trips to the playground, after-school training, and even the games on the weekend. And always prioritise that day or two off school or work.

FLUIDS. Being sick burns lots of fluids, and our immune system just doesn’t work well when you’re dehydrated. So it’s imperative you're drinking lots - enough to make you go to the toilet too regularly with nice clear wee. If you can eat then water is fine; if you’ve lost your appetite, then fluids with salts and sugars in them are best, as they help fluid absorption and strengthen the immune system.

PAIN RELIEF. Drugs like paracetamol and ibuprofen won’t boost your immune system, but when you feel more comfortable, you rest better and make better decisions - like not going to school or work, drinking lots, and eating well!

STOP THE SPREAD. Keep your distance from sick people, cover your mouth and nose when you cough or sneeze, and wash those hands. We all learned these lessons during the great COVID-19 crisis - so keep them up! And get the flu shot!

Is prevention better than cure? 

Short of putting the family in a bubble, we can’t escape colds and flus completely, which means maximising your family’s health and immunity before they get sick is ideal.

• Stay hydrated and keep rested.
• Manage other chronic medical issues.
• Keeping the family active is proven to boost the immune system and be protective against colds and flus.
• A dose of vitamin C every day leads to shorter episodes of colds by up to 10 per cent. It has to be taken every day and started well before the cold kicks in.
• It’s low quality evidence, but two supplements - Probiotics and Echinachea - do seem to help the immune system.

Originally published as Coughing for weeks: Why won't the doctor give us anything for this flu?