Navigating Respiratory Illness

• Get plenty of rest.
• Drink plenty of fluids.
• Use a cool mist humidifier in a dry room.
• Colds, flu, COVID, and RSV are all viral illnesses and are not treated with antibiotics. To treat symptoms use over-the-counter medications as per package instructions. If you have:
  • Pain/fever - use acetaminophen or ibuprofen for pain/fever
  • Congestion - use phenylephrine, antihistamines or saline nasal spray
  • Sore throat - use cough drops or lozenges
  • Cough - honey, dextromethorphan, or guaifenesin
• Those at high risk for severe illness or complications may qualify for treatment for the flu (Tamiflu) or COVID (Paxlovid). Call SHS at 315-228-7750 to discuss treatment. More information about Tamiflu and Paxlovid are below.
• Strep throat should be treated with antibiotics

Note: Be aware of any medication allergies you may have and avoid those medications.
Use caution with combination cold medications — be aware of what medications are in them to avoid an accidental overdose of medications like acetaminophen or ibuprofen.
 

• You are at high risk for severe disease for any illness and have symptoms, call SHS to talk with a nurse or schedule an appointment. 
• You have a high-risk condition, have symptoms, and have tested positive for COVID and want to consider treatment for COVID (Paxlovid- more information below), call SHS to discuss treatment.
• You have a high-risk condition, have symptoms consistent with flu, and would consider treatment for flu (Tamiflu-More information below), call SHS to discuss treatment.
• You have a high-risk condition, have been exposed to flu by a roommate or close friend, and would consider preventative treatment with Tamiflu (More information below), call SHS to discuss treatment. 
• You feel you are sick enough that you need to be seen, call SHS to schedule an appointment. Call if you experience the following:
  • a fever > 101 degrees for more than two days
  • any difficulty breathing
  • vomiting or diarrhea that is accompanied by significant abdominal pain, fever or persists for > 48 hours.
  • other severe or persistent symptoms you are having trouble managing with rest, fluids, and over the counter medications
  • Symptoms that are significant or worsening after 3-5 days or persisting for > 10 days. 
• You have COVID symptoms and do not have access to a home test, please call SHS to discuss your symptoms and self-care with a nurse or send a portal message..
• You don’t feel you need to be seen but have questions or tested positive for COVID on a home test, please refer to the You Test Positive web page for guidance.

(From the CDC)

• Trouble breathing
• Persistent pain or pressure in the chest
• New confusion
• Inability to wake or stay awake
• Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone

Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer. Washing your hands will help protect you from germs.

Avoid touching your eyes, nose, and mouth with unwashed hands. Germs spread this way.

Avoid close contact, such as kissing, sharing cups, or eating utensils with people with cold-like symptoms.

Cover your mouth and nose with a tissue or your upper shirt sleeve when coughing or sneezing. Throw the tissue in the trash afterward. Then wash your hands.

Clean and disinfect surfaces and objects that people frequently touch, such as toys, doorknobs, and mobile devices. When people infected with RSV touch surfaces and objects, they can leave behind germs. Also, droplets containing germs can land on surfaces and objects when they cough or sneeze.

If possible, stay home from work, school, and public areas when you are sick. This will help protect others from catching your illness. If you need to go out, wear a mask to decrease the spread of illness.

• Only recommended for those with medical conditions that put them at high risk for severe disease.
• It must be started within 5 days of the onset of symptoms. 
• The efficacy studies were done with unimmunized patients and showed 88% relative risk reduction in hospitalization and death. Some believe that it decreases the risk of long COVID, but that data is not as well established.
• Common Side Effects:
  • Bitter or metallic taste in the mouth (anecdotal evidence is that the use of hard candies or cola sodas can improve this)
  • Diarrhea
  • High Blood Pressure
  • Muscle Aches
• There is a question about rebound COVID associated with Paxlovid, but there is no data on whether Paxlovid increases this occurrence.
  • Anecdotally, most people who experience rebound after Paxlovid know someone that did not receive Paxlovid and also had rebound COVID. It is possible it is more related to this variant and not related to Paxlovid. We do not know.
  • Rebound COVID should NOT be treated with another course of Paxlovid.
• There is also a concern about medication interactions, so if you qualify for Paxlovid and are interested in treatment SHS will need to know if you are taking any other medications.
  • It is known to interact with Birth Control Pills. The recommendation is to consider a non-hormonal method of contraception during the 5 days of Paxlovid treatment and until one menstrual cycle after stopping Paxlovid.
• The local pharmacy requires kidney function (blood work) documentation within the past year. If you haven’t had bloodwork in the last year, that will need to be done before the prescription can be sent to the pharmacy. 

• Treatment:
  • SHS only prescribes Tamiflu for students with high-risk medical conditions presenting within 48 hrs of symptom onset.
  • This is based on an evidence review:
    • Tamiflu reduces symptoms by 16 hrs
    • There was insignificant benefit in asthmatic patients
    • Cochrane review failed to establish any definitive benefit in pneumonia, hospitalization, and virus transmission.
    • Adverse effects: elevated LFTs, neuropsychiatric events, cardiac arrhythmias, Stevens-Johnson syndrome, Erythema Multiforme. Typically occur within 48 hrs.
• Prophylaxis:
  • There is limited evidence of effectiveness in prevention with Tamiflu; however, the CDC has recommended considering it in high-risk medical conditions and congregate living cases. 
  • There are known side effects, including nausea and vomiting, and neuropsychiatric side effects (including confusion, hallucinations, and seizures)
  • Asymptomatic students with high-risk medical conditions who are in close contact with someone with the flu who are interested in Tamiflu prophylaxis should contact SHS.