Getting the flu is an experience everyone hopes to avoid. The fever, chills and body aches hit fast and hard and can keep a person bedridden for several days — sometimes even weeks. When seriously ill, many people question whether they are better off staying in bed, calling a doctor or seeking more urgent medical attention. This year, many patients will face even more confusion since the flu and COVID-19 can have similar symptoms.
Anjali Mahoney, MD, a family medicine physician at Keck Medicine of USC, recently spoke with HSC News and offered the following guidelines.
When to stay in bed
If the patient’s temperature is below 101°, they are in no serious pain and their breathing is fine — even with a cough — chances are the patient has a mild version of the flu. It may even be a bad cold, instead. As long as symptoms stay this mild and the patient can stand up without getting dizzy, Mahoney encourages following what she calls “The standard: rest, lots of fluids, vitamin C and acetaminophen or ibuprofen for body aches and fever.”
Signs that a doctor is needed
If the patient’s fever goes above 101°, they ache badly all over and feel wiped out, chances are it’s the flu. In this case, it’s extremely important to call a doctor right away for anti-flu medication. It can help lessen the severity and duration of the symptoms, but it only works effectively if taken within the first 48 hours.
If additional symptoms include loss of taste and smell or a persistent cough, a COVID-19 test may be necessary.
“With COVID it’s tough because this virus presents in so many different ways and can look just like the flu. That’s why it’s important to reach out to your doctor when you start to feel sick and have a high fever or if you know you’ve been exposed,” Mahoney said.
If it does turn out to be COVID-19, it will be extremely important for the patient to know so they can take steps to avoid passing it on to others.
Illness that requires urgent care
In cases of high fever or dehydration, it is recommended to not wait for a doctor appointment.
“They really can handle a great deal at urgent care,” Mahoney said. “If you’re dehydrated from vomiting, diarrhea or your fever, they can set you up with an IV. They’re also equipped to handle high fevers.”
Symptoms of dehydration include dizziness, dark urine — or not being able to urinate for several hours — extreme thirst and a severe headache. If a person experiences any of these, it is crucial that they seek out an urgent care clinic for prompt care.
It is also important to go if the patient’s fever hits the 102°-104° range, so clinicians can help bring it back down.
Recognizing a health emergency
There are some people more vulnerable to serious flu complications, such as people over 65, babies under 2, people with pre-existing conditions and those on immunosuppressants. That said, a serious flu complication can hit anyone.
“Bacterial pneumonia can happen with the flu,” Mahoney said. “You can also get inflammatory reactions that can affect the heart, the brain and sometimes even trigger multiorgan failure. You can also get an extreme inflammatory reaction like the cytokine storms you have heard about with COVID that can cause sepsis and can be life threatening.”
If a person’s fever reaches 104° or higher, they cannot stop shaking, they have trouble breathing, they have chest pain or they feel like they will pass out, it’s time to go to the nearest emergency department. A seizure or uncontrollable gastrointestinal distress (nausea or vomiting) is also a sign of an emergency. The sooner the patient gets help, the easier it will be for doctors and nurses to treat them.
— Kate Faye