Have COVID or flu symptoms? Here’s when you should go to the doctor, urgent care or emergency room

BOSTON – More people are going to the emergency room these days with the flu and COVID-19, according to the Centers for Disease Control and Prevention.

So how do you know when you should go see a doctor about your symptoms?

The number of patients who came to be seen at the urgent care clinic where I work was overwhelming on Tuesday, largely due to respiratory illnesses. We’re definitely seeing a sharp rise in flu and COVID cases (and still some RSV) but there are clearly other respiratory viruses at play, ones that we don’t generally test for and usually refer to as the common cold or a flu-like illness. And the surge has been largely driven by the holidays when germs easily passed from person to person.

When should I go urgent care or emergency room?

Most people who get a cold or cough do not need to be seen in an urgent care or emergency room. If you are generally healthy and have a sore throat, stuffy nose, headache, cough, body aches, or even fever and you’re managing your symptoms at home with over-the-counter remedies, you don’t need to be seen. 

However, if you develop shortness of breath, chest discomfort, severe belly pain, uncontrollable vomiting, or can’t keep fluids down, then you should get immediate attention.

If your child is sick, and you’re concerned about them, call your pediatrician, who should have someone available by phone 24 hours a day who can tell you whether you need to get to an urgent care or ER. 

And yes, if you develop cold symptoms, you should test for COVID at home, keeping in mind that it can take several days for a rapid home test to turn positive, so a negative test at the onset of symptoms is not enough.

What do you prescribe for the flu or COVID?

Antibiotics won’t help in these cases, but there are antiviral medications that can help in certain situations.

Let’s start with the flu. We are prescribing antiviral medications for the flu pretty liberally right now, but ideally, they should be started within 48 hours of the onset of symptoms. And certain people really should be treated, including young children, pregnant women, the elderly, people with asthma, diabetes, heart disease, and other conditions. So if you develop fever, body aches, and cough, call your doctor to see if they can prescribe an antiviral flu medication over the phone.

As for COVID, Paxlovid is an antiviral medication that is typically used in people 50 and older and those with certain underlying medical conditions. It should be started within five days of the onset of symptoms, so if you test positive for COVID, call your doctor to determine whether you should be taking Paxlovid.

Dr. Mallika Marshall is offering her best advice, but as always, consult your personal doctor before making any decisions about your personal health.      

Mallika Marshall, MD

Mallika Marshall, MD is an Emmy-award-winning journalist and physician who has served as the HealthWatch Reporter for CBS Boston/WBZ-TV for over 20 years. A practicing physician Board Certified in both Internal Medicine and Pediatrics, Dr. Marshall serves on staff at Harvard Medical School and practices at Massachusetts General Hospital at the MGH Chelsea Urgent Care and the MGH Revere Health Center, where she is currently working on the frontlines caring for patients with COVID-19. She is also a host and contributing editor for Harvard Health Publications (HHP), the publishing division of Harvard Medical School.

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