Best Strategies for Avoiding and Treating Colds, the Flu & COVID-19 with Dr. Donald Ford

Podcast Transcript

Cassandra Holloway:  Hi. Thanks for joining us. You're listening to the Health Essentials Podcast, brought to you by Cleveland Clinic. My name is Cassandra Holloway and I'll be your host for this episode. We're broadcasting virtually as we are practicing social distancing during the coronavirus pandemic. We're joined virtually by family medicine specialist, Dr. Donald Ford. Dr. Ford, thank you for joining us, and welcome to the podcast.

Dr. Donald Ford:  Thank you very much, Cassandra. It's nice to be here.

Cassandra Holloway:  Today, we'll be talking about how cold and flu season is colliding with the COVID-19 pandemic. We'll discuss what that means for you and your family's health. Everything from preventing illness, to medicine, to what to actually do if you end up getting sick. Before we dive into this podcast, we want to remind listeners that this is for informational purposes only and is not intended to replace your own doctor's advice. Also, please note that this interview was prerecorded and does not reflect any changes to COVID-19 precautions that may have been made after the recording.

Dr. Ford, I imagine you've been quite busy these past several months dealing with the coronavirus pandemic, and especially now that it's cold and flu season. So I want to first start off by asking you how you're doing with everything going on.

Dr. Donald Ford:  That's very nice for you to ask, Cassandra. It's been a remarkable period of time and nothing like it that I've ever experienced in my career. Certainly, I grew up during a time when there were at least memories of the polio virus epidemic, and even my grandparents could tell stories about the flu epidemic of 1918, but nothing like this has happened in my life. So we have been operating full charge since March and we're learning new things every day.

Cassandra Holloway:  Absolutely. We have a lot to unpack with this episode, so I want to dive right in starting with prevention. I guess this is kind of the golden ticket question that I think many of us are thinking and talking about right now, how does someone boost their immunity and reduce the risk of getting sick in the first place?

Dr. Donald Ford:  That's a great question. Boosting the immunity is something that a lot of people have a lot of opinions on. The things that we know work are the things that are good, healthy living. The most important thing is to maintain your own health as much as you can, and whether you've got medical conditions that need treatment, make sure that you're taking your medicines as prescribed by your doctor, make sure that you're eating well, make sure above all that you're getting plenty of rest. And that's hard these days for a lot of people because there's so much stress. But if you can take time for yourself, if you can make things easy and peaceful for yourself at night, get a good night's sleep, you're going to do a lot better fighting things off.

Cassandra Holloway:  Absolutely. And you mentioned losing sleep because of stress, and you mentioned that there's so much stress going on with everything crazy going on with the world. Is it true that living in a chronic state of stress and anxiety actually lowers your immune system?

Dr. Donald Ford:  There's no question. There have been a lot of studies that have actually demonstrated that. It's a hard thing because I work as a family doctor, so I'm not looking at a microscope all day, I'm looking at real people, and so this always comes as a matter of degrees. All of us have stressful lives. We have family, we have work right now with the pandemic, there's issues without people not being able to work, people who are unable to do the things that they normally enjoy doing. This is all stressful. We all have our coping mechanisms. And what's important is that we look to each other to keep each other well.

Cassandra Holloway:  Just reason number 500 why we need to get our stress under control for sure.

Dr. Donald Ford:  Exactly.

Cassandra Holloway:  So you mentioned a couple of the wellness basics like get rest, eat well, exercise, what else can listeners do to protect themselves? Just as a reminder, I think it's worth noting, wearing a mask, social distancing. What else can listeners do to protect themselves in those terms?

Dr. Donald Ford:  Well, this time of year is when we always start to talk about hand-washing. We can't forget that in the midst of this pandemic, even though the focus has very much been on the masks and the social distance thing, which are absolutely the best imperfect tools we have to protect ourselves, we also have to wash our hands. You're bringing up a great subject, which is that we're not immune to the same normal types of bugs we see throughout a normal course of a year, and so they're going to be cold bugs and viruses and other types of infectious organisms that are around. One of the characteristics, I'd say, of this past summer has been that it was a very bad allergy season.

I'm an allergy sufferer, so I know I could tell you that in the middle of August when my eyes were weeping and my nose was stuffy and my throat was scratching, it was a bad allergy season, so I had to protect myself. And it just makes it that much more challenging for us to try to figure this out one illness at a time, but we protect ourselves the same way we always have. Along with the masking and social distancing, when you're in contact with people, and most importantly, when you're in contact with surfaces that other people will touch, make sure you're washing your hands before you do anything like touch your face, drink something, bring your hands to your mouth. That's the most important thing we can do on a daily basis in our routine lives to help protect us from infectious organisms.

Cassandra Holloway:  I'm curious, we were told to wear a face mask and to practice social and physical distancing to reduce the spread of COVID-19, but does those two things also help reduce the spread of cold and flu as well?

Dr. Donald Ford:  We're going to find out this year, we're learning a lot. It's going to be very interesting in terms of seeing what the disease patterns are. I'll tell you from my experience as a family doctor, I'm still seeing people come in with stomach bugs, with colds, with sore throats, with things that are not COVID. And our responsibility is to try to figure this out and try to discern on the basis of symptoms, on the basis of exposure, on the basis of likelihood, what are the chances this could be COVID versus something that in a normal year we would just live with and go to the drugstore and get a little bit of medicine and work our way through?

Cassandra Holloway:  Sure. So going back to what you said about practicing good, healthy living to prevent and avoid illness to begin with, are there any vitamins or the buzzword super foods that we should consider taking or eating to help fend off some of these illnesses?

Dr. Donald Ford:  I'm a big believer in healthy nutrition. I think what we put into our bodies is essential for good health. And living well, eating well, eating things that are rich in vitamins and minerals is really critical to good health in the long run. I'm also, I would say, a bit of a skeptic in terms of supplements. Now, I think the problem that we face is that there really haven't been great scientific studies to look at the effect of various supplements on the things that we're talking about, on immunity, on protection from disease, on how do we boost our immune system.

The problem is that we can't really demonstrate that if you take a mega dose of vitamin this or a mega dose of vitamin that that it's really going to have any significant impact. I say that as humbly as I can, because I know even in our institution right now, we have studies going on that are looking at some of these things, particularly relevant to COVID-19. So I'll be the first to say, if it comes out in the end that there is some benefit to taking some of these vitamins and minerals, I will be on that train, but I want to see the group first.

Cassandra Holloway:  Sure. It makes sense. Yeah. Follow the science for sure. So still talking along the lines of prevention and just preparing for the cold and flu season, what should listeners have on hand before they get sick? Should they stock up on thermometers or over-the-counter cough medication, what would you recommend as staple items that we should add to our pantries or medicine cabinets now?

Dr. Donald Ford:  Well, I hope I don't make too long a list. I remember myself in March, my daughter had been out of the country and came back, and because she was out of the country and potentially exposed, she had to quarantine for two weeks. And one of our instructions was to take her temperature every day. We were hard pressed to find a thermometer. I'm ashamed to admit that as a doctor, that we didn't have one that worked in the house, we had an old one, but we had to get new batteries for it. And then I went out to the drug store and I couldn't find one on the shelves. So a little bit of prevention in this type of thing is a really good idea. So make sure that you have a working thermometer.

There's a long list of types of thermometers, you can get the ones that go in the mouth, you can get the ones that go in the ears, you can get ones that go on the skin of the forehead, they're all okay. There's a little bit of variation from one to another, and I don't really have a preference. I would say that the ones that go under the tongue are going to be a little bit more accurate in the big picture, but that doesn't mean you can't successfully use one of the other ones to tell you if your normal temperature is elevated. There's another type of device that is available now, and I know a lot of patients who have gotten them, I actually don't have one. And this is something called a pulse oximeter, and this measures the oxygen in your blood.

I am not going to say that everybody should run out and get one, on the other hand, it might not be a bad idea to take a look around at your local drug stores and see if they have them, see if you can find them online, see if you know where to get one if you should need one, because that's one of the tools we've used to monitor folks who have COVID and who are having problems with shortness of breath, watching that their oxygen levels don't fall. There are even some watches that are available now that offer that type of technology. I'm not enough of an expert to be able to tell you how accurate those are, but I know that they're available. So that's one thing you might want to think of.

The other type of thing that is useful to have on hand, aside, I suppose, from toilet paper and Kleenex, which again, that's another story we've all been through, you want to make sure that you have enough of whatever type of pain reliever, fever reducer, whether it's acetaminophen or ibuprofen or Naprosyn. All those are available over the counter, they're all helpful. We had some concerns in the early days of COVID about a possible worsening or conflict with using ibuprofen or Naprosyn, but those haven't turned out to be true. So any of those are perfectly good, but I would definitely recommend that people have those in the house and have those available because you don't want to be running out when the fever hits, you want to be able to have that in your toolbox, in your medicine cabinet.

Other types of medicines, it depends. I'm not sure that everybody needs to run out and stock up on their cough syrup and their decongestants and their antihistamines, unless those are things you usually use. I mentioned that I was an allergy sufferer, so I have a little supply of some of my nose spray and some of my antihistamines, and those are in the house. You certainly could get some of those types of medicines into the house and keep them. Remember, all these things are going to expire, so you'll have to keep an eye on the dates and you don't want to just leave them there and then pick them up next year and find out they expired a few months ago.

That's one clue that I think is a good idea, which is check your medicine cabinet, make sure the things you have in there are working and that the medicines that you have haven't expired.

Cassandra Holloway:  Absolutely. All good advice for things to add to your toolbox, but hopefully, our listeners won't need them. So moving on to sickness. We talked about prevention first, and now I want to talk about what actually happens when you get sick. So starting off with symptoms, I feel like there's so much overlap between cold flu and COVID-19, and it could be a little bit confusing. So I'm wondering what the difference is between all three of those illnesses. And do you have any advice for listeners on how to tell the difference? Is there red flag, warning signs, symptoms? Walk me through that.

Dr. Donald Ford:  Well, it's a complicated subject, and I will tell you that's a good part of what I spend my day doing, is talking to patients and trying to discern which symptoms are suspicious and which are less suspicious. There is mostly overlap, as you say, between all of these illnesses. Now, this goes back to prevention. One of the things that we are trying to do, and this is really an important piece of staying well through this winter is get your flu shot. We believe that the flu shot that we have available this year is going to be very effective. We can always tell what types of strains are coming to us, and we start to have a sense of how well the vaccine for each year is going to work against the strains that we anticipate are going to come.

This is a global problem, so we actually see the pattern coming from South America, and sometimes from Asia, that the strains that they have there are the ones that we're going to see here. And this year we believe that the vaccine is particularly well tailored. I can't guarantee it, but that's certainly the early evidence. So getting your flu shot is going to take one piece of that out of the mix. So obviously, I'm a fan of preventing disease to begin with, so I think it's a good idea in and of itself, but especially when we're trying to deal with this complex topic of COVID, and just as you say, trying to sort out the symptoms, what's what?

If you've had your flu shot, if we're not seeing a high rate of flu in the neighborhood, in the community, then we know that a high fever is going to be more likely to represent something like COVID and we can spend our energies looking at that and decide whether or whether or not we need testing. So that's an important part of the strategy. In the big picture, as you say, all of these illnesses have similar symptoms. We can talk about the symptoms that we look for with COVID. And I'm sure that most people are familiar with these by now; a high fever, a cough, shortness of breath. One thing that's fairly unique is this loss of taste and smell, and we don't see that with other typical viruses. That's fairly unique to COVID.

But the other symptoms; congestion, sore throat, scratchy throat, GI symptoms, which are the stomach symptoms, diarrhea, nausea, those can occur with many, many other viruses. So we always look for the pattern of the onset of the illness, how it's progressed, we ask about exposures, whether people know that they've been exposed to COVID, so if you were with somebody and two days ago they got diagnosed with COVID and your symptoms are starting today, that's certainly suspicious and that would lead me to recommend testing for somebody. But you do have to put the whole picture into mind and try to discern what these things are.

I spend a lot of time talking with people. I believe that the patients do know their bodies, and I think that's very important. So people will understand if something is different. "No, this doesn't feel like a typical cold. No, this isn't my allergies." So that's going to raise my suspicion as well. So I try to listen as well as I can, along with knowing the basics of what symptoms I have to look out for.

Cassandra Holloway:  So I want to ask you about a scenario that I think many of us have experienced before. So let's say that someone wakes up sick, maybe they weren't feeling well last night and they woke up this morning and maybe they have a fever, maybe they don't, they just don't feel well. What do we do in a situation, given everything going on with the pandemic, what do we do in a situation like that?

Dr. Donald Ford:  Well, we are trying to make ourselves as available as we can to patients. We ask them to call, and if we can, if I can talk to one of my patients myself rather than having somebody else talk to them, that's the best. Sometimes I'm busy, sometimes I'm seeing other patients in the clinic, so we really try to expand our reach and we have nurses, we have nurse practitioners, we have online availability for appointments, and we're really running 24/7 so that that's as available as possible to all of our patients so that we can have that conversation and determine, is this a high risk? Is this a medium risk? Is this a low risk or something that we can watch?

Those are the most important things. We have some limitations too, because when somebody is highly suspicious for COVID, we prefer not to see them in the office. We'd much rather see them virtually like this, talk to them on the phone, or have them have a distance health visit, a virtual visit so that we can get them the right kind of testing or the right kind of treatment and not put them and other people at risk. There's always the risk too if somebody comes in with symptoms and it turns out it's just a cold, if we brought them in with other sick people, they could get exposed to COVID. And so we always have to think these things through.

So in the scenario that you bring up, I would very much encourage people to reach out to their doctor's office, and we'll use every tool we have to try to get you a rapid answer of what we should do next.

Cassandra Holloway:  Absolutely. So going along those lines, another scenario for you. If I develop a sore throat and I've had it for a couple of days now, do I need to limit my interactions with other people, not go to the store or not go to work? I think it's so much different than a year ago when it was normal to go to work or school with a mild cough and mild cold, but given everything going on, I feel like it's a little bit different. So I guess what would be your advice in those situations?

Dr. Donald Ford:  That is a great question and one that we struggle with all the time, because we really are working hard to try to figure out in each individual, what is the likelihood that they could have COVID? It's not that we don't think strep is a serious illness, it's not that these other types of viruses aren't things that could be catching to other people and even put people at risk, people who are older or who have other health conditions. That's all very important, but we certainly want to make sure that we're not encouraging somebody who potentially has COVID to put other people at risk. So that's the challenge for us each and every day as we go through this.

We do have a general approach that if you're not sure what's going on, it's best to isolate yourself. Now, one reminder I would always use is, that's the time you make sure you're wearing your mask. That's the time you make sure you're staying six feet away from other people, because even if you're feeling fairly sure that this is just a cold and this isn't anything to worry about, we don't know. There's a question mark there. And the best thing we can do for our neighbors, for our loved ones and for the strangers that we meet in the grocery store is to do our best to keep our distance.

We have some reassurance in this, even in this pandemic, this is not something that just jumps across the room arbitrarily, the virus travels in moisture drops that come from our mouth and nose. And that's why the masks are still effective if we wear them right, if we're not wearing them around our chin, and if we're wearing them properly and if we're not taking them off to talk to somebody, if you really follow those guidelines, even if it turns out that it's not just a cold and that it's COVID, you're going to reduce the chance of transmitting it to somebody else if you're wearing your mask.

And likewise, if you run into somebody like that and you've got your mask on, you're going to be protecting yourself as well. These things are not 100%, but that's why we always talk about them together, that's why we always talk about wearing your mask and social distancing, and as we approach cold and flu season, washing your hands,

Cassandra Holloway:  Do the same rules apply to children? I know, especially it's difficult with school and kids getting sent home over a headache or a stomach ache, which earlier that maybe wouldn't have happened last year. Do the same rules apply that maybe we should err on the side of caution and keep kids home when they do present with a cough or a cold?

Dr. Donald Ford:  I think it's the right thing to do. The schools around here that I hear about, everybody's still trying to figure out what's the best way to conduct themselves. And it's very hard with little kids. My kids are all grown, so I've got it easy, but when we had little kids, I just think back to, is it really possible to keep them away from each other? It's a challenging situation, and my heart goes out to all of our teachers out there who are trying to manage this as well. As a parent, I think it is the responsible thing to err on the side of caution in terms of sending your kids to school, if you think they might be sick.

We'll do everything we can in the medical community to help you figure that out. And if it's just a cold and we can get them back to school in a day or two, that's wonderful. But my message today is err on the side of caution.

Cassandra Holloway:  Sure. One last scenario question for you here, if someone in your household test positive for COVID-19, what are the chances of you getting it?

Dr. Donald Ford:  It's really remarkable, I've actually dealt with a lot of situations like this, where one person comes in positive and I hear from the other family members that they've been around each other, the spouse sleeps in the same bed, they use the same towels and kitchen utensils and so forth. It is not universal that everybody is getting sick. I'm really in all of this fact, I think that something that we have as a secret blessing through all this, it doesn't seem to be universally contagious. It's not 100% guaranteed that just because one person in the household gets the virus that everybody's going to.

I can't prove it because I'm not in people's homes with them, but I do think it comes down to basic conscientiousness. I think people who are observing appropriate protection measures in the outside, are probably doing that at home, washing their hands, not talking right into somebody's face, whether you're wearing a mask in your home or not. Again, we've seen lots of situations somebody gets sick, we do encourage them to go in a separate room if they can, have the rest of the family bring them meals, bring them things that they need.

We did that with my daughter for the two weeks when she came home, fortunately, she was well. It's a disruptive thing in people's lives, no question, and not everybody's household is set up for that. If some family members are working and other family members are at school, who's going to help the person who's up there in their bedroom? These are tough things to figure out and yet, doing that really seems to make a difference. And we see one family member getting sick, getting through this virus, getting better and not everybody got sick.

Cassandra Holloway:  That's really fascinating when you put that in those words and that experience. I want to talk to you about typical courses of treatment for cold and flu. What are some over-the-counter medicines that we can take for cold and flu? And are there any prescription medicines that we should be aware of that a provider might prescribe us if we do end up seeking medical help for cold and flu?

Dr. Donald Ford:  Yep. And they do vary because for things that we call the common cold, unfortunately, we don't have any curative medicine, we don't have anything that can make it go away. What we have is symptomatic treatment, so if you have a cold that has a cough associated with it, we will encourage you to use a cough syrup. Sometimes we can prescribe cough syrups that are maybe a little stronger than what you can get in the drug store, and I'm always happy to do that, if people are staying up at night with their cough and it's keeping them up, that's certainly something that we can do.

Decongestants, cold medicines, like you see in the pharmacy shelves, everybody's got their favorite. And truthfully, they're all just slight variations on the same group of medicines. And some are going to be more apt to make you sleepy, some are more apt to maybe make you less sleepy so you can use them during the day. There's not a good or bad. I encourage people to try different things and see what works for you because everybody's body is a little bit different.

In terms of influenza, if you have influenza, there is a prescription medication that we can give, and that can shorten the course. It doesn't cure it, it simply shortens the course of the illness. The other thing that's important is that it doesn't reduce the transmission completely. So people who have the flu still could give it to other people even if they're on medicine. Although we know that the likelihood of transmission is somewhat reduced, we still encourage people to protect people around them if they're diagnosed with flu.

Now, the important thing about that medicine is that you get it very early in the course. So if you get a high fever to the scenarios that you were talking about before you wake up with a high fever, call your doctor's office, because if it is flu, the sooner you get the medicine in you, the better it is going to be and the better the medicine is going to work in terms of shortening the course eventually. Then there's strep throat, which is out of all the things that we talk about, strep is the one that's caused by a bacteria rather than a virus. And that's very important.

It doesn't really matter to most patient, you still feel sick, you still have the same types of symptoms, but it makes a big difference in terms of treatment because strep, we can actually make it go away, we can give you antibiotics that will make it go away. We are still sorting through what the right course of action is to do with folks who have, for instance, a high fever and a sore throat. In the old days, let's say last year, it would have been no-brainer, "Go get a strep test." Now, we're less eager to do that because of the risk of transmission.

And if somebody called me last year, last fall and said, "My son has a 101 fever and a sore throat." "Bring them, I'll get their throat swabs in 10 minutes." And now we don't want to do that because we've got to go through this process of trying to figure out what's COVID or not. So it's one of the issues that we're dealing with this fall going into the winter, is how are we going to sort these out to try to figure out what's curable, like strep and what are things that we're going to have to manage like flu, like COVID. So the only common message in all of that is, please call us, let us know what's going on and we can help you sort it out because it's not always a clear, easy answer.

Cassandra Holloway:  Turning the tables here, I want to ask you the same question, but now with COVID-19, and I'm sure there's some overlap in terms of medicines that you can get over the counter or prescriptions. Walk us through some of the treatments options for COVID-19 over the counter and maybe prescription if there are any.

Dr. Donald Ford:  Yeah. So a lot of people who get COVID end up with what we think of as these common cold or flu type symptoms, folks have sore throat, nasal congestion. One of the curious things is there is loss of taste and smell and that actually in my experience has led to people actually having a little less of the typical upper respiratory symptoms in terms of their nose, they just can't taste or smell it. But we can use all the same types of medicines, the decongestants I'm a big fan of saline spray, which you can buy in little bottles in the drugstore, just saline, salt water.

And usually it comes either a little aroma or a little lubricant in it. That's great because it's not a medicine and it's simply hydrates your tissues. That is something that we can use in COVID too because for the loss of taste and smell, if you can hydrate regularly over the course of the illness, there may be a little bit of improvement, a little bit faster in terms of some of those symptoms of the loss of taste and smell. The worst symptoms of COVID are when people are having shortness of breath. Now, somebody has a cough without shortness of breath, that's something I feel very confident just recommending a cough syrup or prescribing a prescription cough syrup. There's no problem.

But if the cough is associated with shortness of breath, those are the people we want to watch very closely. There are times when we can use medicines, like what's called prednisone, which is a steroid. And people are probably familiar with hearing about that, something that's being used in the course of illness for COVID. We hear about people in the public who are diagnosed with COVID, who are put on steroids. It is an effective treatment. We have to be very thoughtful about how we use it and when we use it, because it's something that can create a lot of potentially.

So that's something that really should be managed by your doctor. It is a potential treatment for some of these symptoms that have to do with the chest and the lungs and the breathing, but it's not a preventative in any sense. In fact, we have some concern that it could possibly make things worse if given at the wrong time. So I'm not making any specific recommendations about when you should or should have it, but let your doctor manage that for you, because it's not something you want to just jump into.

Some of the other things that have come across the news in terms of potential medications that might be helpful, unfortunately, most of them are not turning out to be as helpful as we had certainly hoped. There are some medicines that are being used in hospital settings that definitely seem to have some potential, but these are really only when people are very ill and they'd be closely watched by a team of medical professionals in a hospital setting. So I won't get into those as much, but back to my point, the upper respiratory symptoms easily treated with over-the-counter medications.

If it's starting to affect the breathing or shortness of breath as a symptom, there are some things that we can use, we just have to be careful about them. Also some asthma medications, inhalers, we found to be fairly helpful with those types of symptoms. One thing I didn't mention is the intestinal symptoms, a fair number of people who get COVID do get diarrhea and nausea, that sort of thing. And we can use typical medications. There are not a lot of prescription medications for diarrhea that are better than the ones that you can get over the counter.

But I can certainly talk with patients and give them advice about what might be best for them to use and whether it's safe. The other things in terms of treatment, we've talked about already, rest and hydration. Those are very important. If you're sick with COVID, you might think, "Well, what else am I going to do other than rest and hydrate?" Well, sometimes you really have to work with that. If your particular case gives you a lot of nausea, you might be reluctant to try to drink a lot, try to eat even some mild than bland food. So we do have to encourage people sometimes to make sure they're staying hydrated and actually, getting rest while they're sick.

Cassandra Holloway:  Dr. Ford, you started talking about things you can do to recover. So I wanted to talk more about getting back on your feet after you've been sick and really recovering from these illnesses. So I'm wondering if you could tell us how long on average does the typical cold or flu last? Do we have like a ballpark timeframe for that?

Dr. Donald Ford:  Ballpark would for a cold would be about five to seven days. Flu can be a little bit longer, we'd probably say in the region of seven to 10 days. COVID we are saying roughly 10 to 14 days, typically. We've seen a wide variety of people in terms of the length of their illness, so, much harder to classify. If something's going on for more than a week, I think that should be a red flag to people too that it might be time... If you thought that this was just a virus, just a cold and you're still sick after a week, especially if you're having any kind of fever, you definitely should check in with your doctor.

Cassandra Holloway:  And you mentioned resting and drinking plenty of fluids, what other advice do you have for people as they recover from whatever illness they might have? Do they jump back into their normal routine? Should they really take it easy? What other advice do you have?

Dr. Donald Ford:  Yeah. It's a hard question to give one piece of advice for everybody. If you just have a cold, there's really no reason you can't just go back to your normal level of activity, because what we're talking about is a virus that really doesn't make it much past the throat. It doesn't get into your lungs, it doesn't get into your lower organs. It's really just up in the head and neck. And most people are just fine, just going back to their regular activity. Flus can really knock people for a loop and some people, I will say.... I've had people say to me, "I don't get my flu shot because I've never had the flu."

And I say, "Well, you're very lucky. Let me go with you on your next trip to Vegas." Because it really can be a serious illness, even if you're a young, healthy person. We talk about that with COVID all the time about how there are certainly more risks for people who are older or people who have a lot of chronic illnesses, but young and healthy people can get very ill from these as well. So both the flu and COVID, I would say, you do have to be a little respectful. These can really set you back. And we do see, unfortunately, some people with COVID where the illness, the symptoms linger for weeks or even months.

This is a small percentage of people, fortunately, most people are going to be fine within about 14 days, but there are some people who went into this feeling perfectly fine, they were athletic, they were healthy, and they've got symptoms of cough and shortness of breath and weakness and fatigue. They can go on for months. And I hate to say it, but there is just a lack of knowledge about this virus, about why would affect some people one way and some people in other way, we're learning as we go.

Cassandra Holloway:  And I think it's an important reminder to listeners and everyone in our community that this is why we take the precaution seriously, because we don't know enough about it at this point.

Dr. Donald Ford:  Right. If you're just going to go on the odds, the odds are that it's going to be a mild illness, but it might not be.

Cassandra Holloway:  Dr. Ford, the last thing I want to ask you about here is if you could leave our listeners with one piece of information about staying safe during cold and flu season and during the global pandemic, what would you tell them?

Dr. Donald Ford:  I would say, love your neighbors, be kind to people, we're all in this together. There are a lot of things we can do to stay safe, and I've talked about a lot of them, treating yourself well, staying healthy, living a healthy lifestyle. Those are the best things you can do, but know that we're all in this together and we can help each other through this. We can give each other advice, we can do so safely at a respectful distance while wearing a mask, and we can help each other, remind each other when we're not doing the things that we need to do to stay safe.

Please reach out to your doc, we're here to help. There's no question that right now is probably the time of my career that I've been busier than any other time that I've been a doctor. So bear with us and don't get frustrated if it takes a while to get through on the phones or through messaging, we're really trying hard to get ourselves out there and to be able to talk to everybody who's got concerns. But please, let us be your partners as well.

Cassandra Holloway:  That's all the time we have today. Thank you, Dr. Ford for joining us and sharing some valuable insight about cold, flu and COVID-19.

Dr. Donald Ford:  It's a pleasure. Nice to see you.

Cassandra Holloway:  For the latest news about COVID-19, visit clevelandclinic.org/coronavirus. If you want to listen to more Health Essentials Podcast, featuring experts at Cleveland Clinic, subscribe wherever you get your podcasts from or visit clevelandclinic.org/hepodcasts. Also, don't forget to follow us on Facebook, Twitter, and Instagram @clevelandclinic, all one word, to stay up-to-date on the latest health news and information about coronavirus, as well as your own health and wellness. Thanks for listening and stay safe.