Let's just call it like it is: Having the flu sucks. It basically knocks you on your butt for days, and it feels like you'll never get better. We wanted to understand the ins and outs of influenza and if visiting a doctor is really necessary (spoiler: it's not). So we talked to Stephanie Long, MD, a family medicine physician at OneMedical and one of the district medical directors at the SoMa Clinic in San Francisco. Many of us probably get a little dramatic when we're sick, but when someone really has the flu, you have to take it easy to get better.
When Is the Flu at Its Absolute Worse?
"True influenza is its own virus, and it's spread by respiratory droplets," Long explained. The highest viral count is in the incubation phase, before you have symptoms, which means people can easily spread the illness before they even know they have it. This phase is usually two to five days before the onset of symptoms. Once those symptoms hit and you realize that you're sick, those first few days are when you'll most likely feel the worst.
Should You Go to the Doctor When You Think You Have the Flu?
Many people may not realize that, according to Long, "the majority of folks who get the flu can take care of it on their own." The prescription is a cocktail of those things your mother told you growing up: get enough rest and fluids, take Tylenol or ibuprofen for aches and pains, and take something (like Sudafed) for congestion.
If a patient comes in within 48 hours of symptoms starting, physicians could help prevent it from getting worse or progressing into a complication. While medications like Tamiflu can help in that respect, they're not actually fighting the sickness. Remember: influenza is a virus, not a bacteria, so it cannot be treated with antibiotics. You also have to keep in mind that even if you are within those first 48 hours, that's when you're most contagious. It's not ideal to have a patient come in, spreading the illness in the office. Luckily, many doctors' offices, like OneMedical, have virtual care systems in order to treat patients without having them come in. Keep in mind that there's no magic medication, though; it's all about rest, fluids, and riding it out.
There are some patients who need medical attention when they have the flu, such as older people (65 and up), non-school-aged children, pregnant women, and anyone with other issues like asthma, COPD, diabetes, and morbid obesity. Also, people with conditions that compromise their immune systems, like HIV, can get even sicker from the flu. Those people should talk to their doctors.
At What Point Should You Start Feeling Better?
Long mentioned that once the symptoms begin, you'll probably start feeling worse for three or four days (sorry!), and then symptoms will begin to improve from there.
How Long Does the Flu Actually Last?
For a lot of people, it can linger for up to two weeks. However, this is a somewhat challenging question, Long pointed out. During the first week, people experience fever, chills, body aches, congestion, cough, and wheezing. After that, people typically start feeling better with each passing day. Their fever is gone and maybe they're even back to working out again, but they're still experiencing coughing and wheezing. Sometimes these people think they're still sick, so they want to go to their doctor. However, these are likely just lingering symptoms as the inflammatory process in the lungs tries to clean and protect itself. But if patients are still feeling like they did during the first week of illness, it could be a complication such as pneumonia or sinusitis, in which case they should call their doctor.
What Are Easy Ways to Prevent the Flu?
You've heard it time and time again, but WASH YOUR HANDS. Seriously — especially during cold and flu season. Besides that, avoid sharing food, and cough or sneeze into a napkin or your arm (doing so into your hand or, even worse, onto someone is a key way to spread the virus). If you're thinking that these sound like common-sense preventive methods, that's because they are, so practice them!
In addition, the flu vaccine is a huge epidemiologic advantage in terms of taking control of the virus. "If more people used it, I think we could decrease flu even more," Long explained. While the vaccine will never be 100 percent perfect (because it's created based on researchers' best guesses as to which strains will be circulating), there's a better chance of protection with it. As Long put it: "Taking precautions is always a good idea."