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Staying Healthy This Winter: 10 Questions, Answered

COVID lingers, flu season is at hand and germs are everywhere. Here’s how you can reduce your risk


spinner image a hand outstretched to ward off winter diseases
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If there’s one thing we can agree on, it’s that nearly three years of pandemic living has left us sick of sickness. But as sure as fall leads to winter, so will virus season soon be upon us. COVID-19 variants now outnumber Tom Brady’s Super Bowl wins, the flu’s latest model is in the showroom, and more than 200 viruses lurking out there are capable of causing the common cold.

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Here’s the thing: You have the power to reduce your risk of getting sick significantly.

What’s important is to start taking the precautions you need today to reduce your risk of getting a cold, the flu and COVID, and make it through the winter healthy and safe. So we called up the experts and pressed them to answer some of your most common questions.

1. COVID seems much milder now. Do I still have to worry about it?

How to Score Cheap COVID Tests

The federal government no longer offers free at-home tests, but you can find COVID testing on the cheap.

  • Via insurance or Medicare: Health insurance or Medicare Part B plans cover as many as eight over-the-counter COVID-19 tests each month. Your plan may have preferred outlets where you can get tests for free, but you can also get reimbursed up to $12 for each individual test. Go to medicare.gov for a list of participating pharmacies.
  • From your doctor: Medicare covers you when you get a COVID-19 test from a lab, doctor, pharmacy or hospital.

While the majority of Americans have gotten COVID at least once, the virus that causes it, SARS-CoV-2, continues to evolve and mutate, sending thousands of people to the hospital every day.

No one knows exactly where this bug is headed, says Panagis Galiatsatos, M.D., an assistant professor of pulmonary and critical care medicine at Johns Hopkins School of Medicine. He’s predicting more cases as the weather cools, with a potential wave of yet another subvariant of the omicron variant.

You already know the immune system weakens with age, making infections more precarious and recovery time longer. More than 75 percent of COVID deaths have been in those age 65 and over, a risk that increases if you have underlying medical conditions.

But there’s another issue to keep in mind: A prolonged recovery time — and the bed rest that can go with it — puts you at an increased risk for a cadre of complications, from loss of muscle mass and strength to prolonged immobility and falls, leading to a potential downward spiral. That’s true for COVID, the flu and even the common cold.

“Trying to fight your way back to where you were before can be a tremendous battle,” says Magdalena Bednarczyk, M.D., section chief of geriatric medicine at Rush University Medical Center. “For a fit, younger adult, a common cold or the flu could be an inconvenience. For a frail older adult, it can literally knock them off their feet,” she says.

Bottom line on COVID: It’s still out there, it’s serious, and it’s not alone.

2. Should I get the new COVID booster? And if so, when?

For a person 65 and older, being up to date on your vaccinations significantly reduces the likelihood of heading to the hospital. So yes, you want that booster.

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And right now is the perfect time for it, assuming you’ve already had the initial vaccine. The recently introduced booster targets the most contagious of the omicron subvariants, so adding it to your previous vaccinations is like donning a full-body suit of immunity armor. And since it’s also the right time of year to get your flu vaccine, you can combine them into one simple appointment.

Just getting over COVID? According to the Centers for Disease Control and Prevention (CDC), you may want to wait three months from the onset of symptoms (or a positive test) before getting the booster. That gives your immune system time to reset its own natural defenses before you add the additional protection of the vaccine. (If you experienced rebound COVID, wait until three months after the return of symptoms or a positive test.)

However, if you suffer from chronic liver or lung disease, diabetes, heart problems or other health issues that put you at increased risk, consult your health care provider about vaccine timing, says Cameron Wolfe, M.D., an infectious disease specialist at the Duke University School of Medicine.

3. Will we ever stop needing these shots?

Maybe, but the more likely scenario is that COVID boosters become an annual routine. “The goal is to get into a pattern that’s similar to the once-a-year flu shot, where companies can modify the vaccine to stay up to date on whatever variants are floating around at the time. Ideally, we are looking at a situation where they are combined with the flu shot to make it easy,” Wolfe says. But we’re not there yet because, unlike the flu, COVID is still a year-round threat.

4. How can I help my immune system naturally?

“There are no injections or vitamins that will produce a supercharged immune system,” says infectious disease expert Lawrence Livornese, M.D., chairman of the department of medicine at Main Line Health System. “Not smoking, not drinking excessively, exercising regularly, preventive immunizations and following a healthy diet are your best bets.”

That said, a recent study found our immune systems respond more vigorously to both COVID and flu vaccines if we perform 90 minutes of light- to moderate-intensity exercise about 30 minutes after receiving the vaccine — and there were no reported increases in side effects. While the study was small, it may make sense to plan a long walk or other light-intensity movement post-vaccination.

5. Beyond vaccines, what’s the latest thinking on protecting myself from COVID?

Galiatsatos recommends keeping two tools at your disposal: rapid tests and well-fitting masks. Testing ahead of holiday gatherings and after exposure can help identify infection so that you don’t spread it to loved ones. And while you’re probably sick of masks by now, he recommends wearing a tightly fitting one — those include N95, KN95 or KF94 — if you’re planning on being out in public for an hour or two, leisurely grocery shopping or taking public transportation.

6. With all this at-home testing, how do we know if COVID is increasing or not?

The increase in home testing is already baked into the CDC’s estimates of COVID infection numbers, says David Cennimo,​ M.D., associate professor of medicine at Rutgers New Jersey Medical School. But for a truly accurate statistic, look at hospitalization rates. If the number is rising in your region, COVID is on the rise and your caution should be as well. Hospitalizations spike in winter: The U.S. saw a peak of close to 155,000 people hospitalized in January 2022; the previous January, we hit nearly 135,000.

7. I’ve already had COVID once. Does that make me less likely to get it again?

5 Risk Factors You Never Knew About

1. Hugging: After COVID, hugs have been replaced by air high-fives. Among those you love, though, more frequent embracing is ​associated with less severe symptoms of illness, according to Carnegie Mellon University researchers. That’s likely because social support counters stress, improving the body’s infection-fighting abilities.

2. Shift work: People who work the midnight shift are 1.2 times more likely to get struck down by the cold or flu compared with those who work more traditional hours — and their illnesses are more likely to be severe, according to a study on hospital workers published in the American Journal of Epidemiology. This shift in circadian rhythm may affect immune system function, making you more vulnerable to infection.

3. Low-carb diets: Those who ate low-carbohydrate, high-protein diets were more likely to develop moderate to severe COVID infections compared with those following a plant-based diet filled with fruits, veggies and whole grains, according to a study in BMJ Nutrition, Prevention & Health. Plant-based diets are packed with nutrients that fight respiratory illness.

4. Sleeping: Logging fewer than six hours of sleep per night is associated with four times the risk of catching a cold compared with sleeping more than seven hours, research in the journal Sleep found. Inadequate z’s may impair the activity of immune cells.

5. Sunshine: Spending time in the sun has been shown to protect against the flu, possibly because it activates the production of vitamin D, which decreases the risk of respiratory infections.

Not fully. Think of COVID as like a supercharged common cold: Coming down with it once doesn’t mean you can’t get sick again. “The virus changes enough over time that the immune response you develop against one version is enough to protect against serious illness but not from developing another infection,” says Steven Lawrence, M.D., Washington University infectious disease specialist at Barnes-Jewish Hospital. And every new infection brings new risk of complications — including long COVID.

8. Should I ask for antivirals if I test positive for COVID?

Yes. “Early treatment with Paxlovid or Lagevrio [another antiviral] can keep individuals out of the hospital and minimize the risk of death,” says Thomas Tsai, M.D., senior policy adviser for the White House COVID-19 Response Team. But getting the drugs into the hands of those who are most vulnerable is critical. “Historically, we’ve always seen underutilization of the treatments for our older populations. And this is why older individuals are often the most vulnerable groups,” he points out.

“Our older Americans are, once again, bearing the highest burden of severe outcomes from COVID-19, including higher rates of hospitalization and, unfortunately, death,” Tsai says. Reach out to your doctor about antivirals if you suspect COVID.

9. I’ve heard of “flurona” — or getting sick with the coronavirus and the flu at the same time. Can that really happen?

In a study on nearly 7,000 people with COVID in the U.K., about 8 percent of them were sick with a second virus; about half of those cases involved the flu. Patients who had flurona were significantly more likely to require ventilation and to die in the hospital. That’s another reason to get both the flu vaccine and the COVID booster this year.

The looming danger of the upcoming flu season has the CDC on alert, and this year its recommendation is that adults age 65-plus get the higher-dose or adjuvanted flu vaccines rather than the standard dose.

“The flu is a very serious illness in older people,” says Nina Blachman, M.D., geriatric medicine specialist and assistant professor of medicine at NYU Langone Health. One study in The New England Journal of Medicine found that older adults are six times more likely to suffer a heart attack in the seven days after catching the flu.

10. If I got really whacked by COVID, does that mean I’ll be hit hard by the flu too?

Your Get-Healthy Kit

Before you find yourself sidelined with fever, body aches, coughing and sneezing, make sure you’re fully stocked up on these eight essentials.

1. COVID tests: Avoid the embarrassment of hacking while standing in line at the pharmacy buying COVID tests. Keep two or three rapid tests on hand to help you identify if your symptoms are related to COVID.

2. Masks: Whether you have COVID or not, protect yourself and those around you by wearing a mask. N95s, KN95s or KF94s are best.

3. Acetaminophen: Acetaminophen (Tylenol) is the preferred fever reducer for fighting illnesses, says June McKoy, M.D., a geriatrician and professor of medicine at Northwestern University Feinberg School of Medicine. Ibuprofen is great for sprains and strains, but in older people it may cause elevated blood pressure, interfere with kidney function and cause gastrointestinal discomfort.

4. Thermometer: Fever can be a symptom of COVID-19 and the flu, but is less likely for the common cold. Having a thermometer on hand will arm you with important info if you need to call your doctor. Pro tip: Purchase a contact thermometer (one used on the forehead or in the mouth or armpit), as contactless forehead thermometers have been shown to miss the majority of fevers.

5. Pulse oximeter: This device, which clips to your fingertip, measures your blood oxygen saturation level and can indicate if your oxygen level is decreasing, necessitating medical intervention. The U.S. Food and Drug Administration warns that these monitors may be less accurate for people with darker skin tones, so talk to your doctor before getting one. If you’re experiencing breathing problems, call your health care provider.

6. Throat lozenges: Stick with a plain, non-zinc throat lozenge, McKoy recommends. (Zinc can alter your sense of smell and taste for several days, she says.)

7. Cough syrup: Dextromethorphan (Robitussin) is a good option for quieting a pesky cough. “You don’t want to get rid of a cough completely, as it serves a purpose to clear your airways,” McKoy notes.

8. Soup: Keep your soup shelf stocked with several varieties this winter and grab any can when the mood strikes. Soup is hydrating and can help speed the movement of mucus and lessen congestion.

Not necessarily. “Our immune systems are as unique as fingerprints,” Lawrence says. Overall, in the absence of another medical condition (lung disease, for example) that leaves you vulnerable to respiratory infections, your response to COVID doesn’t predict how you’ll handle the flu — and vice versa, he says.

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