Colds, Flu and You: A Practical Guide for the Season Ahead

There's that moment. A tickle in the throat. A slight heaviness behind the eyes. The nagging feeling that you may have to get back to bed.

Most South Africans will catch a cold or the flu at least once this year. It's not fun, but it's rarely serious. The trick is knowing how to handle it without suffering more than necessary, and recognising the times when a doctor is actually needed.

Stopping a cold before it starts

Prevention sounds boring, but it works better than any treatment. The annual flu vaccine is the single most effective step anyone can take. It's available at most pharmacies from around March. Does it guarantee you won't get sick? No. But it dramatically lowers your chances of ending up in bed for a week or worse, in hospital.

Beyond the jab, simple habits make a real difference. Washing hands properly—with soap, for twenty seconds—dislodges viruses before they reach your face. And that's the key: viruses enter through the eyes, nose, and mouth. Touching your face less often is harder than it sounds, but worth practising.

Good sleep is quietly powerful. People running on six hours or less are far more susceptible to catching whatever is going around. And when someone at home is sick, opening a window for even a few minutes reduces the amount of virus floating around the room.

Is it a cold or the flu?

This matters because the flu has a narrow treatment window. But the experience of each is quite different. A cold announces itself slowly. One day a scratchy throat, the next a runny nose, maybe a mild headache. There might be no fever at all, or a very low one. Annoying, certainly, but the average person can still function—make tea, watch television, grumble from the couch.

The flu hits like a freight train. People often remember the exact hour it started. Suddenly there is a high fever, often over 38°C, with chills that won't quit. Every muscle aches. The headache is deep and pounding. Getting out of bed feels like a monumental task. That is influenza.

What actually helps when you're already sick?

There is no magic cure. Anyone promising to "kill a cold overnight" is selling something that does not exist. But there are several things that genuinely reduce suffering and help the body recover faster.

• Drink well. Water is fine, but if there is a fever with sweating, an electrolyte solution (like Rehidrat or a sports drink without too much sugar) is better. Warm tea with honey genuinely soothes a sore throat. What does not help is alcohol, excessive coffee, or sugary energy drinks. Those dehydrate and inflame.

  
  

• Use pain and fever relievers wisely. Paracetamol brings down a fever and eases aches. Ibuprofen does the same and also helps with muscle inflammation. The danger is doubling up—many over-the-counter flu remedies already contain paracetamol, so taking them alongside a separate paracetamol tablet can damage the liver. Read the labels.

  
  

• Clear the nose without making things worse. Saline sprays are drug‑free, safe, and effective. Steam from a hot shower or a bowl of warm water with a towel over the head loosens mucus naturally. Decongestant sprays work quickly, but should never be used for more than three days - they cause rebound congestion that leaves you more blocked than before.

  
  

• Try honey for a night‑time cough. A teaspoon of honey before bed has surprisingly good evidence behind it, even outperforming some over‑the‑counter cough syrups. Just do not give honey to babies under one year.

  
  

• Rest properly. Closing the laptop, but still answering emails is not rest. The body needs energy for the immune system, not for work. Taking sick leave is not a sign of weakness; it is the medically correct choice. And yes, a medical certificate is reasonable to ask for.

  
  

Common mistakes that make things worse

The biggest one is demanding antibiotics. Colds and flu are viruses. Antibiotics kill bacteria. Taking them for a virus does absolutely nothing except cause diarrhoea, thrush, and contribute to antibiotic resistance. Any doctor who prescribes antibiotics for a straightforward cold is not doing their job properly.

Another mistake is going back to work or socialising while still febrile. A person with fever is contagious and also prolongs their own illness. The safe rule is to stay home until fever has resolved for 24 hours without using paracetamol or ibuprofen.

When a doctor is genuinely needed

Most colds and flu resolve on their own within a week or so. But there are clear warning signs that should not be ignored. Seek medical advice if any of these occur:

· Shortness of breath or difficulty breathing

· Fever that goes away then suddenly returns after a day or two

· A cough that starts producing green, yellow, or brown phlegm after several days

· Chest pain or pain that worsens with each deep breath

· Being unable to keep fluids down for more than 12 hours

· A severe headache accompanied by a stiff neck or sensitivity to light

· Any existing condition like asthma or diabetes getting significantly worse

· Feeling better for a day, then suddenly much worse

Pregnant women, people over 65, and anyone with a chronic medical condition should have a lower threshold for calling a doctor, ideally within the first 48 hours of developing a fever.

The window for flu treatment

There is an antiviral medication for influenza that can shorten the illness by about a day and reduce complications. But it only works if started within 48 hours of symptom onset. That is why knowing the difference between a cold and the flu matters. Waiting several days to see if things improve closes that window.

A final word about recovery

Most people bounce back fully. The mistake is trying to bounce back too fast. Even after the fever breaks, fatigue often lingers. Returning to exercise or a full work schedule prematurely is a common way to relapse or drag out the recovery. Listen to your body. If getting up to make tea still feels exhausting, it is too early to return to normal life.

When you need help without the waiting room

If cold or flu symptoms are making daily life difficult, or if there is any concern about those warning signs, an online GP consultation is a convenient and clinically appropriate option.

Same‑day appointments are available. The doctor will provide a written management plan, any necessary prescriptions, and a medical certificate if required.

Dr S Brandt

General Practitioner, Johannesburg