Cold and Flu Season

It is the beginning of cold and flu season. Our colleagues at PrimeCare of Michigan are already beginning to diagnose influenza on a regular basis. It is our clinical impression that distinguishing between COVID-19 and influenza is almost impossible to tell based on signs (what we see) and symptoms (what the patients tell us). Since treatment of the two illnesses is quite different, we believe it is important to test for their presence, even if the initial presentation seems somewhat mild. Fortunately, at PrimeCare of Michigan, we utilize a simple test to check for both illnesses with one quick nasal swab. Accurate results are available are in less than 15 minutes.

The prevalence of COVID-19 is not being reported in the lay press. We are finding that any pronged close exposure to the public is enough to virtually guarantee you have been exposed to the virus. Whether or not a person develops a clinical illness depends on factors that are hard to quantitate. It’s much like the late-night movie in which mongrels overrun a castle. Whether that happens depends on the defenses and thickness of the castle walls as well as how many mongrels are on the attack.

In a recent study I read in the Journal of Therapeutic Advances in Respiratory Disease, among patients with acute exacerbation of chronic obstructive lung disease otherwise known as COPD, a 2-day course of levofloxacin 500 mg/d was equivalent to a 7-day course in terms of cure rate, need for additional antibiotics, ICU admission, 1-year re-exacerbation rate, and 1-year mortality. This is a radical departure from prior recommendations. Available guidelines state that antibiotic treatment should be maintained at an average of 7–10days. Researchers believe the findings from this rather small, randomized control trial involving 310 patients could improve patient adherence and reduce rates of bacterial resistance and adverse effects.