Is it normal for cold-like symptoms to last for weeks? An expert explains

The winter surge of respiratory viruses is underway. The US Centers for Disease Control and Prevention continues to record rising levels of hospitalizations associated with Covid-19 as well as increasing hospitalizations for influenza and the respiratory syncytial virus, also known as RSV.

Many ill people are reporting that their symptoms are lasting for more than a week, even up to two weeks for some. Is this normal? What should your expectations be about the length of viral respiratory illnesses? When should you contact your doctor for additional testing? And what other steps could you take to facilitate your recovery? For example, is it advisable to work, go to school or exercise?

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To guide us through these questions, I spoke with CNN wellness expert Dr. Leana Wen. Wen is an emergency physician and professor of health policy and management at George Washington University’s Milken Institute School of Public Health. She previously was Baltimore’s health commissioner.

CNN: Many of us have friends and colleagues who are experiencing weeks of virus symptoms. Is this normal?

Dr. Leana Wen: There are three issues to consider here. First, let’s discuss how long symptoms typically persist for some common illnesses. For a regular cold, symptoms tend to peak within the first few days after they start. However, some symptoms, especially a runny or stuffy nose or cough, can last up to 14 days, according to the CDC.

Similarly, though those infected with influenza are typically better within seven days, some could have symptoms lasting over two weeks. And the same goes for RSV, the coronavirus and other viruses. Most symptoms generally peak within the first week, and most people are better within two weeks, but it’s not uncommon for some people’s recovery to take longer.

Second, it’s not unusual for some specific symptoms to linger even after others resolve. For instance, some people may develop a persistent cough that lasts several weeks, while other symptoms like body aches and fever could be gone within a few days.

This is especially true for people who have underlying lung disease, for whom the virus could have worsened that condition. Someone with asthma might need to use their inhaler more in the weeks or months following their infection, for example. Then there are also post-viral conditions, such as long Covid, that are associated with ongoing symptoms like fatigue and brain fog. These symptoms could last for months or longer.

Third, it’s also possible that someone who thinks they have one long viral illness is actually experiencing multiple rounds of viral infections. Kids in school and day care, for instance, may have one viral illness that is just beginning to resolve when they contract another one. They may even contract more than one virus at the same time. What seems like a prolonged recovery may really be several overlapping viruses.

CNN: When should people decide to seek additional medical care?

Wen: First and most importantly, what is the age of the individual and what are their preexisting medical conditions? People at the extremes of ages — newborns and elderly individuals — are more likely to become severely ill from viral illnesses. Those with underlying medical conditions like heart and lung disease and who are immunocompromised are also more vulnerable.

These individuals should seek additional medical care sooner. Ideally, they should already have a plan with their primary care provider about what kinds of symptoms should prompt them to get care. Everyone should know how to reach their provider after hours and, if this is not possible, to have a plan for which emergency room or urgent care they will go to if a need arises.

Another factor is whether testing has been done. Do you already know which virus is causing your symptoms? Some people might have already tested positive for, say, Covid-19, and have started an antiviral treatment. Have you also had a chest X-ray? Getting additional testing is one reason to seek medical care, and someone who just underwent tests may not need them repeated so soon. Still, they should contact their medical provider to be certain, especially if they are in a vulnerable group.

A third key factor is time and the progression of your symptoms. If it’s been 10 days but your symptoms are improving, that’s a different story from if it’s been over two weeks and now you have new or worse symptoms. Symptoms that should prompt urgent care would include shortness of breath, chest pain and inability to keep down fluids.

Also, if your symptoms improved but then got worse again, it’s possible that you could have a second, different infection. If you are eligible for antiviral treatment, consider contacting your physician to see if you could be tested for flu or Covid-19. There is also the possibility that you could have something other than a viral respiratory infection. Some people who first have a viral infection could then develop a bacterial infection.

Or perhaps your symptoms are due to something other than an infection. The fatigue you’re experiencing could be a sign of anemia or thyroid dysfunction, for instance. A final factor to consider is to listen to your body. Your doctor is the expert when it comes to medicine, but you are the expert when it comes to yourself. You know your body the best. If something doesn’t feel right, that’s another reason to seek care sooner rather than later.

CNN: What should you expect if you do reach out to your doctor, and what questions should you ask?

Wen: Your doctor may schedule an in-person or virtual appointment with you. They will ask you about your symptoms, so make sure you bring a detailed description of how you’ve felt and how the symptoms changed — or not — over time. Describe what treatments you’ve tried and whether they’ve helped. Be sure to mention a particular symptom that is concerning to you.

You could be recommended to receive additional testing, such as viral tests, blood tests or a chest X-ray. Questions to ask include what these tests are intended to show, as well as what to do if the tests are negative. Should you continue supportive treatments such as fluids and fever-reducing medications? Are there other diagnoses that your doctor is considering? If tests are not recommended at this time, when might they be in the future?

CNN: What other steps could you take to facilitate your recovery? For example, is it advisable to work, go to school or exercise?

Wen: Most viral illnesses self-resolve, which means that they go away on their own without specific treatment. How people recover depends a lot on what they’ve done in the past and what their condition is at present. Some people need a lot of rest. Others prefer to keep busy and continue light exercise. All of these are generally reasonable options, and people should discuss individual circumstances with their health care provider.

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