The cold and flu season looks very different this year with the COVID-19 pandemic. Symptoms like fever, sore throat, aches and chills could be a common cold, the flu, a bacterial infection or the novel coronavirus.

In a recent article in the British Medical Journal, we provide advice on symptom management and treatment approaches for viral and bacterial infections — as well as when patients need virtual versus in-person assessments.

In the past, during the winter months, our medical offices were full of patients with concerns about symptoms caused by seasonal cold and flu viruses. In the context of the COVID-19 pandemic, these symptoms now could be due to COVID-19. Public health advice to Canadians experiencing some of these symptoms is to first get tested for COVID-19 and self isolate at home while awaiting the test result. For those who test negative, but have ongoing symptoms, what to do next can be confusing.

A virtual visit to your doctor may be in order.

Doctors’ offices and clinics now extend beyond the four walls of examination and waiting rooms as patients are accessing more of their care virtually, through phone calls and video visits to reduce the risk of COVID-19 spread. These platforms are ideal for the initial assessment of cold and flu-like symptoms. The majority of viral infections can be accurately diagnosed and managed without a physical exam. Bacterial infections, which are the exception, generally require an in-person visit to assess and confirm.

Making this distinction is important since antibiotics, which are used to treat bacteria, do not improve recovery from viral infections and can have harmful side effects when prescribed unnecessarily.

There’s actually another global health threat that can compound the COVID-19 pandemic: antibiotic resistance. When antibiotics are overused, they create antibiotic-resistant bacteria that make it more difficult to treat common bacterial infections when we need them.

In 2018, approximately 5,400 people in Canada died as a direct result of antibiotic resistance. It is projected that by the year 2050, antibiotic resistant bacteria could lead to 10 million more people dying around the globe each year. Now, more than ever preserving the effectiveness of antibiotics is vital.

Research shows that when antibiotics are prescribed based on virtual visits alone, they may be overused. This occurs because virtual visits lack the ability to perform physical examinations or obtain additional testing required to make an accurate diagnosis of a bacterial infection.

Choosing Wisely Canada and The College of Family Physicians of Canada have created guidance for when an in-person examination may be important to assess if symptoms are caused by viral illness or a bacterial infection.

Right now, patients with cold and flu symptoms are more anxious than in previous years. Primary care providers are equipped to support patients. Although the cold and flu season is very different this year, you are not on your own. Talk to your primary care provider about how to manage your symptoms.