As co-workers are coughing and sneezing, as high school kids are exhausted and achy, as little kids have runnier noses than usual, here’s what to keep an eye out for in the coming weeks besides more snow flurries.

Public health experts are focused on three respiratory illnesses they expect to be causing problems this fall and winter – influenza, COVID-19 and RSV – along with the stubborn common cold.

“With colder temperatures, people tend to spend more time indoors, which means there’s less fresh air circulation – which means there’s more of the flu going around,” said Mark Springer, an epidemiologist with the Spokane Regional Health District.

Last year brought an especially early flu season to Spokane, but the prevalence of seasonal illnesses typically begins in November and December.

With the snow and the cold, staff in Spokane’s Multicare Rockwood Clinics are gearing up for more patients in the coming weeks who present the tell-tale signs of seasonal illness.

“It only takes one person in a room with illness to spread a viral illness to the others. A typical viral illness ranges seven to 10 days,” said Rockwood urgent care Physician Assistant Nikolus Richey.

Depending on the type of illness and its severity, children and teens may need to stay home from school. But so far, attendance at Spokane Public Schools has remained above 90%. According to the district’s guidance, children should stay home from school if they have had a temperature above 100.4 degrees in the past 24 hours or a bad cough, or other symptoms listed in guidance found on the district’s website.

Most individuals should be able to suffer through their illnesses at home if they are a healthy adult, according to Springer.

“You should be able to stay home and take over-the-counter medicine for the most part,” he said. “Symptoms that we would encourage people to consider seeking medical evaluation would be those where they have high fever, or shortness of breath or difficulty breathing, because those can be significant signs for pneumonia.”

Richey said those with mild symptoms might need to see their primary care physician if their illness does not improve after seven to 10 days.

“Drink plenty of fluids, which can help decrease the risk of dehydration, which leads to urgent care visits. Get plenty of rest. Wash your hands frequently. Stay home if you are sick so you don’t expose others,” Richey said.

Symptoms of these three respiratory illnesses circulating in Spokane overlap to a great degree. But some are more prevalent with one illness than another. Here’s what to watch for when feeling ill.

Flu

Among the most evident symptoms are fatigue, muscle aches and high fever. But other symptoms such as a sore throat, runny nose and cough can show up.

Symptoms tend to appear quickly and be the worst in the first few days until resolving within a week.

If caught early enough, the flu can be treated by antiviral medication Tamiflu. The drug works by preventing the flu virus from multiplying in your body.

Over-the-counter medication can be useful to relieve pain or discomfort. However, the FDA recently put out a warning that common decongestant ingredient phenylephrine is largely ineffective.

The flu is caused by either the type A or B influenza virus. One is usually the dominant strain and tends to peak in Spokane in January and February, according to Springer. It is spread via mucus or saliva that is expelled by an infected person coughing, sneezing or even talking.

Getting vaccinated in the next few weeks provides the most protection .

COVID-19

Compared to flu, those with COVID-19 are likely to have more respiratory symptoms like a cough or sore throat. High fevers are less common, compared to flu.

COVID-19 is most infectious for five days after symptoms first appear, which is typically two to four days after infection. Symptoms typically go away within a week.

Unlike many other respiratory illnesses, COVID-19 is largely not seasonal and is contracted year-round. Rapid tests are widely available and remain the easiest way to see if you have it.

COVID-19 can be treated with Paxlovid, an antiviral pill. The drug is reserved for those who have contracted a severe case or are at high-risk of serious complications from the disease.

Vaccination provides the most protection.

RSV

Those with respiratory syncytial virus have similar symptoms of fever, cough and wheezing, and shortness of breath.

It tends to affect the lower respiratory tract of the lungs more so than other respiratory illnesses, which carries greater risk of severe complications for infants.

These symptoms tend to be less severe than either COVID-19 or the flu, except in infants and the elderly. The condition is especially mild for healthy adults or older adolescents, making it easier to ignore than, say, the flu.

Most symptoms will last approximately a week. The disease is spread through droplets discharged by an ill person’s sneeze or cough.

Earlier this year, the FDA approved a new RSV protection called nirsevimab for infants. It is also known under the brand name Beyfortus. It boosts the immune system by mimicking the body’s ability to fight off an infection. The drug is available to infants born or entering their first fall RSV season and to especially vulnerable children up to 2 years old.

Cold

The common cold, a catchall term rather than a specific illness, is the collective name for a number of mild respiratory illness prevalent this time of the year.

Symptoms tend to be located in the upper respiratory system, such as the nose, mouth or throat.

It is rare for the cold to lead to serious complications, but it can be the cause of missing school or work.

The flu, COVID-19 and RSV all have vaccines that are effective as a preventive measure to respiratory illness.

“People should understand that they’re not perfect vaccines in the sense that they’re not going to prevent illness 100%. But what they will do is, they will provide a protective effect for people who’ve been exposed to these illnesses and minimize the risk of them getting sick, and may also minimize the severity of symptoms,” Springer said of the three vaccines.

An updated COVID vaccine was approved for use in September, and the FDA recommends everyone 6 months and older receive the shot if it has been at least two months since their last coronavirus vaccine. A new flu vaccine is released each flu season and should be taken soon so the several months of protection it provides also coincides with the height of flu season.

A vaccine for RSV was approved for the first time earlier this year by the FDA. The vaccine is currently approved only for pregnant women and those 60 and above.

Unlike COVID and the flu, some people may not have heard of RSV outside of information campaigns focused specifically on the parents of infants. According to Springer, that’s because public health officials have not had access to the vaccine and other treatment options for it before this year.

“RSV has become a more prominent respiratory illness from a public health perspective because now we have more tools. And looking for this from a clinical perspective, it’s hard for providers to test for something or to look for something when they don’t have a treatment option. And we did not have that treatment option for RSV until now,” he said.

Springer speculated many in Spokane may be experiencing public health fatigue following the COVID-19 crisis. But he urged it’s still important for individuals to get vaccinated and stay protected as much as possible.

“We’ve been dealing with COVID for so many years and we’re tired of that. At this point, many of us have the sense that we don’t want to do something unless it’s absolutely necessary. And I understand that,” he said. “But once we have, we’re in the middle of respiratory illness season, we’re really at risk of getting this and vaccines provide protection. We just want to encourage people not to wait.”