A Guide to Cold and Flu Season

Oct 26, 2023


Alto Pharmacy

illustration for a mother taking care of her daughter with the flu
illustration for a mother taking care of her daughter with the flu
illustration for a mother taking care of her daughter with the flu

Navigating cold and flu season has become more complicated in recent years, with multiple virus-caused respiratory illnesses to be mindful of. Since symptoms of the cold, flu, and Covid frequently overlap, it can be challenging to tell these seasonal health risks apart. On top of that, there’s the issue of staying up to date with treatment and vaccine recommendations in a continually evolving landscape. The guide below is here to help!

The cold

There are more than 200 viruses that can cause viral rhinitis, an infection of the nose, sinuses, and windpipe better known as the common cold. And it really is quite common: the illness is estimated to account for over 22 million missed school days and even more missed days of work every year. The mildest of all the infections covered in this guide, it typically resolves on its own within 7-10 days.

Common symptoms

  • Cough

  • Runny nose or nasal congestion

  • Sneezing

  • Sore throat

These symptoms tend to develop gradually and are typically mild. In rare cases, a cold may also cause chills, vomiting, a fever, or shortness of breath, but the presence of these symptoms usually indicates a more severe viral infection such as the flu.

Immunization and treatment options

Currently, there is neither a vaccine nor a cure, in part because of just how many viruses can cause a cold. However, there are many effective treatment options for specific symptoms, including over-the-counter cough medicines, antihistamines, and decongestants. (You can purchase many of these right from your Alto account at the Essentials Store!) Maintaining enough humidity can ease congestion, and some people find it helpful to use a humidifier. It’s also important to stay well rested and hydrated.

Visit a healthcare provider if cold symptoms don’t resolve within 10 days. If you experience cold symptoms and are vulnerable to complications from a viral illness, take an at-home Covid test, if possible. This includes individuals who are 65 and older, have a preexisting chronic condition, or are immunocompromised.

The flu

Like the common cold, the flu is a contagious respiratory illness, but there are several key differences in causes, symptoms, and treatment. The flu is only caused by influenza viruses and tends to bring more severe symptoms than the cold. Although it too is common, with about 20 to 40 million cases in the US every year, it can be serious, especially for people with other health conditions.

Common symptoms

Like the cold, the flu can cause coughing, sneezing, a runny or stuffy nose, and a sore throat. Additionally, the flu is typically accompanied by body aches and a fever (with or without chills), and the presence of these symptoms likely indicates that you have an illness other than the common cold. In contrast to the gradual development of cold symptoms, flu symptoms often appear suddenly.

Immunization and treatment options

The flu vaccine offers protection against influenza viruses. Each year, a new “flu shot” is developed to target the specific influenza virus expected to circulate most that season, based on research. This vaccine is recommended for all age groups, including infants over six months of age, children, and adults. Immunization is even more critical for those who are more vulnerable to complications. Since flu cases typically peak between December and February, the CDC recommends getting your flu shot during the fall. Check with your provider for tailored recommendations.

In addition to over-the-counter treatments like acetaminophen (Tylenol®) and ibuprofen (Advil®, Motrin®) for fever, an antiviral medication called Tamiflu® can reduce the severity of flu cases and prevent complications. This type of medication is typically prescribed for several days up to a week or more. It is usually most effective if taken within two days of infection but may still be beneficial if taken after.

While Tamiflu and other antivirals are an effective and powerful treatment option, they aren’t a substitute for a vaccine, and it is still important to stay current with immunizations.


Covid-19 is a respiratory illness caused by a coronavirus called SARS-CoV-2, which was first discovered in 2019. While there are similarities between the flu and Covid, the latter appears to be more contagious than the flu and is also linked to more severe illness, although many Covid cases are mild. Another key difference between the two illnesses is that Covid symptoms typically take longer to become visible and people infected with it are often contagious for a longer duration.

Common symptoms

  • Fever, with or without chills

  • Cough

  • Shortness of breath

  • Fatigue

  • Sore threat

  • Runny or stuffy nose

  • Muscle pain or body aches

  • Vomiting

  • Reduction or loss of taste or smell

Many of these symptoms overlap with those of the flu, though changes in taste and smell are more characteristic of Covid. Testing can provide a more specific diagnosis so that you can receive treatment, if necessary.

Immunization and treatment options

First approved in 2021, Covid vaccines have been continually updated to offer even better protection against newer variants. The most recent versions of the Pfizer-BioNTech and Moderna Covid vaccines were approved this fall. The CDC recommends one dose of an updated 2023-2024 Covid vaccine for everyone five years and older. If you are immunocompromised, ask your provider about recommendations for additional doses.

An antiviral, Paxlovid®, can reduce the severity and duration of Covid infections. Currently, it is only available to people at risk of progression to a more severe case of Covid. This includes, but is not limited to, individuals who are immunocompromised or living with a chronic illness that could increase the chance of Covid-related complications. Additionally, Paxlovid eligibility is limited to adults and children who are twelve or older and weigh at least 88 pounds.


Respiratory syncytial virus (RSV) is frequently linked with cold-like symptoms. The majority of cases are mild, and most people recover within one to two weeks, but it can become more serious. Infants and older adults are at the greatest risk of severe illness and hospitalization.

Common symptoms

  • Runny nose

  • Decrease in appetite

  • Coughing or sneezing

  • Fever

  • Wheezing

These symptoms often appear within four to six days of infection, typically in stages. In young infants, RSV may present as irritability, less energy, and difficulty breathing, without the above symptoms.

Immunization and treatment options

Thankfully, there are now multiple protections against RSV for vulnerable groups. Infants can get an antibody shot called nirsevimab (Beyfortus®). (An antibody shot is a form of immunization that is safe for babies, whose immune systems aren’t strong enough for most vaccines.) There are two approved vaccines for adults over 60: an option from Pfizer and an option from GlaxoSmithKline. The Pfizer RSV vaccine is also available to pregnant women, who can pass on the immunity to their child.

Over-the-counter fever and pain relief can help manage symptoms. Additionally, drink plenty of fluids to stay hydrated.

If your child has RSV, check with your provider about the safety of OTC treatment options before giving them the medication. Some medication ingredients may be unsafe for younger children.

Get OTC essentials from Alto

We’re here to help you navigate cold and flu season. The Essentials Store in the Alto app has cold medicine, fever relief, Covid tests, face masks, and more available for purchase. Buy these items at any time or bundle them into your next prescription delivery. To browse the selection, tap the "Store" icon along the bottom of the app or in your account on desktop.

Additionally, Alto is proud to partner with the New York City Health Department in the distribution of Covid antivirals. If you live in the city and have a prescription for Paxlovid, we’ll deliver it right to your doorstep.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

Believe in a better pharmacy

Believe in a better pharmacy

Believe in a better pharmacy