A Word from Dr Greg White, Cromwell GP


Not all coughs require attention from a doctor

This month has seen our first proper epidemic since lockdown, the perennial RSV virus.

What’s interesting is the sharp rise in cases and hospitalisation rates that has overwhelmed EDs, wards and GP clinics.

We missed a whole year of winter bugs in 2020, so we get exponential spread in those with no immunity.

RSV causes cough and cold, often associated with wheezing, similar to asthma.

What is a cough, when should we worry about it, and what can be done?

Coughing is a reflex triggered by irritation in the vocal cords, trachea and bronchial tubes.

A cough is designed to keep our airway clear of debris.

It is very powerful, even a general anaesthetic doesn’t fully suppress it, so most drugs don’t have a huge effect, unfortunately.

The only real cure is to resolve the infection.

Antibiotics nearly always speed recovery, but should only be used when complications arise.

Inhalers, steam, vaporisers, cough lozenges and syrup help for short periods only.

So when to see your doctor or pharmacy?

Not every child with a cough needs to see the doctor.

Vomiting after cough is common, but can be whooping cough, and should be checked. Shortness of breath should be checked rapidly.

Turning blue, of course, means dialling 111.

Croupy cough is common in kids, if they have a stridor which is a noise when breathing quietly, they need to be seen.

What about duration?

People often are surprised they have been coughing for several weeks.

This is normal, up to six weeks, with chest infections, but persistent mucky phlegm needs attention.

What about other red flags?

Bloody phlegm, wheeze at night, chest pains, cough for more than six weeks, weight loss, night sweats, high fever, rash, extreme lethargy, and smoker’s cough should be checked by a GP.

Finally, please bear with your overworked GP clinics, as Covid restrictions may involve being seen in the car park and being swabbed.

This is not just for Covid surveillance, but is required before a chest X-ray can be done.

So stay home if sick, you will just make others sick if you soldier on.

“Covid” hygiene like distancing, hand washing, masking and cough etiquette, also work quite nicely at stopping RSV and cold viruses.