How to stock your first aid kit during the ‘tripledemic’

The flu and respiratory syncytial virus, or RSV, are here with a vengeance, and COVID-19 cases are experiencing an uptick across the country. Together, these three respiratory diseases are overwhelming hospitals and disrupting schools and offices.

They are also driving demand for medicines to reduce fever and pain. In recent weeks, some families have had trouble finding acetaminophen (Tylenol) and ibuprofen (Advil or Motrin) for children. Johnson & Johnson, which makes Children’s Tylenol and Children’s Motrin, said in a statement to The New York Times that there are no nationwide shortages, but increased demand means “products may be less available in some stores.” The company said it was maximizing production capacity.

Meanwhile, CVS and Walgreens are limiting purchases of fever and pain-reducing medications for children to ensure continued access for families. These developments may seem worrisome, but experts say there are only a couple of things that are really essential for managing headaches, fever, coughs, and a runny or stuffy nose if someone gets sick. And you don’t need to stock a large quantity of any one medication, said Rebekah Wrenn, coordinator of infectious disease pharmacy services at Duke University Hospital. “You just need to have enough for your family for a possible week of symptoms.”

Here’s what doctors recommend for relieving flu, COVID, and RSV symptoms at home.

ESSENTIALS

a thermometer or two

The first item many experts recommend is a digital multi-use stick thermometer, a temporal (or forehead) thermometer, or both. A fever can be one of the first signs of a viral infection, and being able to objectively gauge when your temperature starts to rise and by how much it rises can help you figure out how to manage the symptoms, as well as how long you may be contagious.

Digital Multi-Purpose Stick Thermometers provide quick, easy-to-read body temperature measurements for people of all ages. They can be used by mouth for adults and children up to age 4 and under the armpit for anyone (although the American Academy of Pediatrics cautions that armpit temperatures are not always accurate). Multi-use thermometers can also record rectally, which produces the most accurate readings for young children, particularly those under 3 months of age.

Temporal thermometers are a good choice for adults and children because they can measure heat waves leaving the temporal artery in the forehead in a matter of seconds, said Dr. Sarah Adams, a pediatrician at Akron Children’s Hospital in Ohio. It can be helpful to have two different types of thermometers available so you can compare them if a reading seems off, Adams said. But even if you only have one, using it to take repeated measurements over time can help you make sure the temperatures you’re seeing are accurate.

Medicines to reduce pain and fever

These come in two categories: acetaminophen (sold under the brand name Tylenol) and nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen (sold under the brand names Advil or Motrin).

According to Adams, it’s a good idea to keep both on hand. Acetaminophen alone helps relieve pain and fever, while ibuprofen also reduces inflammation.

You can use paracetamol or ibuprofen interchangeably; it all comes down to personal preference, Wrenn said. You may choose one over the other to avoid interactions with other medications you take, or to avoid side effects that you or your child may have experienced in the past, such as ibuprofen stomach ache. You can also choose based on formulation: Adult pain relievers and fever reducers come in several types of pills; Children’s medicines come in chewable tablets or liquid form.

You can alternate between acetaminophen and ibuprofen, Wrenn said. It’s best to avoid high doses or long-term use of either drug, so pay close attention to the dosing instructions and frequency given for each and don’t hesitate to ask a doctor or pharmacist for help, Wrenn said.

If you can’t find a fever reducer

First, take a breather: Doctors stress that there’s usually no medical need to bring down a fever unless it’s over 103 degrees, or makes you or your child miserable. “It’s your body’s response to infection,” said Dr. Michael Chang, a pediatric infectious disease specialist at Memorial Hermann Health System in Houston.

Pay attention to your child’s behavior. If they usually sleep, eat and drink well, experts said it’s best to let a fever run its course. The AAP offers guidelines to help parents determine if a child’s fever warrants a call to the pediatrician. However, experts acknowledge that fever-reducing medications can be helpful for young children who do not speak because it can be more difficult to tell when they are uncomfortable and cannot sleep or eat because of their illness.

If you need to use a fever reducer, you can try a generic version approved by the Food and Drug Administration.

You can also try non-pharmaceutical interventions. Focus on keeping your child well-hydrated, said Dr. Misbah Keen, a professor and executive vice president of family medicine at UW Medicine in Seattle. Place a washcloth rinsed with warm water on the forehead. Dress them lightly and keep the room at a pleasantly cool temperature.

Older children can take adult ibuprofen or acetaminophen tablets, but you may need to cut them to achieve the correct dose, Keen said. The AAP has dosage guidelines based on age and weight. She stressed that it’s best to check with your child’s pediatrician or family doctor first.

OTHER DRUGS NICE TO HAVE AROUND

Saline spray or drops

If you’re experiencing congestion, try a spray or saline drops to help loosen and clear mucus from your nose, said Dr. Dana Mazo, an infectious disease specialist and clinical associate professor of medicine at NYU Langone Health. This can also help relieve cough and sore throat symptoms that are often triggered, at least in part, by excess accumulated mucus draining down the throat, creating a condition called postnasal drip.

Saline sprays or drops are particularly helpful for children younger than 4 who may not be able to blow their noses and should not receive over-the-counter cough and cold medications because of the risk of side effects, Adams said. You can also use a saline spray along with other home remedies that soothe an irritated nose and throat, such as nasal aspirators, cool-mist humidifiers, hot teas, or honey. (Honey should not be given to babies under 12 months of age due to the risk of infant botulism.)

Medicines for cough, congestion and sore throat

Some experts recommend combination medications to relieve cough and congestion in adults; others prefer to use separate medications for each symptom. “It really depends on what symptoms a patient is having,” Wrenn said. “If they only have one symptom at a time, which is often the way these respiratory illnesses progress, then I would only use one medication at a time.”

If you decide to take a combination medication, be sure to read the ingredients and follow the dosing instructions to avoid an inadvertent double dose with a fever reducer like acetaminophen. Other than that, the brand of the drug doesn’t really matter. “We’ve all had a lot of colds and respiratory viruses in our lives and have tried different things to treat them,” Mazo said. “If you’ve found in the past that one brand seems to work better for you or that a decongestant works better alone compared to a combination medication, I think it’s okay to take it.”

What the experts do agree on is that you should go through your medicine cabinet (or secure storage space) at least twice a year and throw away any medications that are out of date so you can be sure that the medications you have will work.

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