Common cold

Also called Upper respiratory tract infection, URTI

The most common illness there is, and the one antibiotics are most often wasted on. Worth knowing when it is not a cold.

What it is

A viral infection of the nose and throat, caused by any of more than two hundred viruses, which is why having had one confers almost no protection against the next.

Adults get two to four a year and young children considerably more, which is normal rather than a sign of a weak immune system.

It is self-limiting. It runs seven to ten days, the cough often lasts three weeks, and nothing available shortens it. Antibiotics do nothing at all, because there is no bacterium involved, and taking them anyway is the single largest driver of antibiotic resistance in the community.

The reason this entry is here is not the cold. It is the small number of times something that started as a cold has become pneumonia, sepsis or an asthma attack, and the signs that separate them.

Signs you might notice

Blocked or runny nose, sneezing, sore throat, cough, mild headache, and feeling tired and achy for a few days.

A raised temperature is common in children and less so in adults.

Green mucus means the immune system is working. It does not mean antibiotics.

What is not a cold: breathlessness, chest pain, a temperature that returns after settling, a cough lasting more than three weeks, coughing blood, confusion, drowsiness, or being unable to keep fluids down.

In an older or frail person, confusion and being off their feet may be the only signs of a chest infection, with no cough at all. See delirium.

How it can affect day-to-day life

A cold matters more than it sounds for people it is not really about: someone with COPD, asthma, heart failure, cystic fibrosis or a weakened immune system can be tipped into a serious illness by an ordinary virus.

For someone with dysphagia, a blocked nose changes how they swallow, and aspiration risk rises for a fortnight.

In a care setting, one cold becomes everybody's cold in about four days. Hand hygiene and keeping unwell staff at home does more than anything else on this list.

Supporting someone well

Fluids, rest, paracetamol or ibuprofen if needed, and time. Honey and a warm drink is as evidence-based as most cough remedies and cheaper than all of them.

Do not ask for antibiotics and do not accept them for an uncomplicated cold. Ask instead what would need to happen for antibiotics to be right, and what to watch for.

Use Pharmacy First rather than a GP appointment for the first assessment in most cases.

For anybody with a long-term lung or heart condition, get the flu and COVID vaccinations they are entitled to and make sure their rescue or self-management plan is where they can find it.

Watch for the person going downhill after having started to improve. That pattern is worth a call.

Where to get help

A pharmacist first. NHS 111 for advice out of hours.

999 for severe breathlessness, chest pain, blue lips, confusion, or a child who is floppy, will not wake, or has a rash that does not fade under a glass.

A GP if a cough lasts more than three weeks, if there is blood, or for anybody with a long-term lung condition who is not recovering as usual.