Protection from respiratory illnesses

Overview

Respiratory illnesses, such as  COVID-19, flu and RSV, affect the lungs and throat, and can be spread when an infected person coughs, sneezes or has face-to-face contact with another person.

Respiratory viruses generally circulate in highest numbers between November and April with some variation between specific viruses. They can be serious and can result in a hospital stay and serious complications, and although this can vary by virus, seniors and young children are especially impacted.

Using layers of protection and staying up to date with your recommended immunizations is the best way to keep you, your family, and your loved ones safe and healthy during respiratory illness season.  

Symptoms

Symptoms of COVID-19, flu and RSV are similar and may include fever, cough, and shortness of breath. Because the symptoms are similar, it can be difficult to distinguish between illnesses caused by respiratory viruses.

Symptoms range from mild to severe. If you feel sick, it’s important that you stay home and talk with a primary care provider if necessary.

Symptoms of respiratory viruses may include any one or more of:

• fever or chills
• cough
• shortness of breath
• runny nose or nasal congestion
• headache
• fatigue
• sore throat
• muscle aches or joint pain
• stomach problems (such as vomiting or diarrhea)

When to seek medical attention

Those who are immunocompromised or at high risk of severe outcomes should speak with a health care provider as testing and treatment options may be available.

If you are having difficulty accessing care, you may contact Health811 by phone at 811 or visit Health811 to chat online with a registered nurse for health advice.

If you think you or your child have a respiratory illness, it’s important to monitor your symptoms. Some people can develop severe illnesses which may result in pneumonia or, in infants and children, bronchiolitis. These illnesses can be serious and may require a visit to a health care provider or to the emergency department.

Respiratory illnesses can also lead to worsening of:

• asthma
• Chronic Obstructive Pulmonary Disease (COPD) — a chronic disease of the lungs that makes it hard to breathe
• congestive heart failure — when the heart can’t pump enough blood and oxygen through the body

Go to an emergency department if someone has:

• trouble breathing (working hard to breathe, breathing faster than normal)
• pale skin
• lips that look white or blue
• asthma or wheezing
• any of the following symptoms:
  • very sleepy/difficult to wake
  • a prolonged or very high fever
  • repeated vomiting and unable to keep any liquids down
  • vomiting or diarrhea containing a large amount of blood
  • signs of dehydration with dry mouth or no urination

Who is most at risk

Although this can vary by virus, some people are more vulnerable to infection or serious complications and hospitalization from respiratory illness.

Populations that are generally at an increased risk include:

• infants and children under 5 years of age, because their immune systems are developing, and their airways are small and more easily blocked
• older adults, because their immune systems are weaker and they are more likely to have an underlying condition that increases their risk
• residents of congregate living settings (such as long-term care homes, retirement homes)
• people who are pregnant, because their immune system, heart and lungs change – especially later in pregnancy – making them more likely to get seriously ill
• people with underlying health conditions, such as asthma, heart disease or diabetes, and those who are immunocompromised

If you are immunocompromised

If you are moderately to severely immunocompromised and develop symptoms of respiratory illness, you may be eligible for testing, treatment and/or supportive care and should contact a health care provider.

People with the following conditions are considered to be moderately to severely immunocompromised:

• solid tumour or hematologic malignancies or treatments for these conditions
• solid-organ transplant and taking immunosuppressive therapy
• hematopoietic stem cell transplant (HSCT) (within 2 years of transplantation or taking immunosuppression therapy)
• immunocompromised due to chimeric antigen receptor (CAR) T cell therapy targeting lymphocytes
• moderate to severe primary immunodeficiency with associated humoral and/or cell-mediated immunodeficiency or immune dysregulation
• HIV with AIDS-defining illness or Tuberculosis (TB) diagnosis in last 12 months before starting vaccine series, or severe immune compromise with CD4 ‹ 200 cells/µL or CD4

How respiratory illnesses spreads

Respiratory infectious diseases can spread in different ways, including from:

• person to person
• contact with contaminated surfaces or objects

Many respiratory infectious diseases spread through a combination of both, so it's best to use more than one personal protective measure at a time.

Viruses that cause respiratory illnesses like COVID-19, flu and RSV can spread easily from an infected person when they breathe, talk, cough, or sneeze. Viruses can remain in the air or on surfaces for minutes, to hours, depending on the virus and people can become infected if they breathe that air or touch a contaminated surface, then touch their eyes, nose or mouth.

Protection from respiratory illness

Immunization

Immunization is safe, effective and the best way to protect you and those around you from infectious diseases.

Learn about vaccines and immunizations in Ontario

Seasonal immunization

Respiratory illness season typically runs from late fall to early spring, with some variation based on the specific virus. To keep you and your loved ones protected , it is important to be up to date with recommended immunizations.

COVID-19 vaccines, flu shots and RSV vaccines may be given at the same time as, or at any time before or after administration of other immunizations, for those aged six months of age and older. Talk to a health care provider or pharmacist to learn more.

COVID-19 vaccines and flu shots

Getting your COVID-19 vaccine and flu shot is the best way to remain protected against the most severe outcomes of infection, including hospitalization and death.

The COVID-19 vaccine and flu shot are recommended for everyone six months of age and older to receive annually during respiratory illness season. These immunizations are:

• safe (including for kids and if you are pregnant or breastfeeding)
• free for eligible individuals
• proven to reduce the number of doctor visits and hospitalizations

Populations at high-risk of COVID-19 infection are recommended to receive an additional dose of a COVID-19 vaccine in the spring.

Learn about Ontario’s COVID-19 vaccination program

Learn about Ontario’s flu vaccination program

RSV immunization

Immunization against RSV is available to eligible infants, high-risk children and specific groups of older adults to help prevent serious outcomes, such as hospitalization, caused by the virus.

Learn about Ontario’s RSV Immunization programs for infants and high-risk older adults

Personal protection

While immunization is the best way to help protect yourself and others from respiratory illness, there are additional steps you can take to help keep yourself, your friends and family and your community safe.

Personal protective measures are actions you can take to reduce the spread of viruses and bacteria and break the chain of infection. While no single measure is 100% effective, combining these layers of protection is an effective way of preventing illness and can help reduce your risk of getting sick or spreading respiratory illnesses to others.

Protective measures include:

• staying home when you are sick
• washing your hands often for at least 15 seconds or using hand sanitizer to help prevent viruses from spreading
• covering your mouth when you cough or sneeze
• avoiding touching your face
• regularly cleaning high touch surfaces as viruses can live for 24 to 48 hours on hard surfaces such as countertops, door handles, computer keyboards and phones
• wearing a tight-fitting, well-constructed mask in indoor public settings, especially if you are at higher risk of severe infection, or in settings that require masking
• optimizing indoor air quality by improving ventilation (for example, opening windows to allow fresh outdoor air into rooms) and air filtration can help maintain a healthy indoor environment

For more information on how to protect yourself and others, read Public Health Ontario’s fact sheet.

Testing and treatment

Who is eligible for COVID-19 testing

If you are at increased risk of severe illness and have symptoms of respiratory illness you may be eligible for COVID-19 testing (including PCR and rapid antigen tests). If you are unsure if you are eligible for a test, speak with a health care provider.

Patients at increased risk may include any of the following individuals:

• 65 years of age or older (regardless of immunization status and any other risk factors)
• immunocompromised (regardless of immunization status)
• at increased risk due to one or more medical conditions or risk factors

COVID-19 treatment

Antiviral treatments for COVID-19 (including Paxlovid and Remdesivir) can prevent serious illness if administered within the first few days after symptoms start.

A physician, nurse practitioner or participating pharmacist may prescribe antiviral treatments if you:

• have symptoms and test positive for COVID-19 (positive PCR or rapid antigen test)
• are at increased risk for severe outcomes from COVID-19

Learn more about COVID-19 testing and treatment

Flu treatment

Antiviral treatments for the flu (Tamiflu) may reduce the severity and duration of infection if administered within 48 hours of symptom onset.

A physician, nurse practitioner or participating pharmacist may prescribe Tamiflu if you have symptoms of respiratory illness and are at higher risk of complications of influenza.

Treatment coverage

Antiviral treatments for COVID-19 and flu (such as Paxlovid, Remdesivir, and Tamiflu) are covered with specific criteria under the Ontario Drug Benefit (ODB) program. If you are not eligible for Ontario Drug Benefit coverage, the cost may be covered by your private insurance. You can apply for the Trillium Drug Program if you do not have an insurance plan that pays for 100% of your drug costs and spend about 4% or more of your after-tax household income on prescription-drug costs.