Respiratory and Health Management

What is the cost for a COVID-19 test?
COVID-19 tests are available at no cost nationwide. The only cost to the patient is for the initial evaluation. As a Community Health Center, PHN accepts all patients regardless of insurance status or ability to pay. We participate in most managed care plans, process most insurances, and offer a Sliding Fee Scale to eligible patients for discounted services.

If you test positive for COVID-19 (regardless of vaccination status):

• You can go back to your normal activities when, for at least 24 hours, both are true:
  • Your symptoms are getting better overall, and
  • You have not had a fever (and are not using fever-reducing medication).
• When you go back to your normal activities, take added precaution over the next 5 days, such as performing hand hygiene, wearing masks, physical distancing, and/or testing when you will be around other people indoors. This is especially important to protect people with factors that increase their risk of severe illness from respiratory viruses.
  • Keep in mind that you may still be able to spread the virus that made you sick, even if you are feeling better. You are likely to be less contagious at this time, depending on factors like how long you were sick or how sick you were.
  • If you develop a fever or you start to feel worse after you have gone back to normal activities, stay home and away from others again until, for at least 24 hours, both are true: your symptoms are improving overall, and you have not had a fever (and are not using fever-reducing medication). Then take added precaution for the next 5 days.
• Monitor your symptoms. If you have an emergency warning sign (like trouble breathing or chest pain), seek emergency medical care immediately.

What should you do if you were exposed to COVID-19?

Using these prevention strategies can be especially helpful when you or those around you were recently exposed to a respiratory virus, are sick, or are recovering:

• Stay up to date with COVID-19 vaccines
  • Although vaccinated people sometimes get infected with the virus that causes COVID-19, staying up to date on COVID-19 vaccines significantly lowers the risk of getting very sick, being hospitalized, or dying from COVID-19.
• Practice good hand hygiene
• Stay home and away from others (including people you live with who are not sick) if you have respiratory symptoms.
• Seek health care promptly for testing and/or treatment if you have risk factors for severe illness. Treatment may help lower your risk of severe illness, but it needs to be started within a few days of when your symptoms begin.
• Wearing a mask and putting distance between yourself and others can help lower the risk of COVID-19 transmission.
• Testing for COVID-19 can help you decide what to do next, like getting treatment to reduce your risk of severe illness and taking steps to lower your chances of spreading COVID-19 to others.

Oral Antiviral Molnupiravir, Paxlovid

Fact Sheets & Information

• Molnupiravir Fact Sheet (English)
• Molnupiravir Fact Sheet (Espanol) 
• Paxlovid Fact Sheet (English)

If you’re feeling congested or have other cold symptoms, here are some helpful treatments:

• Hydration: Stay hydrated by drinking warm liquids like tea or soup. These can help loosen mucus and soothe your airway.
• Vitamin C: Vitamin C supplements are generally safe and may slightly reduce the duration of symptoms, but they do not prevent colds or flu. A daily intake of 200 mg may help you feel better a little faster.
• Zinc: Zinc may decrease the severity and duration of flu-like symptoms by about 2 days, but it is not proven to prevent colds or flu. It can cause side effects like a bad taste in the mouth or nausea, and intranasal zinc (like Zicam®) can cause permanent loss of smell. If you choose to take zinc, lozenges or syrups may be better tolerated than tablets.
• Cold Medicines: Over-the-counter cold medicines that include a combination of antihistamines (e.g., cetirizine, loratadine, fexofenadine) and decongestants (e.g., pseudoephedrine, oxymetazoline) may help relieve symptoms. Always read the labels carefully, especially if the product contains acetaminophen or NSAIDs (Motrin®), to avoid exceeding the recommended daily dosage.
• Nasal Sprays: To reduce congestion, you can use:
  • Saline nasal spray (e.g., Ayr Saline®)
  • Cromolyn sodium (Nasalcrom®) or ipratropium bromide (Atrovent®). Be aware that ipratropium may cause dryness and mild nosebleeds.
  • Decongestants (e.g., phenylephrine [Sudafed PE®], oxymetazoline [Afrin®]). These should not be used for more than 5 days to avoid worsening congestion.
  • Topical steroids (e.g., Flonase®) are not effective for treating RSV-related symptoms.

How long will my cold symptoms last?
Cold symptoms typically peak around day 3 and improve over the next 10 days. However, a cough may persist for a few weeks. If you have underlying lung conditions (such as asthma, COPD, or are a smoker), symptoms may last longer.

When should I seek medical care?
Contact your healthcare provider or visit an emergency department if you experience:

• A high fever (above 102°F)
• Confusion, blurry vision, or difficulty breathing or swallowing
• A severe headache that does not improve with pain medication
• Facial pain or new fevers (101-102°F) after an initial fever resolves
• Symptoms that do not improve after 10 days

Should adults get the flu vaccine?
Flu vaccination is recommended for everyone over the age of 6 months. Adults aged 65 years and older should receive a high-dose or adjuvanted flu vaccine. Talk to your healthcare provider if you’re interested in getting the flu vaccine.

Can the flu vaccine cause the flu?
The flu vaccine cannot give you the flu. Some people may experience mild, short-lasting side effects, including:

• Mild headaches
• Slight fever
• Muscle aches
• Nausea
• Fatigue
• Redness or swelling at the injection site

Can Vitamin C help with flu recovery?
Vitamin C supplements are generally safe and may slightly reduce the duration of flu symptoms. In one study, people taking 200 mg of Vitamin C daily had about two fewer days of symptoms and felt a little better. However, Vitamin C does not prevent colds or the flu.

Can Zinc help with flu recovery?
Zinc may reduce the severity and duration of flu symptoms by about 2 days in adults. However, it can cause side effects like a bad taste in the mouth or nausea, and we generally do not recommend it. If you choose to take zinc, lozenges or syrup forms may be better tolerated than tablets. Avoid intranasal zinc (e.g., Zicam®), as it has been linked to a permanent loss of smell. You may want to consider taking Vitamin C instead to help reduce flu symptoms.

I still have a cough from the flu. What should I do?

• Hydration: Drink warm liquids like tea or soup to help loosen mucus and soothe your airway.
• Cold Medicines: Over-the-counter medications combining antihistamines and decongestants may work best. Examples include:
  • Antihistamines: cetirizine (Zyrtec®), loratadine (Claritin®), fexofenadine (Allegra®), diphenhydramine (Benadryl®)
  • Decongestants: pseudoephedrine (Sudafed®), oxymetazoline (Afrin®) Be sure to carefully read labels to avoid exceeding the daily recommended dosage if you’re taking other medications containing acetaminophen (Tylenol®) or NSAIDs (Motrin®).

How long will my flu symptoms last?
Flu symptoms are usually worst on the third day and can last for about a week. A cough may persist for a few weeks.

When should I call for an in-person visit?
Seek medical care if you develop:

• New fevers after an initial fever resolves
• Facial pain or pain in the forehead
• A persistent high fever (above 102°F)
• Headaches that don’t improve with pain medication
• Rash or other new symptoms
• If symptoms do not improve after 10 days

When should I go to the emergency room?
Go to the emergency room immediately if you experience:

• High fevers (above 102°F)
• Confusion or severe fatigue
• Blurry vision, difficulty breathing or swallowing
• Severe headache that does not respond to pain medication

Should adults get an RSV vaccine?
The CDC recommends RSV vaccination for:

• Adults aged 75 years and older
• Adults aged 60-74 years with underlying medical conditions
• Pregnant women in their third trimester (32 to 36 weeks) of pregnancy
• If you are 60 years or older, or pregnant, and interested in receiving the RSV vaccine, please talk to your healthcare provider

Can Vitamin C help with RSV recovery?
Vitamin C supplements are generally safe for adults and may provide some benefit. One study showed that people who took 200 mg of Vitamin C daily experienced two fewer days of symptoms and felt slightly better. However, Vitamin C does not prevent RSV or colds.

Can Zinc help with RSV recovery?
Zinc has not been shown to prevent RSV, but it may reduce the severity and duration of RSV-like symptoms by about 2 days. However, we generally recommend against zinc due to side effects like a bad taste in the mouth and nausea. If you choose to take zinc, the syrup or lozenge forms may be tolerated better than tablets. Avoid intranasal zinc (such as Zicam®) due to the risk of irreversible loss of smell. Instead, consider Vitamin C supplements to help reduce the severity of RSV symptoms.

I’m still feeling congested from RSV. What should I do?

• Hydration: Make sure to stay hydrated, as drinking warm liquids like tea or soup can loosen mucus and ease your airway.
• Cold Medicines: Over-the-counter medications that combine antihistamines and decongestants may help alleviate congestion. Examples include:
  • Antihistamines: cetirizine (Zyrtec®), loratadine (Claritin®), fexofenadine (Allegra®), diphenhydramine (Benadryl®)
  • Decongestants: pseudoephedrine (Sudafed®), oxymetazoline (Afrin®) Be sure to read the label carefully to avoid exceeding the recommended daily dose of acetaminophen (Tylenol®) or NSAIDs (Motrin®).

Is there a nasal spray that can help with RSV-related congestion?
Several nasal sprays may help reduce congestion:

• Nasal Saline (e.g., Ayr Saline®)
• Cromolyn Sodium (e.g., Nasalcrom®)
• Ipratropium Bromide (e.g., Atrovent®) — Note that this can cause nasal dryness and mild nose bleeds.
• Decongestants (e.g., phenylephrine [Sudafed PE®], oxymetazoline [Afrin®]) — Do not use decongestants for more than 5 days, as prolonged use may worsen symptoms.
• Topical Steroids (e.g., Flonase®) have not been shown to be effective for treating RSV.

How long can I expect my RSV symptoms to last?
In general, RSV symptoms peak around day 3 and gradually improve over the next 10 days. A cough may persist for a few weeks. People with underlying lung diseases (e.g., asthma, COPD, smokers) may experience longer-lasting symptoms.

When should I call for an in-person visit?
Seek medical care if:

• You develop high fevers (above 102°F), confusion, blurry vision, difficulty breathing or swallowing, or a severe headache that doesn’t improve with pain medication.
• If you experience pain in your face or forehead, or if your symptoms don’t improve after 10 days, you may need an in-person visit to assess if antibiotics are necessary.

When should I go to the emergency room?
Go to the emergency room immediately if you experience:

• High fevers (above 102°F)
• Confusion or severe fatigue
• Blurry vision or difficulty breathing/swallowing
• Severe headache not responding to pain medication

• Give acetaminophen (Tylenol®) or ibuprofen (Motrin®) as directed by your child’s healthcare provider.
• Apply a warm cloth to the affected ear for comfort.
• Keep your child’s head elevated to help relieve ear pressure.
• Engage them with distractions such as a favorite toy or movie.
• If pain persists or worsens, schedule a follow-up with a healthcare provider.

• Temporary hearing loss can occur due to fluid buildup or inflammation in the middle ear. This usually resolves once the infection clears.
• Recurrent infections may impact hearing, so let your child’s provider know if you have concerns.

Schedule an in-person visit if:

• Symptoms do not improve within 48–72 hours of starting antibiotics.
• Your child appears confused, lethargic, or excessively tired.
• Your child looks seriously ill.
• If your child is confused or lethargic, seek immediate care at the emergency department. Otherwise, a follow-up with their regular healthcare provider is appropriate.

While some children are more prone to ear infections, you can take steps to reduce the risk:

• Avoid secondhand smoke, which increases the risk of infections.
• Breastfeeding for the first six months may offer protection.
• Encourage frequent hand washing to limit germ exposure.
• Keep your child up-to-date on vaccinations, including the flu shot, to prevent infections that can lead to ear issues.

Not likely. Nausea and vomiting are common side effects, not signs of an allergy. To help prevent these side effects:

• Take the antibiotic with food.
• Stick to a bland diet.
• Avoid caffeine, alcohol, and other stomach irritants.
• Stay upright for 30 minutes after taking the medicine.
• Talk to your provider if symptoms are severe or worsen.

Tell all healthcare providers, including doctors and pharmacists, that you or your child are no longer allergic to penicillin. Ask them to:

• Update the medical record.
• Remove the penicillin allergy label if it’s still listed.
• Confirm that pharmacy records also reflect the change.

• Most people begin to feel better within 48–72 hours of starting antibiotics. The area should gradually become less red, painful, and swollen over time. Marking the red area with a pen or marker can help you track the changes.
• Seek in-person medical care if you do not observe any improvement by the third day of treatment or if your symptoms worsen at any point. If a same-day appointment is not available, consider presenting to an urgent care center or emergency department.

• In addition to taking the antibiotics as prescribed, you can help your body recover by:
  • keeping the affected area elevated as much as possible, especially if it’s on your leg or arm
  • keeping the affected area dry
  • taking over-the-counter pain relievers like acetaminophen (Tylenol®) or ibuprofen (Motrin®, Advil®) as needed for discomfort and/or fever.
  • resting and drinking plenty of fluids

• Seek in-person care (preferably in an emergency department) if you notice any of the following:
  • the redness spreads rapidly
  • new blisters or black spots appear
  • the area becomes much more painful
  • you develop new fevers or chills
  • you feel generally more unwell or weak

• Cellulitis can come back, especially if you have underlying conditions like diabetes, swelling in your legs, or frequent skin injuries.
• To help prevent it from coming back, you can try the following:
  • keep your skin moisturized to avoid cracks
  • Consider using petroleum jelly (Vaseline®) on the heels of your feet
  • Treat any athlete’s foot and avoid injury to the skin when possible.
  • Use compression stockings and/or elevate your legs regularly if swelling or drainage problems are a concern

Taking the following steps may help prevent urinary tract infections:

• Staying well hydrated (aim for 6-8 glasses of water daily).
• Urinating immediately after sexual activity.
• Wiping front to back after using the bathroom.
• Avoid holding in urine for prolonged periods of time.
• Consider discussing alternative methods of birth control with your healthcare provider If using diaphragms and spermicides as these can increase the risk of UTIs.

Let your healthcare provider know if you don’t have any improvement by the third day of antibiotics or if you develop fevers, chills, back pain, vomiting or just generally feel unwell.

It is generally not necessary to repeat a urine test after you finish the antibiotic course. However, if you are not having an improvement in your symptoms by day 3 or your symptoms are worse, notify your healthcare provider for next steps.

Two doses of the measles, mumps, and rubella (MMR) vaccine is the best way to prevent measles and stop the spread of measles.
In the United States, two types of vaccines for measles are available:

• MMR – combination of vaccines for measles, mumps, and rubella (German measles)
• MMRV – combination of vaccines for measles, mumps, rubella, and varicella (chicken pox)

Two doses of MMR or MMRV vaccine are 97% effective preventing measles, and one dose is 93% effective at preventing measles.

Common symptoms of measles include:

• High fever
• Cough
• Runny nose
• Red, watery eyes
• Rash that typically begins on the face and spreads to other areas of the body

Symptoms usually appear in 7 to 14 days, but could be as long as 21 days, after exposure to someone who is infected.

Most people should get vaccinated now if they have either never had measles disease or never had two doses of measles vaccine. This is especially important if you live, work, or travel to areas with measles infections. Catch-up and early doses provide real protection when it matters most.

Catch-up and Early Vaccine Doses in a Measles Outbreak:

• Babies: Babies 6 to 11 months should get one early dose of MMR vaccine in areas with a current measles outbreak. They should still receive their routine doses at 12–15 months and 4–6 years old.
• Children: Normally, children receive two doses of MMR vaccine. One is given after their first birthday (12 to 15 months of age recommended) and a second before starting school at 4-6 years old. In an outbreak, they should receive these doses more quickly.
  Children older than 1 year who did not yet start the MMR series should get two doses at least 28 days apart. Children who already received one dose should get their second dose now if it has been at least 28 days since their first dose.
• Adults and Teenagers: Adults and teens who never had measles or the measles vaccine should get two doses at least 28 days apart. Adults and teens who already received one dose should get a second dose now if it has been at least 28 days since their first dose.

If you believe you or someone with you may have measles or has been exposed to measles, please do not enter a PHN health center without notifying us first.

Our team will provide instructions and help coordinate your care while taking appropriate precautions to protect other patients, visitors, and employees.

If you are experiencing a medical emergency, call 911 or visit your nearest emergency department. When possible, notify the emergency department before arriving if you believe you may have measles.