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There’s a bad cough going around. We asked doctors what it is.

a woman coughing outdoors

This cold and flu season, the internet agrees on one thing – lots of us have a cough that won’t go away.

British author Essie Fox posted on X (formerly Twitter), “Has anyone else had this cough that just won’t go away and makes you feel wretched and exhausted?” It seems like “at least fifty percent of the people that you know have this hacking cough that has been going on for weeks,” said TikToker Bethany Veach in one viral video.

While your cough amid this potent cold, COVID, and flu season might be nothing to worry about, a lingering cough can also be a sign of something more serious. Here’s what you need to know about that cough you can’t kick.

What’s causing my cough?

Unfortunately, it’s hard to say for sure.

“I think that the biggest thing is that we’re seeing multiple respiratory viruses,” Danielle Sebbens, a pediatric nurse practitioner at Arizona State University, told Mashable. A year ago, a “tripledemic” of COVID-19, the flu, and respiratory syncytial virus (RSV) made headlines, and the three viruses are again circulating. And of course, the various viruses that cause the common cold are going around. All of these can cause a cough – and a number of them are different coronaviruses (that have infected humans for ages).

Out of the three well-known viruses circulating, RSV might be the most likely culprit behind your gross cough, said Dr. Janet O’Mahony, an internal medicine doctor in Baltimore at Mercy Personal Physicians. In an email to Mashable, she wrote that she saw many patients with a “junky cough” around Thanksgiving, when there were many cases of RSV in her area. Cases of the virus have since gone down near her, she said.

Regardless of what specifically caused it, a lingering cough with no other remaining symptoms is probably caused by some type of virus, said Sebbens. If the infection were bacterial, you would usually have other symptoms that linger, like fever and fatigue.

Why won’t my cough go away?

Coughing when you’re sick (and in general) is a reflex to expel mucus, germs, and other sources of irritation from your lungs. Likely the most common reason for a persistent cough is lingering inflammation in your lungs and windpipe, even after the infection itself has cleared, Dr. Maureen Tierney, the chair and associate dean for clinical research and public health at Creighton University School of Medicine in Nebraska, told Mashable.

It’s also possible you managed to get multiple infections. Along with lowering your overall immunity, fighting a respiratory illness can damage tiny hair-like structures in your lungs called cilia, Tierney explained. These cilia help keep infections out of your body, so a respiratory infection might make you vulnerable to other viral and bacterial infections.

“It’s not normal to have a cough that persists for more than three to four weeks.”

A more serious cause of a persistent cough is developing a complication of respiratory illness, said Tierney, like pneumonia. For this and other reasons, she recommends that anyone who has had a cough for more than a few weeks seek medical care.

“It’s not normal to have a cough that persists for more than three to four weeks,” she said.

Why is this non-COVID illness happening now?

It might be that our immune systems are still recovering from years of extra protection during the COVID-19 pandemic. As some people leave masking and social distancing behind, their immune systems might have a hard time adjusting to the change.

“We didn’t get the same immune system development that we get from year to year” during the pandemic, said Sebbens. “Our immune system is just not prepared for this influx of viruses.”

Tierney thinks our immunity is up to speed, but is currently contending with a large number of viruses.

“I think that we pretty much caught up with immunity over the past two years,” she said. Tierney attributes the ubiquitous cough and other symptoms to widespread circulation of many different viruses, something that the addition of COVID-19 can only increase.

How do I make the cough stop?

If it’s been over three weeks, you should seek out medical care, or if you have symptoms like coughing up blood, cough so violently you throw up, or have other symptoms, like fever and fatigue that won’t go away. If it turns out you have a bacterial infection, your doctor might prescribe antibiotics.

You can also test yourself for COVID, and a medical professional can test you for the flu. Both viruses have effective antiviral treatments – Paxlovid for COVID-19, and Tamiflu for influenza (both these treatments must start relatively soon after symptoms begin). If your cough is caused by lingering inflammation, Tierney says your doctor might prescribe an inhaler, which can sometimes help.

“It’s not too late to get vaccinated.”

Unfortunately, some viruses like COVID are just going to make you cough. O’Mahony recommends people use over-the-counter medication like Tylenol, Claritin, and Mucinex to treat their symptoms. There’s even some research to suggest that honey might help.

Though it won’t help you if you already have a cough, you can also get vaccinated. Many people haven’t yet gotten updated COVID and flu shots, and there is also a new RSV shot if you are 60 or older or have other risk factors for severe illness.

“It’s not too late to get vaccinated,” said Tierney. 

Mashable