Even before COVID-19, most acute upper chest infections are caused by viruses. Patients with these infections and most cases of COVID-19 can stay home and get care virtually through telehealth by communicating with the doctor by internet. Patients with respiratory symptoms (such as breathing problems) who test negative for COVID-19 likely have a viral infection. In most cases, patients can manage virtually from home. The worry is that online health exams can limit the ability to diagnose correctly. This can lead to prescribing antibiotics when a patient might not need them. Why is this a problem? Because overprescribing antibiotics can lead to antibiotic resistance, which is when germs (like bacteria) develop the ability to defeat the drugs (antibiotics), so they keep growing. This is an international health threat that can put more people at risk of more severe infections. How can we avoid this? Patients and doctors (especially in primary care) should do an in-person exam if possible to confirm the diagnosis when there is uncertainty. For example, for people with upper chest infections that may be bacterial, a doctor could check the patient’s ears, perform a test for Group A streptococcus, or do an X-ray in person. Patients, too, should understand the differences between viral and bacterial infections to avoid unnecessary antibiotics.

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