Flu? Covid? RSV? Norovirus? A cold?

You may be living with someone who is sick, or be sick yourself.

Of course, rule #1 before winter is to get ALL recommended vaccines, preferably two weeks apart. If you didn't and get sick, catch up as soon as the guidelines say to.

If the sick person can mask up (KN95 or KF94), that is of course ideal. But often it's not possible.

If they can stay in a separate area, or on a different floor (preferably below you), that can help. Of course, wiping down surfaces, wearing gloves when handling anything with secretions or bodily fluids, disinfectant wipes…it's all going to reduce risk of transmission and viral load if you do catch something.

In addition to trying to separate your ventilation, any air purifiers that don't generate ozone and a high-quality furnace filter (MERV13 if your furnace can handle it, MERV8 if it can't) might reduce risk.

And if it turns out to be Covid on home testing, I would ask about getting Paxlovid or remdesivir (whichever works with the PALS' meds) ASAP. If it's flu, the current (2025) strains are reportedly responsive to Tamiflu.

Also see the Managing Secretions page.

The main things are keeping mucus thin and hydration, and avoiding irritants.

BiPAP adjustments

If a PALS develops a severe cough while using BiPAP, the best thing is to change the mode to fixed BiPAP (switch mode to S or ST and if you have to set a backup rate aka RR set it to 0). And of course use a nasal mask instead of a full face mask.

Then set IPAP to 10 or whatever's comfortable, EPAP of 4. That way, coughs aren't interfering with the machine and vice versa.

Let me know if you need help adjusting your machine.