Last winter in Western Sydney, I saw a young child brought to hospital with what initially looked like a routine viral illness. The family had managed the symptoms at home for several days, assuming it was a common cold. By the time they came to hospital, the child was struggling to breathe and was diagnosed with an RSV infection.
What stood out was not the virus itself, but the timing. The family was caring and attentive, but like many families, they were unsure when a common respiratory illness becomes something more serious.
Having trained and worked across India and Australia, and within different health systems and communities, I have seen how language, cultural expectations and health literacy shape how families understand illness and decide when to seek care. These are not simply knowledge gaps. They often relate to access, communication and confidence in navigating the health system.
Each winter across Australia, flu, RSV and COVID-19 circulate more widely, and these challenges become more visible.
Public health guidance explains that respiratory viruses spread more easily in colder months due to increased indoor contact in homes, schools and workplaces:
https://www.vic.gov.au/stay-well-winter
Why winter viruses are not “just a cold”
Influenza, RSV and COVID-19 often begin with similar symptoms — fever, cough, sore throat and tiredness. Because of this, many people assume they are mild illnesses.
In most cases, people recover at home. However, these infections can sometimes become serious.
RSV can cause breathing difficulties in infants. Influenza can lead to pneumonia in older adults. COVID-19 can still result in severe illness in people with underlying medical conditions.
For families, the challenge is not recognising the virus itself, but recognising when symptoms are worsening.
Vaccination remains the strongest protection
Health authorities across Australia continue to recommend vaccination as the most effective way to reduce severe illness from flu and COVID-19.
The flu vaccine is recommended every year for everyone aged six months and over, and it is free for many groups under the National Immunisation Program. COVID-19 vaccination is also recommended, particularly for people at higher risk of severe illness.
For reliable information, the National Centre for Immunisation Research and Surveillance (NCIRS) provides evidence-based guidance on vaccines and safety: https://ncirs.org.au/influenza/influenza-vaccines-frequently-asked-questions-faqs
The Australian Government Department of Health also provides updated immunisation information: https://www.health.gov.au/topics/immunisation
Short educational videos explaining winter viruses and vaccination are available through Australian Government health resources:
- https://www.health.gov.au/childhood-immunisation/resources/videos/what-is-influenza-why-childhood-immunisation-are-important
- https://www.health.gov.au/maternal-vaccinations/resources/videos/rsv-expert-video-with-dr-linny-kimly-phuong
- https://www.health.gov.au/resources/videos
RSV prevention options are also now available for some infants and older adults, depending on eligibility.
Vaccination does not prevent every infection, but it significantly reduces the risk of severe illness and hospital admission.
When families should seek medical care
Most respiratory infections can be managed safely at home with rest, fluids and monitoring. Medical advice should be sought if there are warning signs such as:
- difficulty breathing or rapid breathing
- persistent high fever
- chest pain or worsening cough
- unusual drowsiness or confusion
- in children, poor feeding, dehydration or reduced responsiveness
Infants, older adults and people with chronic medical conditions should be assessed earlier rather than later.
Early medical review can prevent deterioration and reduce hospital admissions.
Why some families are affected differently
In multicultural communities, several everyday factors influence how winter illness is experienced:
- multigenerational households, increasing spread between age groups
- language barriers affecting understanding of when to seek care
- difficulty accessing timely GP appointments during peak winter periods
- reliance on informal advice before seeking medical assessment
These are not simply issues of awareness. They reflect how effectively health services connect with communities in practice.
Improving communication, access and culturally appropriate care remains essential in reducing avoidable hospital presentations.
What this winter should remind us
The child who arrived late to hospital with RSV is not an isolated case. Similar situations occur every winter across Australia.
The message for families is clear:
- vaccination helps reduce risk
- early recognition of worsening symptoms matters
- timely medical care makes a difference
Winter respiratory illness is not only about viruses. It is also about how quickly families can recognise illness and access care when needed.
As winter progresses, the focus should be on preventing severe illness, not just managing infections, and ensuring families have the information and support to act early.
Author — A/Prof Dr Habib Bhurawala
Head of Department and Clinical Associate Professor of Paediatrics
Nepean Hospital, NSW, Australia
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