Life

I’m Just Coughing Here!

The coronavirus has scrambled all of our norms, but we cough for reasons beyond illness. Let us!

A woman in a surgical mask coughs into her fist.
It’s the pollen! Tomwang112/iStock/Getty Images Plus

A few weekends ago, I was sitting in a park on a picnic blanket with a close friend and her mother. No one else was close by. A cool breeze was blowing. We’d all been fully vaccinated for months. Thoughts of the pandemic were cozily tucked away somewhere in the deep recesses of my brain.

Then, my friend’s mom spun around and sneezed into her elbow. She’d barely turned her head back to the blanket before she rushed to swear that her sneeze was benign. “I don’t have COVID,” she said.

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It hadn’t even occurred to me to worry that her sneeze might indicate a symptomatic COVID case. “Ha, it’s fine,” I said, feeling the need to put her at ease. “Sneezing isn’t really a COVID symptom, anyway.”

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For more than a year and a half, the public expulsion of various irritants from our airways has engendered a heightened degree of suspicion. Every clearing of the throat could be the calling card of a superspreader, and every cough—particularly coughs, the most universal COVID symptom—could be the reckless spewing of disease. This isn’t entirely new: The sound of a nearby person’s mucus has always been unpleasant to hear—and for some, including the immunocompromised, a worrying sign of possible infection. But today, even as vaccinated people face an extraordinarily low risk of severe illness from COVID-19, coughs still prompt hostile looks from bystanders and defensive pleas from those with ticklish throats. When my iced tea went down the wrong pipe outside a coffee shop on a recent afternoon, the whole patio turned to stare in horror as I coughed it up.

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I resisted the reflex to assure everyone that I was merely a klutz, not contagious. For one thing, the two are not mutually exclusive; no one can ever be 100 percent sure they’re not spreading a germ or two. But more importantly, I was covering my mouth with all due diligence, and the goings-on south of my uvula are nobody’s business but my own.

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In other words, I think it’s long past time for us to stop feeling ashamed—or making others feel ashamed—of the everyday cough. We’ve already endured two spring allergy seasons and two autumn ragweed seasons since the beginning of the pandemic. Each time a new one starts, there’s an onslaught of service journalism advising readers on the difference between COVID symptoms and everything else. (TL;DR: Allergies don’t cause fevers, and COVID doesn’t make the eyes itch.) Though these pieces are usually written as guides for people looking to assess their own symptoms, they could also be read as entreaties for the rest of us to chill out a bit. There are a limited number of ways for the respiratory system to signal distress, which means that people cough for all sorts of reasons.

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The cough surveillance vibe is exacerbated by the boilerplate COVID self-screening signs stuck to the entrances of public gathering places these days. “Do not enter if you have a cough,” they say. Fair enough. But then everyone who enters and proceeds to cough anyway (it’s post-nasal drip, people!) appears to be breaking the rules. I’m not suggesting those signs go away, though I highly doubt that any person with COVID has ever seen one, thought, “oh, shit, that’s me!” and turned away from the baseball stadium. I am miffed, however, that the U.S. viral containment strategy has relied, to its detriment, on the self-policing of already-responsible citizens and the mass demonization of a normal bodily function rather than, say, the widespread rapid testing that has made public spaces safer in other countries. The answer to “does my kid have a cold or is it COVID-19?” is still “it’s really hard to tell.”

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Sure, it would be a good thing if people with colds stopped entering public spaces entirely. But that would be impossible to enforce and, I would argue, largely unnecessary: In the years before we had hand sanitizer stations and mask mandates in every building, most people didn’t get more than a couple of mild colds a year. This isn’t a free pass to go about your business when you’re ill; now that we’ve all had a crash course in how diseases spread and how dangerous they can be for the immunocompromised, we can all do our part by staying in more, touching less, and being vigilant about masks if we’re sick. But at some point, when COVID case rates are low enough, we’re going to have to stop policing coughs as evidence of the worst possible communicable disease.

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With that said, in this moment, I fully understand the impulse toward fear when a nearby cough crops up. On my first post-vaccination trip, in June, I was assigned a middle seat on an airplane. I was feeling free and invincible, buoyed by the Moderna coursing through my veins (muscles?), until the man seated directly next to me began coughing. Every minute or so for the hourlong flight, he’d hack a few times, then pull his mask below his mouth to gasp a breath of air. I eventually realized he was only removing his mask to inhale—he carefully replaced it before every exhale. It struck me as a reasonably polite way to manage the painful, labored breathing of symptomatic COVID on a fully-booked flight. But I felt like I was on some kind of COVID-themed episode of Punk’d. A persistent dry cough? On an airplane? In this economy?

Though I didn’t get sick after that flight, this kind of anxious, repulsed reaction might be one of those COVID-era social adjustments that never really goes away. Once you’ve seen a visualization of how cough droplets spread in an enclosed space, no series of booster shots will erase the image from your brain. In fact, our cough paranoia will probably get worse before it gets better: If people get skeeved out by coughing now, imagine how they’ll feel when the masks come off.

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