Still coughing — are you still infectious?

Summary

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Episode Overview

Podcast: What’s That Rash?
Episode Title: Still coughing — are you still infectious?
Date: June 2, 2026
Host: ABC Australia (Tegan [B] and Dr. Norman Swan [C])
Theme:
The hosts answer listener Jive's question about lingering coughs following a respiratory illness (like the common cold or COVID): When is it safe to return to work if you’re still coughing, and are you still infectious? The episode also explores the function of coughs, the effectiveness (or lack thereof) of cough medicines, societal shifts in attitudes toward illness post-pandemic, and some amusing history of old-timey cough remedies.

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Key Discussion Points & Insights

What is a Cough?

[01:45–02:25]

• Dr. Norman Swan explains:
  • “A cough is... a forcible expulsion of air... to enhance the body's own mechanisms for getting rid of irritants and mucus out of your airways.” (C, 01:45)
  • Coughing helps move irritants out via cilia and mucus, which eventually gets swallowed.
  • Causes include allergies, asthma, chronic lung disease (e.g., cystic fibrosis, bronchiectasis), acid reflux, post-nasal drip, and even certain medications (notably ACE-inhibitors for blood pressure).

Memorable Moment
B: “Human bodies are disgusting.” (B, 02:18)

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Types of Cough & Causes

[03:00–05:21]

• Dry coughs vs. “fruity”/productive coughs described.

• Notable mention of special coughs:

  • Barking cough/inspiratory stridor (croup): “...a very barky cough... on the inhale. And it can be quite scary for parents. And that’s croup.” (C, 04:22)
  • Whooping cough (pertussis): A spasmodic cough, sometimes referred to as “the hundred days cough.” (B, 05:35)

• Clinical history is key for diagnosing underlying causes.

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How Long Does a Post-Viral Cough Last?

[06:35–06:48]

• “A cough after a viral infection is normal and it's normal to last a week or so and not unusual to last three weeks or so. The question really comes down to whether or not you're infectious.” (C, 06:35)

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When Are You Still Infectious?

[06:48–08:24]

• Peak Infectiousness Timing:
  • “You can be infectious before you start coughing…you’re most infectious right before or right at the very beginning of having symptoms. Covid being the classic example.” (B, 06:48; C, 06:59)
• General rules of thumb:
  • Common cold: Infectious for about a day before and two to three days after symptoms start.
  • COVID: Infectious up to 7–8 days after symptoms start (data for new variants is incomplete).
  • “If you’re still coughing five or six days after your original infection and you’ve not got a fever and you’re not breathless…if you’re otherwise well and all you’ve got is a cough after three, four or five days, you’re not infectious.” (C, 07:25)
• Practical Guidance:
  • “If all of the other symptoms have resolved…don’t let a cough keep you away from the office.” (B, 08:11)
  • “Just not too soon afterwards…two or three days later for most infections, you’re probably okay.” (C, 08:24)

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The (In)Effectiveness of Cough Remedies

[08:39–09:50]

• “There’s not a shred of evidence that [cough syrups] do you any good.” (C, 08:50)
• Over-the-counter cough medicines are generally ineffective for viral coughs and may cause side effects.
• Historically, some cough suppressants contained codeine or morphine; these are now considered causing more harm than good.
• “For people with chronic cough…sometimes the GP will wonder whether…you’ve actually got asthma.” (C, 09:30)
• “Cough and cold medications—leave them on the shelf.” (C, 09:45)

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Old-Timey (and Bizarre) Cough Remedies

[09:57–11:56]

• Cigarette-based remedies: “The medication delivery system is a cigarette.” (B, 10:05)
  Norman shares: “My dear old grandfather…had to have a [cigarette] so that you could cough up the phlegm.” (C, 10:24)
• Belladonna and Stramonium: Included in some old remedies. Belladonna dries secretions but can be dangerous. Stramonium is possibly hallucinogenic. “You might imagine that you’re coughing, but you’re not.” (C, 11:19)
• Some old syrups listed “etcetera” as an ingredient. (B, 11:21)

Key Point:
Coughing is a vital cleaning mechanism in the body; suppressing it can be counterproductive.
“If you inhibit that cough, you may well be making yourself worse.” (C, 11:56)

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Helpful Remedies & Modern Advice

[12:14–12:23]

• “There is some evidence for just a warm honey drink or a lemon and honey drink if you need a bit of relief.” (B, 12:14)
• Norman agrees: “Interestingly, there is.” (C, 12:23)

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Changing Work Culture: Sick Leave After COVID

[12:28–14:52]

• Norms have shifted post-pandemic:
  • Colleagues are now less tolerant of coworkers coming in sick, even if just coughing.
  • For extra caution: “If you want to be sure, wear an N95 mask for two or three days after you come back to work.” (C, 13:10)
• Norman’s own rule: “I would say about a week is my goal, but I’m lucky, I can work from home.” (C, 13:29)
• Reference to a study on workplace presenteeism (turning up sick): Rates dropped dramatically post-2020, with healthcare workers leading the way. (B, 13:46)
• Downside: As remote work became more common, people still work while sick from home, making “truly” resting less common.

Humorous moment
“If you find yourself having to clean your computer screen more often, it’s probably a sign that you should close the lid and go to your bed.” (C, 14:52)

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Bottom Line for Listeners

[15:08–15:20]

• “For most common colds, you’re not infectious after, say, let’s say, three days. If it’s COVID, it’s longer than that and it’s hard to generalise, but if you’re still feeling sick, stay at home.” (C, 15:08)

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Notable Quotes & Moments

• “Human bodies are disgusting.” (B, 02:18)
• “There’s not a shred of evidence that they [cough syrups] do you any good.” (C, 08:50)
• “If all you’ve got is a cough after three, four, or five days, you’re not infectious.” (C, 07:35)
• “If you want to be sure, wear an N95 mask for two or three days after you come back to work.” (C, 13:10)
• “If you inhibit that cough, you may well be making yourself worse.” (C, 11:56)
• “If you find yourself having to clean your computer screen more often, it’s probably a sign that you should close the lid and go to your bed.” (C, 14:52)

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Timestamps for Key Segments

• Main question introduction: 01:05
• Cough physiology and causes: 01:45–03:25
• Types of cough in children: 03:59–04:48
• Duration and causes of lingering coughs: 05:21–06:48
• Infectiousness timeline: 06:48–08:24
• Cough medicines myth-busting: 08:39–09:50
• Bizarre historical remedies: 09:57–11:56
• Relief options (honey drinks): 12:14–12:23
• Workplace norms after COVID: 12:28–14:52
• Key bottom line advice: 15:08–15:20

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Listener Q&A and Lighthearted Follow-ups

[16:14–18:46]

• Discussion on probabilities in health communication (e.g., what does “low” risk mean?).
• Reassurance regarding hantavirus pandemic likelihood: “The chances of it being a pandemic are pretty close to non existent unless there’s a mutation.” (C, 17:58)
• Playful follow-up with listener Jamie about eating fruit, with Norman apologizing to Jamie’s mum.

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Takeaways

• Coughing is normal after respiratory infections and may persist for weeks, but isn’t necessarily a sign you’re still infectious.
• You're usually infectious in the days before and just after symptom onset; with most colds, you’re not contagious after about three days (COVID may be longer).
• Stay home if you feel unwell, especially with a fever or other symptoms. If only a cough remains after a few days and you feel well, returning to work is reasonable—but the post-pandemic norm is to exercise caution and consider masking.
• Cough medicines rarely help and can cause harm; stick to simple remedies like honey and lemon drinks if needed.
• Pandemic has permanently changed attitudes—less tolerance for coming to work sick, and more reliance on work-from-home solutions.

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For more answers to health questions or to submit your own, email the hosts at thatrashvc.netau

Transcript

[A]

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[B]

abc listen podcasts, radio, news, music and more. Yuck. I wish you'd muted your mic before you did that. Are you feeling a little under the weather, Norman?

[C]

No, I just, you know, it's a bit like the yawning episode. Why? When you start yawning to other people. Yawn. Why do we start coughing to other people?

[A]

Cough.

[C]

But that's actually not what we're going to be talking about today.

[B]

The reason you start coughing when other people cough is because they've coughed their germs on you and you catch the virus they have. And I'm really glad that I'm 1,000 kilometres away from you as we have this chat.

[C]

I'm still coughing. Am I infectious? Is the topic of this week's what's that Rash.

[B]

It's the show where we answer the health questions everyone is asking. And today's question comes from Jive. Jive says coughs lasting weeks after a respiratory virus have always been annoying. But since COVID going to work with a residual cough feels inappropriate but also unreasonable to expect people to stay home for a month. Plus, Jive's asking, how can we know for sure whether our residual cough is not infectious to others? And when is it okay to go to work? So let's talk about coughing. What is coughing?

[C]

So a cough is. I'm going to explain the bleeding obvious here. It's a forcible expulsion of air and the main purpose is thought to be that to enhance the body's own mechanisms for getting rid of irritants and mucus out of your airways. So you have. In your respiratory, you have little cilia and mucus production, which then waft upwards to your throat and brings all the crap that you're breathing in and slowly brings it to your throat and then you swallow it. In other words, you get rid of the stuff in your lungs. It's a cleaning mechanism.

[B]

Sorry. It wafts it up out of your airways and then you. Yuck. Yuck. Human bodies are disgusting.

[C]

I'm getting a bit of flame in my throat. It is just like yawning Actually, anyway, so anything that irritates the lining of the respiratory tract can cause a cough. So that can be an allergy, it can be hay fever, it can be asthma, it can be that you've got a chronic lung disease, e.g. cystic fibrosis or bronchiectasis, where you've got inflammation in the lungs and hollowed out areas. You can have acid reflux where the acid goes into the lungs and irritates the lungs. You can have a post nasal drip from the back of your throat. And it can also be drug induced. So a common anti blood pressure drug or family of drugs are called ACE inhibitors. And about 40% of people on ACE inhibitors develop a cough which is presumably a central effect on your brain, producing a cough in your respiratory tract.

[B]

Yeah, it makes sense that you're trying to cough something up. And we can wallow in the disgustingness of that as much as we like.

[C]

Wallow's the word. Because sometimes you wallow. Cause it's really fruity and sometimes it's dry.

[B]

But this is it.

[C]

I think a health warning of this.

[B]

We really should. A content warning.

[C]

Stop eating.

[B]

Yeah, it's so disgusting. But again, bodies, man. But I'm thinking about Jive's question and how long a cough sometimes hangs around for me after I've been sick. Or if I'm a bit run down and my throat's a bit scratchy because I've been, I don't know, yelling too much or something because I've been out having too much fun. I often find that I have a cough that isn't bringing anything up. It's almost like it's just that skin. Is it skin when it's on the inside of your throat is irritated and it's sort of just this reflexive action that my body wants to do.

[C]

Yeah. Can I just say. We'll just double back a little bit. I'll just say that there is another kind of cough which parents of children know only too well, which is a barking cough, which was called inspiratory stridor. So in other words, the child has a very barky cough. And then instead of asthma, which is a wheeze, it's a. On the way in.

[B]

On the inhale.

[C]

On the inhale. And it can be quite scary for parents. And that's croup. And then there's whooping cough which you have a spasmodic cough and you cough so much that you run out of breath and you gotta take a deep breath in, which is the whoop of the Whooping cough and you can get it with croup as well. So there are lots of versions of cough. So taking for the doctor or gp, taking a history is really important. What was that question you were asking me again?

[B]

Oh, just thinking about. No. Well, when you're talking about the sorts of horrible noises that kids can make when they're sick, it gives me a shudder because it's a scary thing to hear or to think of happening to your kid. I suppose with Jive's question they're asking about just sort of like run of the mill common cold or post flu coughing, and yet trying to figure out when it's the disgusting spluttering cough that is spraying viruses all over your co workers in your office or when it's that irritation of your throat that you just can't seem to get over, but otherwise you kind of feel fine.

[C]

Yeah. And I think different viruses have, or different bacteria have different durations of cough. So for example, if you have had a bit of pertussis or an episode of the whooping cough, that can go on for a long time. The cough after they call it a

[B]

hundred days cough, don't they? Like that's one of the names for it.

[C]

If you've got asthma already and you have a viral infection, you can get post viral bronchitis, which lasts for quite some time. So different viruses cause a different level of irritation and it also depends on your propensity to getting bronchitis as well. And it doesn't necessarily mean that you're infectious.

[B]

It's interesting that you mentioned bronchitis. So inflammation of the bronchia, is that what you're talking about? And I know sometimes when a cough has hung around for a long time and when you are coughing, especially at night, and it keeps you up and you can't sleep, even if you've only been coughing for a week or so, it feels like a lifetime and you'll do almost anything to make it stop. There was a study that looked at patients expectations around how long their cough should last. And people basically seeking out antibiotics for a cough, which we know. If the reason for your cough is viral and you don't have a bacterial infection, then antibiotics are at best useless and at worst potentially contributing to antimicrobial resistance.

[C]

So a cough after a viral infection is normal and it's normal to last a week or so and not unusual to last three weeks or so. The question really comes down to whether or not you're infectious.

[B]

Well, the irony of this is that you can be infectious before you start coughing. In fact, we know with a lot of respiratory diseases you're most infectious right before or right at the very beginning of having symptoms.

[C]

Covid being the classic example.

[B]

Yes. And so, yeah, let's talk about the infectious period. What we know, especially when it comes to common colds, it's a day or

[C]

so before and probably two or three days afterwards is the average here. And with COVID it can be up to seven or eight days afterwards. Although we're a bit out of date on Covid because it hasn't been as well studied with the newer variants. So it's hard to know. But the COVID infectious period does last a bit longer than influenza or the common cold. But you could pretty much say that if you're still coughing five or six days after your original infection and you've not got a fever and you're not breathless because you can have secondary pneumonia to a viral infection. It's unusual, but you can have it. But if you're otherwise well and all you've got is a cough after three, four or five days, you're not infectious.

[B]

Yeah. There's this thing called presenteeism where people turn up to work even when they're sick. And not only is it horrible if you're the co worker of that person because you're worried that maybe they're going to inflate, it's also not a very productive way to work. You're sort of not at your best. My non professional but very vehement advice is if you're unwell, stay home, stay home, stay on your couch, let your body recover. But what I'm hearing from you, Norman, is if all of the other symptoms have resolved and you're not feeling really rubbish anymore, don't let a cough keep you away from the office.

[C]

Yeah, just not too soon afterwards would be the thing. You wouldn't want to go back to work the day after your fever, fever resolves and you've still got a cough because you're very likely to still be infectious, but two or three days later for most infections, you're probably okay.

[B]

Okay. So you do have a persistent cough. I want to. Well, I feel like I know what your answer is going to be to this question, Norman, because you and I have conversed before, but where do you stand on cough syrup?

[C]

There's not a shred of evidence that they do you any good.

[B]

So cough and cold, not one shred,

[C]

not even a little shred, not even a fragment. There's been plenty of studies done on this and cough and cold medications, although it fills your pharmacist's shelves, are pretty much useless. They can cause side effects. And there are drugs which can suppress a cough and they're called narcotics, morphine, like drugs. You don't want to take those. And early versions of these cough and cold medications did have codeine in them, which caused more problems than they were worth. And so it doesn't shorten the cold, doesn't help the symptoms that much, and so there's not really a lot of benefit from that. For people with chronic cough or cough at night, sometimes the GP will wonder whether or not you've actually got asthma. And treating you for asthma might help you, particularly if that's the only time you're getting a cough is at night or first thing in the morning. So asthma anti asthma medications might help you, but cough and cold medications, leave them on the shelf.

[B]

Well, I did actually go back and find some old timey cough and cold remedies. Can I share a few of them with you?

[C]

Absolutely.

[B]

I'm going to lead with my ace here. One that I really loved is the medication delivery system is a cigarette.

[C]

Oh. Cause it clears the air right into your lungs.

[B]

And so basically, literally, these cigarettes that contain a herb called cubebs. I've never heard of it. It was meant to help loosen mucus. But yeah, the way that you got it into your lungs was by smoking it, which I can only assume.

[C]

Well, my dear old grandfather, who was a 40 cigarette a day smoker and had chronic bronchitis as a result, when he got up in the morning, he had to have a cigaret so that you could cough up the phlegm.

[B]

Oh, God.

[C]

First thing in the morning.

[B]

Oh, charming. There's also ones that contained a belladonna, which was what women used to kill their husbands with, if my history is not mistaken. And something called stramonium. Have you ever heard?

[C]

So the belladonna is not mad stuff because it can dry up secretions.

[B]

Yeah. Like secretions of your blood flowing through your body.

[C]

Yeah. So the mild versions of that are contained in cold tablets, not belladonna itself. But that's the idea is it dries up up secretions, but you know, these secretions and the cough mechanism is part of the healing process from your virus and you don't want to inhibit it.

[B]

And another, another ingredient called stramonium, which I think might be a hallucinogenic.

[C]

Right. So you might imagine that you're coughing, but you're not.

[B]

I think you might be imagining you're coughing and you might actually be dying. I think if you overdose even slightly on this, it can be quite bad for you. The other one that I love, you can't see the packaging here. It looks like something lifted out the of. Of a set of the Addams Family. It's real gothic, but its ingredients list is basically et cetera, which I just love for all that we talk about the fact that old school cough medicines had opium and codeine or all sorts of things in them. I think as much as they had those things in them, they also sometimes didn't and they didn't have anything in them at all anyway, so just remember.

[C]

Sorry to interrupt, but just remember what I said right at the beginning of the podcast. Today's podcast is coughing is a natural mechanism to assist your body getting rid of the stuff in your lungs. And if you inhibit that cough, you may well be making yourself worse. You could risk that.

[B]

Surely there is a limit to that though, like when you're trying to sleep at night, there is some evidence for just a warm honey drink or a lemon and honey drink if you'd need a bit of relief. Right.

[C]

Interestingly there is that a honey drink for some reason can help given that

[B]

you have your finger on the culture pulse as you do. Norman, I'm interested to to see if you think we have a different attitude towards turning up to workplaces sick post 2020 than we did. Like in researching this story I found a couple of ABC articles from like 2017, 2018 and it's quite marked how different they are to the sort of advice that they gave in 2018 compared to what we've sort of come to expect. I think in a post pandemic world.

[C]

Yeah, quite rightly your work colleagues are going to look at you askance if you come in coughing all over the place, particularly a fruity sounding co cough. So you do want to.

[B]

Fruity. It's my least favorite use of that word.

[C]

Well, we have discussed our consumption of fruits. More your problem than mine. So anyway, people, we're much less tolerant of that and I think it's a good thing, you know. And if you want to be sure, wear an N95 mask for two or three days after you. After you come back to work.

[B]

Do you have a personal kind of rule of thumb around when you think you're probably safe to be around people if you've been sick?

[C]

I would say about a week is my goal, but I'm lucky I can work from home. Also, being on radio doesn't sound that good when you come back Too soon after, you don't get sympathy anymore for coming back early, you just get condemnation. But there has been a study on this, hasn't it, Tegan?

[B]

Actually, no, there has. There was one study that looked at Korean healthcare and non healthcare workers and showed that presenteeism, as in going to work while sick, peaked in 2014, declined sharply in 2020 and reached its lowest level in 20. And that was the same in healthcare workers. In fact, healthcare workers became even less likely to show up to work while sick than non healthcare workers, which I think is probably a signal that staying home when you're sick is a good thing.

[C]

Keeps the virus away from the rest of us.

[B]

I guess the flip side of this is that we're better at working from home than we used to be and so we may be getting more presenteeism. Well, more people working through being sick because you're working from home. There's studies that show that this is possibly the case. And it's also something that definitely rings true for me in my networks is that the standard of sickness that kind of requires you to feel like you've got to take a day off feels very high now because you can kind of plug away from your laptop in your bed if you have to, which no one should have to do. But it's harder to take a day off than it is to just log on from home.

[C]

So if you find yourself having to clean your computer screen more often, it's probably a sign that you should close the lid and go to your bed.

[B]

Go have it now. So what's our bottom line for Jive, who's obviously looking for a bit of guidance on when to go back to the office, maybe when to advise their colleagues to come back if they're still coughing.

[C]

For most common colds, you're not infectious after, say, let's say, three days. If it's Covid, it's longer than that and it's hard to generalise, but if you're still feeling sick, stay at home.

[B]

Well, Jive, I hope that has provided you some guidance. Feel free to distribute this far and wide in your office and beyond. And if you have a question you want to ask us, our email address is thatrashbc.net au and what's your no meal pack? So a couple of people emailing us about hantavirus, our hantacast episode that we did as a bonus drop a little while ago, Richard said you hantavirus episode made me think about what exactly is meant by common probability words. You said that the chance of a Hantavirus pandemic was low. But what does this mean? I would have said that low normally means one in ten, but in this case I suspect it's closer to one in a million. Richard continues. Similarly, if a health outcome is possible, probable, likely, I suspect that different people hear different percentages. I'd welcome your thoughts on the definition of low when it comes to the chances of lots of people catching hantavirus.

[C]

So that's a different question from pandemic. So pandemic is an infection that's spreading on every continent on earth. So since it's got a global context and in fact there was an influenza pandemic in was it 2009, which was a pandemic because it was in every continent and lots of people did get infected, many, many thousands. But it wasn't a massive disastrous pandemic that people were predicting. So the key thing here that you are saying, Richard, and asking about is lots of people catching hantavirus in their thousands and the evidence here would be probably non existent rather than low, which is that it takes a lot to spread hantavirus. And people. The whole thing about that boat was, and it amazed me at the time, and we didn't actually say it in the bonus episode, is that we still heard people saying, oh, it was a surprise that people caught on the boat without close contact. Well, how quickly we forget that you didn't need close contact with coronavirus. All you needed to do was breathe in other people's air. And that's almost certainly what happened on this boat, that it was aerosol spread, which is how these things spread. And even with aerosol spread on an enclosed environment, on a boat and in the southern oceans, in the cold weather, that maybe at the time of speaking, 10 or 11 people out of between 160, 180 people, the numbers vary according to people on board is not a high percentage. So in that enclosed environment, even with all that going for the virus, it didn't spread that much. So the chances of it being a pandemic are pretty close to non existent unless there's a mutation.

[B]

Well, Richard, I hope that that is reassuring to you. Norman. We also have a response from Jamie, who was the one that sent us the question that launched our fruit episode. Basically like if you don't eat fruit, but you do eat vegetables, can you be healthy? Short answer, yes, but do go back and listen to that one. Anyway, Jamie has emailed to say thanks to you, Tegan and Norman for researching the topic. It sounds like you guys had a lot of fun with the episode. Yes, we did. Thank you, Jamie. Jamie says I sent it to my mum and she, while being a fan of the podcast, was very cross with nor for undermining her attempts to get me to eat more fruit and claimed I was too easily influenceable. Jamie says expect an angry letter.

[C]

Yeah, well, Jamie, you know, all I can do is apologize to your mum, you know, eat your fruit, Jamie. Eat your fruit.

[B]

Sorry, Jamie's mum. Well, thank you for your emails, as always. We love getting them. If you can't tell, our email address is thatrashvc.netau See you next week. See you then.

[C]

Sam.