Experts have warned of the “triple threat”—influenza,COVID-19, andrespiratory syncytial virus (RSV)—as we head into winter.

In the week ending on Nov. 23, respiratory illnesses remain low, according to data from the Centers for Disease Control and Prevention (CDC).

While flu activity is increasing slightly among children, cases are still lower than they were at the same time last year. The same is true for COVID cases. The levels of COVID viral activity inwastewaterhave remained low after a summer surge.

Flu season typically peaks between December and March, and flu activity can sometimes extend into May. While there’s no distinct COVID peak season, cases peaked in late December 2023 into early January 2024. So far, winter peaks for both COVID and flu have yet to arrive this year.

Here’s a breakdown of the most recent trends for the flu, COVID, and RSV.

Influenza

Although flu activity remains low for now, the trends are preliminary and can change as new data becomes available.

The CDC tracks flu activity using reports of doctor’s visits forflu-like illnesses—symptoms such as fever combined with a cough or sore throat—rather than confirmed cases of influenza. This approach means the data may include other respiratory illnesses like RSV or the common cold.

For the week ending Nov. 23,clinical laboratories tested 44,867specimens for flu viruses, of which 2.5% were positive. Among the positive results, influenza A accounted for 1,055 (95.1%) of positive flu cases, and influenza B accounted for 54 (4.9%).

Influenza patterns depend onthe specific flu virus strainsthat are circulating in a given year and human behavior. For example, some of the measures adopted during the COVID-19 pandemic—such as mask-wearing and social distancing—slowed down the flu spread during those years.

Another factor that affects flu patterns is vaccination.Annual flu vaccinesare a safe and effective way to help curb the spread of the flu and prevent hospitalizations and deaths.Vaccines are a key public health recommendation because they help protect high-risk people, such as young children, older adults, and people with weak immune systems—from the serious complications that can come with a case of the flu.

What About Bird Flu Cases?

COVID-19

The CDC also monitors some “early indicators,” including test positivity rates and emergency room visits, to gauge potential spikes in COVID cases.

The test positivity rate was 4.5%, up slightly from 4.2% the week prior. Emergency room visits with a positive COVID diagnosis remained steady at 0.5%.

For the most current COVID case counts in your area, check with your local health department.

Older Adults Should Get a Second COVID Shot This Year, CDC Says

Does the CDC Track Vaccination Rates?

The CDC providesestimates for how many people in the U.S. have received COVID vaccines, including booster doses. Your state’s public health department may also be tracking COVID vaccinations.

TheCDC will likely start reportingupdated COVID vaccination rates later in the season, as it does with flu vaccines.

Can You Get a Flu Shot and COVID Vaccine at the Same Time?The CDC recommends getting both the annual flu shot and the updated COVID vaccine. You can safely receiveboth shots at the same timeor on separate days.If you get both vaccines on the same day, the CDC says it’s OK toget both injections in the same armas long as they’re administered about 1 inch apart. However, since some flu shots can make your arm sore, your provider may suggest getting the shots in different arms to minimize discomfort.

Can You Get a Flu Shot and COVID Vaccine at the Same Time?

The CDC recommends getting both the annual flu shot and the updated COVID vaccine. You can safely receiveboth shots at the same timeor on separate days.If you get both vaccines on the same day, the CDC says it’s OK toget both injections in the same armas long as they’re administered about 1 inch apart. However, since some flu shots can make your arm sore, your provider may suggest getting the shots in different arms to minimize discomfort.

The CDC recommends getting both the annual flu shot and the updated COVID vaccine. You can safely receiveboth shots at the same timeor on separate days.

If you get both vaccines on the same day, the CDC says it’s OK toget both injections in the same armas long as they’re administered about 1 inch apart. However, since some flu shots can make your arm sore, your provider may suggest getting the shots in different arms to minimize discomfort.

RSV

While RSV is not on the CDC’s current list of Nationally Notifiable Diseases like COVID and influenza, a new rule from the Centers for Medicare & Medicaid Services (CMS) requires hospitals and critical access hospitals to report data on respiratory illnesses, including RSV, starting Nov. 1, 2024.

As of Dec. 2, the CDC’sRespiratory Illness Data Channelreports that RSV activity is elevated and increasing in the southern, central, and eastern U.S., particularly among young children—a group highly vulnerable to severe RSV infections. The number of emergency room visits for RSV is moderate but trending upward.

Despite localized surges, overall RSV case levels remain low.

What Is the First Sign of RSV? A Timeline of RSV Symptoms

Are People Getting the RSV Vaccine?

The CDC also tracks RSVvaccination data. So far this year, the uptake of RSV vaccine among eligible people has been low.

The RSV vaccine is recommended for all adults ages 75 and older. Those ages 60 to 74 who are at high risk for severe RSV are also recommended to get the shot. Older adults face an especially high risk of RSV and its complications, but getting vaccinated can reduce the risk.

As of Nov. 16, about 41% of adults 75 and older reported having received the RSV shot, while 7% said they “definitely” plan to get vaccinated. Among adults aged 60–74 with high-risk conditions, about 32% reported having received the RSV vaccine, and 18% said they plan on getting vaccinated.

Frequently Asked Questions

The CDC tracks “influenza-like illness” (ILI) activity levels in each state and presents aweekly flu surveillance report. ILI activity levels are defined as the following:

Data on ILI activity can give you a sense of how many people have respiratory symptoms in your state.If the ILI activity level where you live is high, it can be a sign that the flu is “going around” in your community. You can take preventive steps, such aswashing your hands frequentlyand getting a flu shot, to help reduce your risk of getting sick.If you haveflu-like symptoms, call your provider to see if you should have a test. They might want you to take antiviral medications such asTamifluto help reduce your symptoms. While you are sick, wear a mask and stay at home to help keep other people from catching the flu from you.

Data on ILI activity can give you a sense of how many people have respiratory symptoms in your state.

If the ILI activity level where you live is high, it can be a sign that the flu is “going around” in your community. You can take preventive steps, such aswashing your hands frequentlyand getting a flu shot, to help reduce your risk of getting sick.

If you haveflu-like symptoms, call your provider to see if you should have a test. They might want you to take antiviral medications such asTamifluto help reduce your symptoms. While you are sick, wear a mask and stay at home to help keep other people from catching the flu from you.

New variants of the COVID virusare always emerging, as it’s natural for viruses to change over time. Researchers follow new variants closely to see if the changes in the viruses may make them more of a threat. For example, they might become better at spreading or resisting vaccines and treatments. Getting the most updated COVID vaccine is key to protecting yourself from severe illness.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on respiratory illnesses, visit ournews page.

2 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Weekly US Influenza Surveillance Report: key updates for week 47, ending November 23, 2024.Centers for Disease Control and Prevention.Updated hospital reporting requirements for respiratory viruses.

2 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Weekly US Influenza Surveillance Report: key updates for week 47, ending November 23, 2024.Centers for Disease Control and Prevention.Updated hospital reporting requirements for respiratory viruses.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Centers for Disease Control and Prevention.Weekly US Influenza Surveillance Report: key updates for week 47, ending November 23, 2024.Centers for Disease Control and Prevention.Updated hospital reporting requirements for respiratory viruses.

Centers for Disease Control and Prevention.Weekly US Influenza Surveillance Report: key updates for week 47, ending November 23, 2024.

Centers for Disease Control and Prevention.Updated hospital reporting requirements for respiratory viruses.

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