Flu and RSV Cases are Rising, Here’s When They May Peak

Person with face over a bowl with blanket over their head.
Hospitalizations related to the flu and other respiratory diseases are on the rise. Roos Koole/Getty Images
  • Respiratory diseases are rising rapidly in the U.S.
  • Over 20,000 people have been hospitalized with the flu this week up from 15,000 the week prior.
  • Flu and other respiratory disease often peaks sometime in January or February.

After a quiet couple of years, respiratory illnesses, including the flu, COVID, and respiratory syncytial virus (RSV), are spreading rapidly across the country. 

The latest influenza report from the Centers for Disease Control and Prevention (CDC) released Friday shows that, in the past week, over 20,000 people were admitted to the hospital with the flu.

So far this season, there’ve been an estimated 10 million cases, over 110,000 hospitalizations, and 6,500 deaths from flu this season.

The colder temperatures and indoor gatherings have accelerated transmission of COVID and RSV, too.

Tania Bubb, PhD, the president of the Association for Professionals in Infection Control and Epidemiology, says seasonal influenza, COVID-19, and RSV levels are currently elevated in many parts of the U.S. — and we’re observing rapid increases in these infections. 

“With holiday celebrations and gatherings and colder weather, we expect to see a continued rise in respiratory infections over the next several weeks,” Bubb told Healthline. 

When will flu season peak?

Flu activity typically picks up in the winter months, from October to March, and peaks sometime between December to February. 

Dr. Carl J. Fichtenbaum, a professor in the Division of Infectious Diseases at the University of Cincinnati College of Medicine, says influenza was abnormally quiet in 2020, 2021, and even throughout 2022.

In the late 2022 and early 2023 flu season, the virus came back with a vengeance, and triggered a surge in cases and hospitalizations, he says.

Flu-like activity is currently high in two-thirds of the country, which is greater than what the country saw this time last year, according to the CDC.

We can usually predict what the Northern Hemisphere’s flu season will be like by looking at what recently transpired in the Southern Hemisphere. 

Australia’s flu season runs from May to October, for example, and they recently saw a 13.5% increase in cases over the past year.

“We may expect something similar in the U.S. The peak will likely be late January or February,” Fichtenbaum said.

Bernadette Boden-Albala, MPH, DrPH, Founding Dean of the UC Irvine Program in Public Health, similarly suspects we are inching toward the peak. 

“We should see the peak of flu season these first few weeks of January, given we are coming off of the holiday season,” she told Healthline. 

Here’s what’s happening with COVID variant JN.1 and RSV

COVID-19 transmission remains steady, with hospital admissions increasing by nearly 20% and deaths rising by 12% for the last week of 2023 compared to the week prior.

The CDC is continuing to track the JN.1 variant that is causing a rapidly-growing share of infections. 

Though COVID-19 activity is increasing, hospitalizations are down compared to 2022, according to Fichtenbaum.

“This is due to widespread immunity from those that already have gotten COVID before and vaccine immunity,” he said.

It’s unclear when this COVID-19 wave will begin to dip, as it appears it has not yet peaked.

RSV, on the other hand, may have just hit its peak as activity is slowly dropping. 

That said, RSV activity is still high and many states have reported an influx in hospitalizations following the holidays. 

“The peak last year was late November 2022. And this year looks like it will be late December or January for the peak,” says Fichtenbaum.

How to protect yourself from the Flu, RSV and COVID-19

There are multiple factors that drive the transmission of respiratory viruses, including the climate and our behaviors. 

“Influenza and RSV spread easily in cold climate due to drier air and natural lower immunity of people during cold seasons,” says Bubb.

In addition, people tend to stay inside and gather together indoors during cold temperatures, which helps the virus spread from person to person. 

The best way to protect yourself is to get vaccinated.

“The vaccines available for influenza, COVID, and RSV are highly effective and significantly reduces one’s chances of becoming seriously ill if they happen to become ill with one of these viruses,” says Bubb. 

RSV vaccines are only available to pregnant women and adults over age 65. There is a monoclonal antibody RSV shot available to young children. Flu and COVID-19 shots are available to nearly all people in the U.S. over the age of 6 months.

If you contract COVID-19 or the flu, there are prescription antiviral treatments that can help relieve symptoms and prevent complications, Bubb added.

Washing your hands and wearing a high-quality mask can help you avoid getting sick, too.  

“I would like to stress for everyone to stay hydrated and eat nutritious foods because if you can bolster your natural defenses with these activities then your immune system is operating at the highest level to protect you against infectious diseases,” says Boden-Albala.

If you are sick, it’s important to stay home to reduce the spread of these illnesses. 

Many people assume they just have a cold and continue to go to work, school, or social events where they run the risk of spreading the viruses to other people. 

“The problem is that the more we get together when we are ill, the more likely that the virus will pass to the most vulnerable in the population,” Fichtenbaum said.

The bottom line: 

After a quiet couple of years, respiratory illnesses, including the flu, COVID, and respiratory syncytial virus (RSV), are spreading rapidly across the country. The colder temperatures and indoor gatherings have accelerated transmission, and flu experts suspect flu activity will peak around the end of the month.

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