Welcome to sick season. According to the CDC, New York City, along with New Jersey and at least 16 other states are now experiencing “high” to “very high” levels of respiratory illness activity, as measured by the number of weekly visits to healthcare providers and emergency rooms by people experiencing symptoms of fever, cough, and sore throat . The culprits are the usual suspects: this year’s strains of influenza, COVID, and RSV. And though flu-like illness levels have been above baseline nationally for several consecutive weeks, the CDC warns that we still haven’t hit the peak.

As CNN notes, COVID wastewater levels have been steadily rising across the country:

Nationally, viral activity for Covid-19 detected in wastewater — a leading indicator of transmission — is high and rising quickly. Levels are highest in the Midwest, where wastewater data from the CDC indicates Covid-19 is spreading more than it has since the Omicron wave two years ago.

There are signs that RSV activity has reached its peak in the US, as test positivity rates and emergency department visits have started to tick down. But RSV hospitalization rates are still higher than they’ve been at any point for the past five years, except for last season’s peak.

The CDC also sent out an alert to healthcare providers this week highlighting low vaccination rates for the three viruses. Per the Washington Post:

This is the first respiratory virus season in which some Americans can be immunized against all three major pathogens. For the first time, all newborns and adults older than 60 can receive RSV shots. An updated coronavirus vaccine targeting the latest variants is available.

Based on surveys, the CDC estimates 8 percent of children, 17 percent of all adults and more than a third of seniors received the new coronavirus shot. About 16 percent of older adults received the RSV shot, while estimates are not available for young children. The flu shot remains most popular, with 40 percent of adults receiving it by December, the same as last year.

As always, seniors remain the most at-risk demographic for severe outcomes from respiratory illnesses, which is why the low vaccination rates for that group remain troubling.

Beyond vaccination, for everyone, the best way to prevent the spread of respiratory illnesses like the flu and RSV is regular handwashing; avoiding touching your eyes, nose, and mouth; and staying home if you get sick. High filtration face masks still work great, too, and not just for avoiding COVID.

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