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The United States seems on track to experience a more typical respiratory virus season in 2023-24. COVID-19 also remains a threat, with an increased amount of COVID-19 activity in recent weeks.

Cases of influenza, respiratory syncytial virus (RSV), and other respiratory viruses were lower than normal in 2019-20, 2020-21, and 2021-22. COVID-19 prevention efforts like physical distancing and masking played a role in those declines. But 2022-23 saw a rise in flu, RSV, and other respiratory illnesses to more typical levels.

“I think it’s a pretty safe prediction to say that this respiratory virus season will be more typical,” says Graham Snyder, MD, medical director, Infection Prevention and Hospital Epidemiology, UPMC. “We’ll have seasonal respiratory viruses circulate. Influenza will have its usual large impact that it has every year.”

COVID-19 cases also spiked in the winters of 2021-22 and 2022-23 and are expected to have high activity this coming winter.

It’s important to take steps to protect yourself against COVID-19, the flu, and other respiratory viruses in the coming months. Here’s what you need to know.

Are COVID-19 Cases Increasing?

The total number of COVID-19 cases in the United States is unknown. But indications are that after months of decline, COVID-19 cases began to rise again in the late summer.

The Centers for Disease Control and Prevention (CDC) reported 12,613 hospitalizations nationwide from COVID-19 in the week of Aug. 6 to 12. That was a 21.6% increase from the previous week. COVID-19 deaths rose 8.3% from the previous week.

Hospitalizations and deaths have not reached the levels of the previous two winters, or even of spring 2023, Dr. Snyder says. But it’s important to note that COVID-19, unlike most respiratory viruses, is still circulating widely this summer.

“We don’t see surges or upticks of most respiratory viruses in mid-August,” Dr. Snyder says. “So, COVID-19 is still something that’s a little different that our immune systems and the viruses have not come to homeostasis on. It has not yet settled in as a seasonal respiratory virus.”

There are several different variants and subvariants of the coronavirus circulating throughout the U.S., Dr. Snyder says. None had emerged as the dominant variant as of late August.

How Can I Prevent COVID-19 and the Flu?

The best way to protect yourself and others from COVID-19, the flu, and other respiratory illnesses is by getting vaccinated if you’re eligible.

“Vaccines prepare you and your body to fight the viruses that are trying to make you sick,” says Donald Yealy, MD, chief medical officer and senior vice president, Health Services, UPMC.

Vaccines are available or will be available in the coming months for COVID-19, the flu, and RSV. If you’re eligible for the vaccines, you can get them at the same time.

“I personally recommend everyone to get their flu and COVID vaccines and take advantage of the opportunity to protect themselves from the flu and the latest strains of COVID-19,” says Tracey Conti, MD, chair, Family Medicine, UPMC. “If you’re older, you can also get a vaccine to help protect you against RSV, which can cause serious respiratory diseases.

“I recommend you check with your primary care provider about the flu, COVID-19, and RSV vaccines. And you can also check with your local pharmacy or your local UPMC Urgent Care.”

New COVID-19 vaccine in fall 2023

In September 2023, the U.S. Food and Drug Administration (FDA) authorized and approved updated COVID-19 vaccines from Pfizer-BioNTech and Moderna. The Centers for Disease Control and Prevention (CDC) recommended the new vaccines for all Americans aged 6 months and older.

The vaccine’s new composition protects against the Omicron XBB subvariant of SARS-CoV-2. XBB is one of the widely circulating subvariants of the coronavirus.

The change means that the updated COVID-19 vaccine is similar to a seasonal flu vaccine because it protects against widely circulating virus strains.

“This will be the first year that we talk about the seasonal COVID-19 vaccine, and accordingly, the conversation is anticipated to be much like the flu conversation,” Dr. Snyder says.

“The annual vaccine is recommended for everybody who is eligible to prevent serious complications. And that’s particularly true for people who are at risk for serious complications.”

The vaccine became available nationwide in September 2023.

All people who are eligible for the updated COVID-19 vaccine when it arrives should get vaccinated, Dr. Snyder says.

Learn more about the new vaccine.

Flu vaccinations

The annual flu vaccine will be available beginning in the fall. All Americans 6 months and older are recommended to get a flu shot. Younger children and older adults are most at risk of serious illness from the flu.

“It’s advisable to get vaccinated because influenza causes a lot of deaths and serious illnesses every year,” Dr. Snyder says. “The vaccine consistently offers good protection. The influenza vaccine is important, especially if you’re at high risk of complications.”

RSV vaccination

There are RSV vaccination options to protect the people most at risk: infants, young children, and older adults.

RSV is a common virus that most children have been infected with by the time they’re 2 years old. It can then return throughout your life, usually in a less severe form. But infants, young children, and older adults are most at risk of severe illness and hospitalization.

“RSV is not just a head cold virus,” Dr. Snyder says. “It can cause serious illness and even death in people of older ages and newborn infants.”

To protect older adults, there is an RSV vaccine available for people over 60. If you are over 60, talk to your doctor about whether you should get the RSV vaccine.

“The most important group for the RSV vaccination are going to be people over the age of 60, and particularly if they have another underlying condition, whether that’s a lung or a heart condition or an immunocompromised state,” Dr. Yealy says.

To protect infants and young children against RSV, there are multiple options:

• Abrysvo. In August 2023, the FDA approved Abrysvo™, an RSV vaccine, for women between 32 and 36 weeks of pregnancy. The vaccine aims to protect newborns and infants from severe RSV illness.
• Nirsevimab-alip (Beyfortus™). This is a monoclonal antibody recommended for all infants under 8 months who are born during RSV season or are entering their first RSV season. It is also recommended for infants between 8 and 19 months old who are at risk of severe RSV illness and are entering their second RSV season. One dose of nirsevimab protects children for five months, the length of an average flu season. It is currently in short supply nationwide and may not be as available as the Abrysvo vaccine.
• Palivizumab (Synagis). This is a monoclonal antibody for children under 24 months old with conditions that put them at risk for severe RSV illness. They receive monthly doses of palivizumab during RSV season.

If you are pregnant or a new mother, talk to your doctor or your child’s doctor about which RSV option is best for your child.

Other COVID-19 and flu prevention methods

Vaccination is the first step in protection. But there are other things you can do to prevent the spread of COVID-19, the flu, RSV, and other respiratory viruses.

• Get tested for COVID-19 and the flu. If you’re feeling symptoms of a respiratory illness, get tested for COVID-19 and the flu. If you test positive for COVID-19, you may qualify for treatment with Paxlovid™, an oral medication. If you test positive for the flu, you may qualify for treatment with the antiviral oseltamivir. “If you have any of those symptoms — fever, congestion, sore throat, cough, stuffiness — any one or more of those, stay isolated and test yourself,” Dr. Yealy says. “It’s the way that you can avail yourself to the most and best care for you and protect all those people around you.”
• Stay home if you’re sick. Isolating yourself can protect others from the spread of respiratory illnesses. If you test positive for COVID-19, you should self-isolate for at least five days. “It’s important to stay home from work or school so you don’t get others sick,” Dr. Snyder says. “What might be a mild head cold to us might be quite serious to somebody else. It’s important to protect those around us.”
• Take symptomatic care. Talk to your doctor about medications you can take to relieve your symptoms. “Do those things that are making you feel better,” Dr. Conti says. “Take the symptomatic care, whether that be medicine to reduce your achiness or a medicine to bring down your fever, making sure you’re taking precautions to avoid spreading it to other people.”
• Wear a mask. Wearing a mask if you’re sick can protect others from the spread of respiratory viruses. If you had COVID-19, you are considered contagious for 10 days. So even if you end self-isolation after five days, you should wear a mask for an additional five days while in indoor public places or while around people at risk of COVID-19 complications. You also can choose to wear a mask even if you’re not sick to protect yourself — especially while in crowded public places.

How Can I Tell If I Have COVID-19 or the Flu?

COVID-19, the flu, RSV, and other respiratory viruses share many symptoms. While there are some subtle differences, there’s often no way to tell which illness you have without getting tested. That’s what makes getting tested so important.

“If you have a runny nose, sore throat, or cough, it could be any of these,” Dr. Snyder says.

As respiratory virus season approaches, it’s important to take every step you can to protect yourself and those around you. The best ways to do that include vaccination, staying home if you’re sick, and getting tested if you’re sick.

Dr. Snyder says that general wellness also is important.

“Managing health conditions, quitting smoking, getting good rest, having a well-balanced diet, and exercising — these are all important,” he says. “Because we’ll always be facing these viruses, and this is how we keep them mild.”

Editor's Note: This article was originally published on August 29, 2023, and was last reviewed on November 28, 2023.