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Are We Seeing a Second Wave of Flu?

Influenza season isn’t over yet. These are the states getting hit the hardest now.

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It’s been a rough winter when it comes to respiratory illnesses. Influenza, COVID-19 and RSV have been circulating at high levels throughout the U.S. for several weeks, and new data from the Centers for Disease Control and Prevention (CDC) shows that respiratory virus activity remains elevated.

There are signs that COVID and RSV infections may be easing, according to the CDC. However flu levels are once again picking up after a post-holiday drop, the latest data shows. The U.S. saw about a 2 percent increase in positive flu tests the week of Feb. 2, compared to the previous week. Flu activity is especially high in a number of southern and mid-Atlantic states, with New Mexico, Georgia, South Carolina, and New York City reporting extremely high levels.

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It’s too early to tell if this bump is an indication that we’ll see a second flu wave this winter, says Rebecca Wurtz, M.D., an infectious disease physician and professor at the University of Minnesota’s School of Public Health. “This time of year is sort of the limbo time. We always expect a spike early in the season with the winter holidays, and then we expect it to decline,” Wurtz says. But in February, she adds, it’s not uncommon for trends to “wobble.”

In fact, February is often an active time of the year for flu, says William Schaffner, M.D., professor of preventive medicine and infectious diseases at Vanderbilt University School of Medicine. Activity typically recedes in March, Schaffner says, but “can smolder along at low levels, sometimes even poking its nose into April.”

The CDC estimates that at least 20 million Americans have had the flu so far this season. There have been at least 230,000 flu-related hospitalizations and 14,000 deaths.

Not too late for a flu shot

Because flu season isn’t over and could be with us for several more weeks, health experts say it's not too late to get your flu shot if you haven't had it yet.

More than half of U.S. adults (about 53 percent) haven’t received this year’s vaccine, which targets the influenza viruses that are currently circulating. That share shrinks when looking at data for older adults, who are at higher risk for serious illness and flu-related complications, such as pneumonia. An estimated 33 percent of the 60-plus population skipped out on this season’s shot.

A new AARP survey of individuals age 18 and older finds that just over half (52 percent) of adults who say they are unlikely to get the flu shot are passing on it because they don’t think they need it. About 26 percent of those not getting the vaccine say it’s because they never get the flu.

Schaffner says another reason he hears from reluctant patients is that the flu vaccine “isn’t very good.” However, he says, the vaccine “provides very substantial protection against getting serious disease,” which is especially important for older adults. During the 2022-2023 flu season, older adults accounted for 72 percent of influenza deaths and 52 percent of hospitalizations, federal data shows.


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Don’t abandon precautions

Another way to stay protected from flu as the season persists, Wurtz says, is to wear a face mask. A mask can also help to block RSV, which is tapering off after a holiday-season surge, and the coronavirus. CDC data shows that more than 22,600 people are still being hospitalized weekly for COVID-19; about 1,000 people are dying each week from the virus.

Schaffner recommends masking up in crowded indoor settings — when you’re in the grocery store, at a religious service or attending a sports game. “It offers another layer of protection,” especially for those at higher risk, he says.

Like with flu, there are also vaccines for RSV and COVID-19. However, uptake has been low. About 22 percent of adults have received the latest COVID-19 vaccine; a similar share of individuals 60 and older have had the new RSV vaccine.

If you do get sick this winter, don’t sit on your symptoms, Schaffner says. Reach out to your doctor right away to get tested. “We have treatments both for flu and for COVID — treatments that, like the vaccine, will help keep you out of the hospital. But we have to start the treatment as early as possible,” he says.

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