FORT LAUDERDALE, Fla. — When you get ready to travel for the holidays, you may want to know how sick people are where you are going.
As of mid-December, 17 states were reporting “high” or “very high” levels of respiratory illness activity, federal health data shows. The states where illness activity is highest are scattered throughout the U.S. but most of the Southeastern states were seeing high levels, along with Western states including California, Nevada and Colorado. New Jersey and New York City also were seeing high levels, based on the percentage of visits to outpatient health care providers or emergency departments for fever and cough or sore throat.
States with the lowest levels of respiratory illness were Minnesota and West Virginia. To check the level of respiratory activity in the area where you are traveling, visit the Centers for Disease Control and Prevention respiratory illness dashboard.
“Every individual has a different risk tolerance and a different medical history,” said Alicia Budd, lead of the domestic surveillance division at the CDC. “It’s important to look at the surveillance, know the situation where you are going and be aware of what your risk will be.”
This year, as people board airplanes and cruise ships and load into their cars to celebrate with friends or family, fewer Americans are vaccinated against flu and COVID-19. Only about 20% of U.S. adults say they have received the updated COVID vaccine, with most of the recipients ages 65 and older, according to the KFF COVID-19 Vaccine Monitor. Also, as of the beginning of December, only about 40% of U.S. adults had received the flu vaccine, lower than at the same time a year ago.
The CDC recently sent an alert to health care providers, encouraging them to administer COVID, flu and RSV vaccines as soon as possible.
“The flu strains now are well matched to the strains circulating,” Budd said. “It may not prevent you from getting the flu, but it reduces severity … it helps prime your immune system so you are better able to respond and fight off infection or you don’t get as severely ill.”
Overall, in most areas of the U.S. the amount of respiratory illness (fever plus cough or sore throat) causing people to seek health care is elevated and ER visits are on the rise, according to mid-December data from the CDC.
“This year we are seeing full-blown everything,” Budd said. “The timing of when one virus is surging and others are not can vary, but in some states you do see all three at same time.”
Flu is hitting hard
Flu, in particular, is on the increase across the country, just as airports are expecting more travelers. Up to 5.4 million people in the United States already have been sick with the flu this fall with symptoms that include headache, fatigue and a lingering coughing, the CDC estimates.
If you’re traveling to cold climates, beware: Health experts believe the flu virus survives better in cold weather, and cold, dry air weakens people’s resistance.
“I think we will see flu activity continuing to increase. … I expect that to be the case for several more weeks,” Budd said.
The southeast, south-central, and West Coast areas of the country are reporting the highest levels of flu activity.
COVID-19 is still out there
COVID-19 also is circulating at high levels in some parts of the country. The new COVID variant JN. 1, a descendant of Omicron, has become an increasing share of cases, the CDC’s tracking shows. The variant will be responsible for at least half of new infections in the U.S. before December ends, the CDC experts say. Although highly contagious, there is no evidence JN. 1 causes more severe disease. The federal agency advisory says COVID-19 tests and treatments are expected to be effective against JN.1.
Francesca Ceddia, senior vice president of respiratory vaccines at Moderna, said the updated shot will work against the JN. 1 strain. “We keep calling them boosters but really they are updated vaccines and were changed for a purpose. They are made to be more specific for the sublineages circulating now.”
Ceddia said Moderna, at this time, feels confident the updated vaccine will cover existing strains. “At this stage, we have not started on a new booster.”
Ceddia says Americans are now facing the most critical part of respiratory illness season as people travel and gather. “If you get the updated vaccine, your protection against infection should be high, but most importantly you get protection against hospitalizations and deaths. They are on the rise week over week, and you want to avoid that.”
The CDC data tracker shows COVID-19 hospitalizations have been increasing following relatively low levels throughout the summer and early fall. Miami-Dade and Broward County hospitals report a 16.9% rise in new COVID-19 admissions during the past week, while Palm Beach County hospitals report only a 3.8% increase.
Test positivity rates are rising too, with some areas of the country seeing higher increases. To check COVID test positivity levels where you are traveling, visit the CDC COVID-19 data tracker. You can also check to see the change in positivity from the prior week.
The CDC also uses wastewater surveillance data to monitor COVID levels. As of Dec. 11, the data suggests there’s a lot of COVID-19 going around, particularly in states such as Wisconsin, Illinois, Michigan and Ohio. In South Florida, however, the data shows minimal levels of COVID-19.
RSV surge may be subsiding
Another respiratory virus circulating this season is respiratory syncytial virus, known as RSV. Health experts believe it may have peaked in November and report the virus appears to be receding nationwide. Nationally, visits to emergency departments for RSV declined slightly in the last week, the new federal data shows. The decline was driven mainly by decreases in Southeastern states.
Overall, it has been a harsh respiratory illness season thus far. CDC estimates that there have been at least 3.7 million illnesses, 38,000 hospitalizations, and 2,300 deaths from flu and COVID.
Health experts expect the numbers for illnesses, hospitalizations and deaths to rise in late December and early January due to travel and holiday gatherings.