The nights are drawing in, the weather’s turning chilly, and spooky season is upon us – the Northern Hemisphere is fully in the grip of fall. But as well as all the cozy vibes and holiday fun, this time of year unfortunately brings with it a wave of respiratory viruses. The Centers for Disease Control and Prevention (CDC) just released its latest outlook for flu, COVID-19, and respiratory syncytial virus (RSV), so what can we expect?

These three viruses together have been dubbed by some a “tripledemic”. A winter increase in cases is to be expected, but the levels and severity do vary year by year. 

This year, according to the CDC, “As of mid-October, overall US respiratory disease activity remained low.” Despite a recent increase in COVID-19 cases caused by the newest kid variant on the block XEC, overall test positivity rates, ER visits, and hospitalizations were on a downward trend. Flu and RSV activity also remains low for now, so if a tripledemic is coming, the US isn’t seeing it quite yet. 

That doesn’t mean that authorities can take their eyes off the ball, and close monitoring will continue, but the overall summary of the outlook is not particularly pessimistic: “CDC continues to expect that the 2024-2025 fall and winter virus season will likely have a similar or lower number of combined peak hospitalizations from flu, COVID-19, and RSV compared to last season.”

As to exactly when the peak might happen for COVID-19, the CDC has a couple of hypothetical scenarios based on SARS-CoV-2 activity during the summer.

In scenario A, the peak of COVID-19 summer activity does not hit until after the fall/winter respiratory season has already started. This leads to a peak of COVID-19 hospitalizations in December.

Scenario B, on the other hand, has summer COVID-19 activity peaking earlier, with a smaller second wave of infections arriving in mid-January. 

In reality, the agency says that “we expect the upcoming season to be more similar to Scenario A, with a winter peak that is higher than the summer/fall peak before it.” That’s because the COVID-19 summer wave seems to have peaked in early August, and population immunity may not be as high as we might have forecast coming into the winter season. 

Therefore, we might expect to see the most COVID-19-related hospitalizations in late December and early January – though, of course, this is just an estimate. 

While the predictions suggest we could be in for a milder season than 2023-24, that doesn’t mean that flu, RSV, and COVID-19 do not continue to pose a real threat – particularly to the elderly, the very young, and those with compromised immune systems. Vaccination is the best line of defense we have, and thankfully is now available for all three of these viruses.

Flu and COVID-19 vaccines are currently recommended by the CDC for everyone aged 6 months and older. RSV vaccination is available for select groups who are most at risk from the virus:

• Adults aged 75 and over
• Adults aged 60-75 who are at increased risk – speak to your doctor or pharmacist to find out if you’re in this category
• Pregnant people between 32 and 36 weeks of gestation
• Babies – either when no vaccine was given during the pregnancy, or where a baby aged 8-19 months is considered at increased risk

And throughout the fall and winter, it’s always worth remembering the simple things everyone can do to help stop the spread of infection: hand washing, staying home when you’re sick, and wearing a face covering in enclosed or crowded spaces.