It's been more than a decade -- since the H1N1 swine flu pandemic -- since flu hospitalization rates have been this high at this point in the season.
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The CDC estimates that there have been at least 880,000 illnesses, nearly 7,000 hospitalizations and 360 deaths from flu in the US this season. The first pediatric death in the country was reported this week.
Getting the flu shot is still the best way to protect yourself, experts say. And the best time to do it is now.
"Please get it this afternoon. Do not linger," said Dr. William Schaffner, medical director of the National Foundation for Infectious Diseases and a professor at Vanderbilt University Medical Center.
"We're in a bit of a race with the virus," he said, with the flu season starting at least a month earlier than usual. And it takes between 10 days and two weeks for the shot to offer full protection.
Similar to previous years, the CDC recommended that people get their flu vaccine before the end of October. But flu vaccination rates are lower than typical for this time of year.
About 128 million doses of flu vaccine have been distributed this season, compared with 140 million at this point last year and 156 million the year before that, according to CDC data.
Even though the current season started early, there is more than enough reason for those who haven't gotten their shot to do it now, Schaffner said.
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"I would assure anyone who hasn't gotten it yet that they're not too late," he said. And "the recommendations couldn't be simpler": Anyone 6 months or older in the US is eligible for and recommended to get the flu vaccine, with rare exception.
"The flu season will be with us for at least a few more months. We don't know whether it will be shorter or longer than usual," Schaffner said. "There is still very good reason to get your protection from the vaccine."
And people who are vaccinated can still get sick -- but the goal of the vaccine is to protect against the most severe outcomes and complications.
"We can acknowledge that the influenza vaccine is not perfect. It cannot protect absolutely everyone completely against influenza," he said. "They help keep you out of the emergency room, the hospital, the intensive care unit, and they protect you from dying. As I used to like to tell my patients, 'I'm so glad you're still here to complain.' "
Overall, CDC data shows that the share of lab tests that are positive for influenza has more than doubled over the past two weeks and that flu activity is highest in the South. Additional data from Walgreens that tracks prescriptions for antiviral treatments -- such as Tamiflu -- suggest hot spots in the Gulf Coast area, including Houston and New Orleans.
And the flu season is ramping up amid the surge of RSV that is filling pediatric hospitals and an ongoing Covid-19 pandemic.
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Eleven states -- along with Washington, DC, and New York City -- are reporting high or very high levels of respiratory illness, according to the CDC.
The surge of respiratory viruses may get worse before it gets better, Dr. Nipunie Rajapakse, a pediatric infectious diseases specialist at Mayo Clinic Children's Center, said Thursday.
She urged people to try to prevent any respiratory illness, including by getting Covid-19 vaccines and boosters, and the annual flu shot.
"Making sure that your kids and anyone over 6 months of age in your family are getting their flu vaccines this year is even more important because we haven't seen a lot of influenza the last couple of years, and so everyone's going into this season with less immunity, less protection from prior infections," Rajapakse said.
Those at risk for complications from respiratory illness, including the elderly and those with underlying conditions, should contact their health care providers as soon as they start to notice any symptoms, Schaffner said. There are treatments for Covid-19 and influenza that offer extra protection from severe outcomes, he said.
"From the point of view of respiratory viruses, the winter season has started early," Schaffner said. "If you do develop symptoms, please don't go to school or work. Shelter at home a little bit so you're not out there spreading the virus -- whatever it is."
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