RALEIGH — Increases in COVID-19 metrics have been seen in North Carolina and nationally during recent weeks, including in the early warning wastewater monitoring system. North Carolina’s COVID-19 metrics had been trending down throughout 2023 to the lowest levels since the pandemic began. Along with wastewater, increases have been seen in other COVID-19 metrics, including hospital admissions and emergency department visits, according to data on the North Carolina Respiratory Virus Dashboard.

“We expect COVID-19 trends to rise and fall. While the public health emergency in response to COVID-19 has ended, COVID-19 is still with us and we expect it to continue to be with us,” said Dr. Elizabeth Cuervo Tilson, state health director and NCDHHS chief medical officer. “Some people, including older people, people with underlying health conditions or compromised immune systems are at higher risk for severe illness with COVID-19. Fortunately, we have the tools for people to protect themselves and each other, including access to vaccines, testing and treatment to help manage COVID-19 and other respiratory diseases.”

Influenza and respiratory syncytial virus (RSV) are two other seasonal viruses that cause respiratory infections and can also cause severe illness or even death, particularly in older adults, young children and those with underlying medical issues. Flu and RSV infections typically peak between December and February, but the timing has been less predictable since the start of the COVID-19 pandemic. COVID-19, flu and RSV were all spreading widely at the same time last fall, causing many infections and putting stress on the health care system and hospital capacity.

Safe and effective vaccines are the best way to protect yourself and your loved ones against COVID-19 and flu; and this year, for the first time, there is an RSV vaccine to protect people 60 years and older. There is also a new medication available to prevent RSV infection in infants.

NCDHHS encourages all North Carolinians to prepare for the fall respiratory virus season by taking the following actions:

Stay up-to-date with vaccines:

• Ensure you are up-to-date with COVID-19 vaccines now and get the updated COVID-19 vaccine when authorized and available this fall. The updated booster is expected to be available by the end of September.
• Get your seasonal flu vaccine, preferably in September or early October. Everyone 6 months and older should get a flu vaccine every year, especially people at higher risk for more severe illness. The flu and COVID-19 vaccines can be administered at the same time.
• People 60 years and older should talk to their doctors about whether an RSV vaccine might also be good for them.

As COVID-19 and flu increase, be prepared to test and seek treatment:

• Have a ready supply of COVID-19 tests and a plan to get treatment if you test positive. There are treatments available for both COVID and flu that can reduce your risk for hospitalization and death.
• Visit Testing & Treatment | NC COVID-19 (ncdhhs.gov) for information on how to get free at home COVID-19 tests and how to access treatment.
• If you have symptoms of COVID-19 or flu and are in a higher-risk group, or are very sick or worried about your illness, contact your health care provider. There are medications  your doctor may prescribe to treat flu illness. CDC recommends prompt treatment for people who have flu or and who are at higher risk of serious flu complications, such as people with asthma, diabetes (including gestational diabetes), or heart disease.

Take other actions to stay healthy:

• Practice basic protective measures, like washing your hands, covering your nose and mouth when you cough or sneeze, cleaning surfaces often and staying home when sick.
• Consider an extra layer of protection of masks in higher risk indoor settings and/or if an individual is high risk.
• Check the North Carolina Respiratory Virus Summary Dashboard for up-to-date information on respiratory virus activity, including COVID-19, influenza and RSV.
• Parents of infants should talk to their child’s doctor about the new medication to prevent RSV infection.