Jan. 19, 2024 – The familiar symptoms are back again – a runny nose, coughing, aches, congestion, and maybe a fever. When the at-home COVID-19 test comes back negative, you head to the doctor to see if they can figure out what you’ve caught. At the doctor, though, the typical COVID and flu tests also come back negative. It could seem like a new mysterious respiratory illness is making the rounds.

Instead, several typical respiratory viruses seem to be peaking at once. Doctors are reporting high levels of COVID, the flu, and respiratory syncytial virus (RSV), as well as other “flu-like illnesses” that cause similar symptoms, such as the common cold, other coronaviruses, and parainfluenza viruses (which cause typical respiratory symptoms such as a fever, runny nose, coughing, sneezing, and a sore throat).

“Respiratory viruses are still very high right now, as you would expect at this time of year,” said Brianne Barker, PhD, who researches viruses and the body’s immune response as an associate professor of biology at Drew University in New Jersey. “Also, a fair number of patients seem to have multiple infections at once, such as flu and strep, which may cause confusion when patients consider their symptoms.”

What Are the Latest Trends?

The current COVID-19 surge appears to be at the highest point since the Omicron variant infected millions in December 2022, according to the CDC’s COVID wastewater data. Test positivity appears to be stabilizing after increasing since November, the CDC’s COVID Data Tracker shows, though the rate was still high at 12.7% positivity during the first week of January. 

At that time, COVID-19 emergency department visits began declining, though hospitalizations were still on the rise and deaths were up 14.3% from the previous week. As of Jan. 6, the JN.1 variant is driving most of the spread, accounting for 61.6% of COVID-19 cases in the U.S., according to CDC variant data.

“COVID doesn’t seem as bad right now as in the days of Omicron, but the problem is that it’s tough to compare because COVID cases aren’t reported in the same way as before, and we don’t have that state data,” said Bernard Camins, MD, an infectious disease specialist and medical director of infection prevention at Mount Sinai Health System in New York City.

Other viruses are circulating as well, such as adenovirus, which can cause a cold, sore throat, diarrhea, pinkeye, and other symptoms. Parainfluenza viruses peaked in late November and saw another jump at the end of December. Rhinoviruses, which cause the common cold, also returned to normal peak levels alongside the flu this season, Camins said. 

“It kicked me harder than other illnesses in recent years, but I did take antivirals, and it was out the door in about 4 days,” he said. “My mom, who is immunocompromised and in her 70s, also got it but took an antiviral even sooner and got over it in about 24-36 hours.”

For the next couple of months, it’s also not too late to get vaccinated against the most prevalent viruses, especially COVID, the flu, and RSV. The most vulnerable groups, such as young children and older adults, could especially benefit from vaccination, Camins said.

“With RSV, for instance, there are vaccines for pregnant women to protect their infants,” he said. “And although we don’t have great data to say whether the current COVID vaccine is protective against infection, we know it still protects against severe disease and death.”

As 2024 continues, experts said they’re looking forward to more effective at-home tests for COVID and the flu, better flu vaccines, and new research on the body’s immune response to these respiratory viruses.

“Disease prevention is key, irrespective of what’s surging and what we’re dealing with right now,” Desai said. “Think about your risk factors and what you’re doing overall this year for your health and wellness – whether routine physical exams or cancer screenings, based on your age. There’s power in staying healthy and advocating for ourselves when we’re feeling well.”