United States hospitals should plan for a winter respiratory peak about as heavy as last season’s, according to the CDC outlook for the 2026-2027 respiratory season. The agency expects the combined peak in hospitalizations from COVID-19, flu and RSV to land within 20% of last season’s peak, with low to moderate confidence. The outlook offers high level information on how the season could unfold, and the CDC stresses that it is not a forecast.
Last season’s combined peak came in the week ending January 3, 2026. This year’s respiratory season outlook, published September 23, lays out what a similar season could look like for each virus, and it arrives as flu activity runs ahead of the usual calendar. In the week ending October 10, 5.0% of clinical lab specimens tested positive for influenza, up from 3.9% the week before, according to the CDC FluView report.
What the respiratory season outlook expects
For COVID-19, modeling suggests a peak weekly hospitalization rate of 1.4 to 2.5 per 100,000 people in early to mid January if no new immune evading variant appears. If a variant with moderate immune escape emerges, the projected peak rises to 2.8 to 6.7 per 100,000, likely in late January 2027. About two thirds of the experts the CDC surveyed considered that scenario unlikely.
For flu, the CDC expects a moderate season across all ages, with low to moderate confidence. Last season was moderate overall but high in severity for children. For RSV, the respiratory season outlook expects a peak within 20% of last season’s, with moderate confidence. RSV peaked unusually late last season, in the week ending February 21, 2026, and the CDC says that may signal another late peak this season.
Early flu activity in the respiratory season
National flu activity remains low overall, but the CDC called early respiratory season activity higher than typical for this time of year while still within expected seasonal variation. FluView shows activity highest in HHS Regions 9 and 10, which include California, Arizona, Nevada, Hawaii, Washington, Oregon, Idaho and Alaska. Nationally, 2.1% of outpatient visits were for flu like illness, below the 2.9% baseline.
Hospitals reported 4,024 lab confirmed flu admissions that week, a rate of 1.2 per 100,000 people, with adults 65 and older highest at 3.8 per 100,000. No flu related pediatric deaths had been reported for the new respiratory season, and no new human infections with novel flu viruses were reported as of October 14. Most flu viruses identified so far are A(H1N1), and early lab testing found that 94.6% of characterized H1N1 viruses, and all tested H3N2 and B/Victoria viruses, were well recognized by antibodies against this season’s vaccine strains.
Who faces the highest risk
The CDC recommends annual flu vaccination for everyone 6 months and older, ideally in September or October, and vaccination can still help later in the respiratory season while flu viruses circulate. Flu vaccines prevented an estimated 180,000 hospitalizations in the 2024-2025 season, according to the outlook. For RSV, CDC recommendations call for vaccinating adults 75 and older and adults 50 to 74 who are at increased risk, while infants under 8 months can be protected through maternal vaccination during pregnancy or a long acting antibody shot.
Prescription flu antivirals work best when started early and matter most for higher risk patients, the CDC says. People with fever, cough or shortness of breath should rest, stay hydrated and seek care for severe symptoms such as difficulty breathing, chest pain, confusion or bluish lips. Families with an infant, an older parent or someone with a chronic condition at home may want a plan now for testing, telehealth visits and where to go after hours.
What could change the outlook
The CDC lists several reasons the peak could run higher: a new COVID-19 variant, flu mutations that weaken immune protection, more severe strains, and lower vaccine uptake or effectiveness than last season. The agency’s October 16 update said COVID-19 activity remains elevated in some regions but is declining nationally, RSV activity is very low, and rhinovirus and enterovirus, common causes of colds, are elevated.
The CDC says it will update the outlook if any virus shifts course, and it posts new respiratory data every Friday. For now, the respiratory season outlook suggests this winter will likely look familiar, and the steps that helped last season still apply.