In most U.S. states, respiratory illness levels are currently considered “high” or “very high,” according to data from the Centers for Disease Control and Prevention.

A few respiratory viruses have been driving the upward trend. “The influenza virus is the thing that’s really skyrocketing right now,” says Dr. Steven Stack, public health commissioner for the state of Kentucky and president of the Association of State and Territorial Health Officials. “Influenza is sharply escalating and driving more hospitalizations.”

Nationally, levels of respiratory syncytial virus (RSV) appear to have plateaued and possibly peaked, while COVID-19 levels are elevated and are expected to climb higher.

“After the holidays, after we’ve traveled and gathered, we are seeing what is pretty typical of this time of year, which is a lot of respiratory viruses,” says Dr. Mandy Cohen, director of the CDC. “We’re seeing particularly high circulation in the southeast, but no part of the country is spared.”