Flu, COVID-19 And RSV: What Marylanders Need To Know Before Thanksgiving

Influenza-related hospitalizations and deaths are already being reported in Maryland as families prepare to gather for Thanksgiving, starting a season of togetherness that gives respiratory viruses plenty of opportunities to spread.

Nationally, seasonal flu activity is increasing in many areas, while viruses that commonly cause colds are circulating at elevated levels, according to the latest update from the Centers for Disease Control and Prevention.

COVID-19 activity is declining nationally, with emergency department visits low and decreasing. Still, wastewater monitoring shows moderate levels of the virus circulating nationwide, with some states reporting high levels.

RSV, or respiratory syncytial virus, usually causes cold-like symptoms but can be serious for infants and older adults. Emergency department visits remain low nationally but are increasing in many areas. Wastewater readings for RSV and influenza A remain very low nationally.

In Maryland, CDC data suggests the respiratory illness level remains low, as do cases in neighboring Virginia. In D.C., officials say the level is "very low."

However, the Maryland Department of Health's dashboard indicates wastewater monitoring showed high levels of COVID-19 activity. As of Oct. 4, MDH reported a total of 150 COVID-19-related hospitalizations. Eight deaths were recorded in October.

When it comes to the seasonal flu, MDH's dashboard notes minimal activity, with influenza-like illnesses accounting for less than 3% of emergency room visits during the last week of October. Since Oct. 4, a total of 254 flu-related hospitalizations were recorded, along with two deaths.

From late August to the start of November, RSV-related hospitalizations in Maryland are little more than half of what they were during the same period in the 2025-2026 season.

While the 2025-2026 season saw a total of 62 RSV-related hospitalizations, the 2026-2027 cases amount to 38.

Available MDH data also shows Baltimore (21%), Montgomery (29%), and Prince George's (12%) counties accounted for the most RSV hospitalizations since Oct. 4.

Vaccines Help, But Hurry

Vaccines help, too, but it takes about two weeks for full protection to begin. So if you’re planning on getting a vaccination, now is the time to do it. Getting vaccinated later can still help protect against illness during the rest of the season.

This season’s flu shot targets H1N1, the influenza A subtype causing most reported flu infections so far, along with H3N2 and an influenza B strain. Early laboratory testing suggests the vaccine is a good match for most H1N1 viruses tested, according to the CDC, although it’s too early to know how much protection that will translate into during this flu season.

This season’s updated COVID-19 vaccines target XFG, a descendant of the Omicron variant, according to the CDC. The formula was selected to better match circulating viruses, but the shots don’t guarantee protection against infection. Their main benefit remains reducing the risk of serious illness, hospitalization and death.

RSV vaccines help prevent serious illness from respiratory syncytial virus, which usually causes cold-like symptoms but can lead to pneumonia and hospitalization. The CDC recommends vaccination for adults 75 and older and those ages 50 to 74 at increased risk. Unlike flu shots, RSV vaccination isn’t currently annual: People who have already received a dose shouldn’t get another at this time.

Check which flu, COVID-19 and RSV immunizations are recommended for your age and health. A pharmacist or other health care provider can help sort that out, and getting vaccinated often doesn’t require a separate doctor’s visit. Pharmacies, including CVS and Walgreens, offer the shots to eligible patients, generally at no cost with most insurance.

Don’t Show Up Sick

Nobody wants to miss Thanksgiving dinner, but showing up sick can send more than leftovers home with the family. The CDC recommends staying home and away from others until symptoms have been improving overall and you’ve been fever-free without fever-reducing medicine for at least 24 hours. For the next five days, take extra precautions because you may still be contagious.

Hosts can help by bringing in fresh air. Open windows when practical, run a portable HEPA air cleaner or take some of the gathering outside if the weather cooperates.

Testing before getting together can add protection, especially when visiting someone at higher risk. But a negative rapid test isn’t an all-clear if you’re coughing, feverish or otherwise feeling sick. A well-fitting N95 or KN95 mask can also reduce risk in crowded indoor spaces, during travel or around vulnerable relatives.

The familiar advice still applies. Wash your hands, cover coughs and sneezes, and clean frequently touched surfaces.