COVID-19 infections are quietly rising across the U.S., just as holiday travel surges—and influenza cases are already making many Americans miserable with fever, aches, and sore throats. As of December 16, the Centers for Disease Control and Prevention estimates that COVID-19 infections are growing or likely growing in 31 states.
The current increase comes after a late summer wave fueled by the highly contagious XFG “Stratus” variant, followed by a brief lull in the fall. Experts warn that with few Americans having received the updated COVID shot—only 15% of adults and 7% of children as of December 6—the virus has ample opportunity to spread during the holidays.
Is COVID-19 Surging Right Now?
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While cases are increasing, current levels remain relatively low compared to previous winter surges.
During the week ending December 13, national COVID-19 viral activity in wastewater was “low,” according to the latest data from the CDC. However, 15 states—mainly in the Midwest—are reporting “high” or “moderate” activity. Data from WastewaterSCAN, a program monitoring viruses through municipal wastewater systems run by Stanford and Emory University, shows SARS-CoV-2 concentrations are in the “moderate” category nationally, up 21% since November.
“Clearly, influenza has taken a big jump up this last week… but COVID has been moving up in a more gradual way,” said Dr. William Schaffner, professor of infectious diseases at Vanderbilt University Medical Center.
The weekly test positivity rate, an early indicator of spread, is 3.6% as of December 6, up 0.5% from the previous week, according to CDC data. Last year at this time, it was 5.5%. The Pandemic Mitigation Collective’s COVID forecasting model estimates over 700,000 new daily infections in the U.S. as of December 22, with “rapid increases” expected between now and December 31.
COVID hospitalizations are slowly increasing, particularly among those 65 and older, Schaffner added. While concerning, this rise isn’t unexpected for this time of year, as COVID-19 tends to cause two major waves: one in winter and another in late summer, driven by new variants, waning immunity, and increased indoor gatherings.
Where Is COVID-19 Rising in the U.S.?
The Midwest and Northeast are currently experiencing the biggest increases in COVID cases.
As of the latest CDC data from December 18, 15 states are reporting “high” or “moderate” levels of COVID viral activity in wastewater:
- Arizona
- Connecticut
- Kansas
- Kentucky
- Maine
- Massachusetts
- Michigan
- Minnesota
- Nebraska
- New Hampshire
- New Mexico
- Ohio
- Oklahoma
- South Dakota
- West Virginia
COVID-19 Symptoms 2025
Symptoms from the dominant Stratus variant are similar to those caused by earlier strains, according to Schaffner.
The most common symptoms of COVID-19, according to the CDC, include:
- Fever or chills
- Sore throat
- Cough
- Fatigue
- Congestion
- Shortness of breath
- New loss of sense of taste or smell
- Headache or muscle aches
- Nausea or vomiting, diarrhea
The type and severity of symptoms can vary. Some groups—those over 65, immunocompromised individuals, or people with underlying medical conditions—are at higher risk of severe illness. However, Schaffner emphasized that even “young, healthy people” can be hospitalized.
If you experience COVID-like symptoms, testing is crucial for prompt treatment. Antiviral medications, such as Paxlovid, can help reduce illness severity, Schaffner added. The symptoms of COVID-19 can closely resemble those of the flu and common colds. “Even infectious disease physicians such as myself, I don’t think we can reliably distinguish the illness just by talking to a patient. That’s why testing is so important,” Schaffner explained.
Testing for COVID-19
Testing helps protect yourself and prevent spreading COVID-19 to others.
PCR and rapid, at-home antigen tests are both reliable and can detect the latest strains, including XFG. 3-in-1 rapid home tests can also detect COVID-19, influenza A and influenza B.
Schaffner recommends stocking up on tests if possible. You should test if you experience COVID-19 symptoms, have a suspected or known exposure, are around high-risk individuals, or are in a high-risk setting (like a crowded hospital).
At-home test results aren’t always 100% accurate depending on timing, Schaffner noted. If you get a negative result, you may need to repeat the rapid test a few times over three to five days for the most accurate results, per the U.S. Food and Drug Administration.
Can You Still Get the COVID Vaccine?
The updated 2025-2026 COVID vaccine is safe and effective at protecting against severe illness, hospitalizations, and death. It’s available to anyone ages 6 months and older after discussing it with a healthcare provider.
This year’s shot is expected to be a good match to circulating strains, Schaffner said. It’s not too late to get vaccinated, which can protect you throughout the winter. Vaccination is especially important for high-risk individuals. “But from a public health perspective, we would like as many people vaccinated as possible,” Schaffner said.
How to Protect Yourself During the Holidays
The holidays present many opportunities for respiratory viruses to spread.
“There are things people can do to make it less likely that they will become sick and less likely they’ll become seriously ill,” Schaffner said. These steps can lower your risk:
- Get vaccinated against COVID-19 and flu.
- Test if you have COVID symptoms.
- Stay home when you’re sick.
- Avoid contact with sick people.
- Wear a well-fitting mask (i.e. KN95 or N95) in crowded, indoor settings.
- Wash your hands frequently.
- Practice social distancing.
If you’re around high-risk individuals, plan to take extra precautions. “If you’re visiting grandma or your aunt who has diabetes, start being careful now and absolutely be vaccinated,” Schaffner said. If you get sick, stay home and skip holiday parties—but if you must be around others, wear a mask until you’re better. “No one wants to be a dreaded spreader,” Schaffner added.