As flu cases tick up in the nation and state, Arkansas medical officials are urging those who haven't already received a COVID-19 booster or flu vaccine to do so as the holidays approach.
The state has seen more than 7,000 positive influenza tests reported as of Nov. 11 and 14 flu-related deaths, according an Arkansas Department of Health weekly report.
Flu activity in Arkansas is described as "very high" based on data collected and distributed by the Centers for Disease Control and Prevention.
"Influenza is the major concern," Dr. Joel Tumlison, Health Department medical director for immunizations, said Thursday. "Right now COVID is low, which is great, but flu is very high. By the time Christmas rolls around -- who knows."
Flu numbers are climbing earlier in the year than typical, Tumlison said. He said when it will peak is unknown. It is also unknown if COVID-19 will start to climb as the holiday season moves into full swing.
COVID-19 started to increase last year right before Thanksgiving, Tumlison said. He said it was mid-December the previous year.
As of Tuesday, there were 2,951 active COVID-19 cases in the state, and 145 people hospitalized.
Dr. Robert Hopkins, chief of internal medicine at University of Arkansas for Medical Sciences, agreed that the flu is a major concern but warned COVID-19 might be underreported as at-home tests have become more available.
"I am very concerned at this point that we have a high flu transmission and our flu vaccine rate seems to be lower and our COVID booster rate is very, very low," Hopkins said. "I'm worried we are going to see a pressure on our care system."
As of Friday, 527,958 people have received the flu vaccine this season, according to Danyelle McNeill, Health Department spokeswoman. She said the data is provisional.
"It is not enough to provide us the degree of coverage we need to protect our communities," Hopkins said.
Travel during the holiday season, family gatherings and also the spread of viruses indoors during winter months are all things that could see cases rise.
"I'm very concerned we are looking at a very difficult winter with the amount of RSV, influenza and COVID we have going around," Hopkins said.
Dr. Rick Barr, executive vice president and chief clinical officer for Arkansas Children's Hospital, said there are not many cases of COVID in kids currently.
"That is part because of the behavior of the virus and a lot of kids have been vaccinated," Barr said.
The flu and Respiratory Syncytial Virus Infection, or RSV, are more concerns right now, Barr said.
Barr also encouraged the COVID booster and flu vaccine for any children who have not had it yet.
RSV, which has no vaccine, is best prevented by good hand washing, masks and others staying home when sick.
"We encourage people to enjoy the holidays -- just do it safely," Barr said. "If you are sick, use precautions."
Nicki Hillard, director of professional affairs of Arkansas Pharmacist Association, said the flu season seems to be tracking what early predictions in Australia were showing. She said it is anticipated to be worse than the normal flu season.
Ahead of the holidays is a good time to remind people who've been distracted to get the flu vaccine and COVID booster.
Hillard said early reports show the flu vaccine is well matched with what is circulating in the community so far this year.
The COVID booster also is a better protection against current strains than the original vaccine, she said.
"A majority of people got the COVID vaccine, but it mutates," Hillard said. "The new vaccine will cover for the strain going around."
Vaccines and the booster will help keep those who are protected from getting seriously ill and also will help keep people from missing work or holiday parties.
Also, some treatments such as tamiflu are difficult to get currently, Hillard said.
"That adds to a reason for getting the vaccine," she said.
Tumlison said the state is starting to see vaccine numbers increase in recent days for both the flu and COVID booster.
He said it's not too late in the season to get the vaccines. He said they both take about two weeks for full immunity.
However, both vaccines start ramping up soon after receiving them, he said. Some people's immunity will only take a week for full coverage.
"Go ahead and do it," Tumlison said. "It gets better every day. Even if you are leaving on your vacation now."
The CDC also has recommended that it's safe to get both on the same day, he said.
Tumlison also recommended that the public start taking other measures to reduce the spread of illness, such as wearing masks.
"If there is a family gathering and one of the members is at risk for high complications -- maybe it is worth considering the wearing of a mask."
He also suggested that a mask could be worn if someone starts feeling mild symptoms but has yet to develop into a full illness.
"My throat is a little scratchy or nose a little stuffy -- put a mask on until you know," Tumlison said. "If it gets worse do a home COVID test or see a doctor for a flu test."