The first wave of the respiratory illness season can feel subtle. It may be easy to miss until perhaps you or someone you know is hit with it. Come September, flu, RSV, and COVID-19, or a rare combo for fewer than five percent of patients, may still be below their winter peaks. But shifts in community spread can give health systems enough time to prep before demand picks up.
Just like when early COVID-19 was getting patients and physicians sick collectively, respiratory illness can thin the workforce through sick calls at the same time more patients are arriving for care. That double pressure is what makes respiratory illness workforce planning something to get on your radar before the season really gets going.
What the 2026–2027 respiratory illness season may look like
As of September 2026, respiratory illness is still putting relatively little pressure on emergency departments across the US. The CDC classifies acute respiratory illness as “very low”, the lowest of five activity levels. That means the share of emergency department visits tied to respiratory illness remains near the baseline established from the lowest-activity periods of recent seasons.
But in the meantime, another measure is quietly shifting. Through September 5, 2026, 5.5% of reported COVID-19 laboratory tests were positive nationally. That’s up from about 0.3% in summer. Flu positivity remained around 1%, while RSV was still close to zero.
What’s good to remember is that the CDC tracks test positivity because it adds context to emergency department and hospital data. Positive-test trends can provide useful warnings alongside those measures. A rising positivity rate should be flagged by your teams because it means more virus is circulating in the community.
Why September is an especially useful planning window
Low hospital activity in September is not unusual, says the CDC. Flu activity typically begins increasing in October and most often peaks between December and February. RSV follows a similar seasonal pattern, usually beginning in the fall and peaking in winter.
For health systems, that creates a window between early movement in community activity and the heavier seasonal demand that may hit next. Respiratory season preparedness starts with using that window well. You can’t predict the exact week demand will peak, but you can at least see what is changing early enough to make staffing and capacity decisions while there are still options.
What recent seasons tell us about the baseline
The CDC has not yet published a full 2026–2027 combined respiratory season outlook for COVID-19, flu and RSV, but recent seasons give health systems a useful baseline.
For 2025–2026, the CDC projected the combined peak of COVID-19, influenza, and RSV hospitalizations would be similar to the previous season (i.e., within 20%). That’s largely what happened. The final combined peak reached 16.6 hospitalizations per 100,000 during the week ending January 3, 2026, versus 19.5 per 100,000 the season before.
“Similar,” however, did mean the 2024–2025 flu season was high severity. The CDC’s finalized estimate put the burden at 51 million flu illnesses, 23 million medical visits, 710,000 hospitalizations, and 45,000 deaths. The cumulative influenza-associated hospitalization rate was the highest observed since 2010–2011.
During 2025–2026, influenza hospitalizations peaked in late December, and COVID-19 peaked in early January. RSV did not peak until February. For workforce planning, the challenge may not be one difficult week. It may be several months of changing demand across different parts of the health system.
How to turn respiratory illness data into workforce decisions
1. Watch the local data
Recent seasons show the range of pressure a health system may face. Current data can help leaders determine when that pressure is beginning to build locally.
The CDC tracks respiratory activity through emergency department visits, test positivity, hospitalizations and wastewater monitoring. Wastewater can detect community viral spread before some people seek medical care. That actually gives health systems another signal to compare with what they are seeing inside their own walls.
That internal picture might include occupancy, respiratory admissions, ED volume, sick calls, overtime, open shifts, fill rates and patient throughput. If several measures begin moving together, leaders have a clearer reason to adjust staffing and capacity.
Local data can explain more than you may think, because respiratory activity does not peak everywhere at the same time. National trends provide useful baseline context at a glance, but local disease activity and a health system’s own operating data should help determine when to act with more precision.
Where’s a good place to start? According to Prolink’s five-year framework for healthcare workforce planning, health systems should begin with expected demand, assess available supply, and then determine the right mix of permanent, flexible, and contingent talent. By doing so, contingent labor becomes a planned variable, not a surprise. That’s because the respiratory season just puts that same planning discipline on a shorter clock.
2. Build flexibility before demand becomes urgent
Respiratory season can create pressure far beyond one unit or profession. Higher patient volume may affect nursing, respiratory therapy, laboratory services, imaging, pharmacy, environmental services and patient transport. Staff illness can also reduce available capacity while patient needs are increasing.
Having an ideal staffing number in mind is a start. But behind the numbers, you need enough flexibility to move when demand changes. A hospital staffing strategy built for respiratory season should account for both sides of the equation: patient volume may rise just as staff availability tightens.
Depending on the organization, that flexibility may come from internal float pools, local or per diem talent, cross-training, contingent clinicians or external staffing partners.
3. Protect cost, staff capacity, and patient care at the same time
Waiting until staffing is strained can stifle options. A health system responding at the last minute may have fewer candidates available, less time to credential or onboard them, and less flexibility around labor cost. Adding too much capacity too early creates an unnecessary expense of its own.
A broader healthcare workforce strategy can help balance those competing pressures, creating enough flexibility to respond without turning every forecast into an overstaffing decision.
That’s true as well for your permanent teams. Repeated overtime and heavier workloads can put additional pressure on staff. As Katie Boston-Leary of the American Nurses Association said in an interview with AHRQ, “A bed is of no use if it’s not staffed properly or not staffed at all.”
Flexible staffing can take some of that pressure off the core team when resources become strained. Sometimes a health system does not need another permanent hire. It simply needs short-term coverage. Temporary assignments can be as short as a few days based on a health system’s needs and available resources. That gives hospitals another option besides stacking up overtime or rushing into a permanent hiring decision to solve a temporary problem.
Respiratory season is a planning problem first and a staffing problem second
Health systems do not need a crystal ball to know exactly when the 2026–2027 peak will hit and when to begin preparing for it. Recent CDC data already shows what the baseline can look like: substantial combined respiratory demand, a disease mix that changes from year to year, and peaks that can stretch across several months.
Three things to know before respiratory season spikes
- What signals to watch
- What workforce options are available
- When to use them
Respiratory season happens annually. When you’re well-prepared, your workforce response won’t need to be reinvented every year.
Get the right workforce strategy in place before demand changes. Prolink helps health systems build flexible workforce solutions that can adapt as needs shift.
