Flu season is here.

Influenza activity has been quiet throughout the region so far, but health experts and officials are urging people to get a flu shot now in hopes of reducing further strain on hospitals treating a surge of COVID-19 patients.

In the Pacific Northwest, flu season typically starts in the fall and lasts until mid-spring. As of early September, Washington hadn’t seen any flu deaths or outbreaks at long-term care facilities this season, according to the state Department of Health’s most recent data. During last year’s flu season, the state counted 114 influenza deaths.

In King County, there’s usually an average of about 48 deaths and 49 outbreaks at long-term care facilities by this time of year, according to the county’s influenza surveillance dashboard. The county will officially begin tabulating data for the 2021-22 flu season on Oct. 2.

Snohomish County reported no recent flu activity as of Thursday, while Pierce County doesn’t typically begin monitoring until October.

Still, public health and medical experts say it’s difficult to predict how the season might unfold.

Gabriel Spitzer, spokesperson for Public Health — Seattle & King County, said that while activity is low, county laboratories have confirmed that infections are present in the community — two weeks ago, they detected at least two positive influenza A cases.

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Because there were so few infections last year, Spitzer said, there could be “reduced immunity in the population that could result in an early and possibly severe flu season.”

Last year, amid experts’ urgent warnings and campaigns for widespread flu shots, an extreme influenza season didn’t materialize. Spitzer said that was likely due in part to widespread precautions being taken against COVID-19, including masking and physical distancing.

Statewide school closures also likely played a role in reducing the burden of the flu last year.

“It is also noteworthy that many people have relaxed their precautions, leaving them more vulnerable to both COVID-19 and influenza,” he said.

Health officials and hospitals are also concerned about a recent increase in other respiratory pathogens, like respiratory syncytial virus, which causes coldlike symptoms. In King County, about 8% of RSV tests returned positive earlier this month, compared with the 1% to 3% the county typically sees this time of year, Spitzer said. Last year, in comparison, there was “minimal” RSV activity throughout the entire fall and winter season, he said.

Predictions for this year’s flu season are still hazy.

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Even though students are back in classrooms and some COVID-19 restrictions have been relaxed, there is a chance the season will be mild, said Dr. Helen Chu, an infectious-disease expert and professor of medicine at the University of Washington who leads the Seattle Flu Study.

All the COVID-19 mitigation efforts in place — including masking, distancing and new air-filtration systems — will likely go a long way in preventing the transmission of other viral infections in classrooms, Chu said.

“Also, the fact that kids that are sick are staying home,” she said. “The threshold of what constitutes a healthy child is a different benchmark than what we’ve ever had before.”

Students with any sort of COVID-19 symptoms are being sent home, Chu said, marking a “sea change from anything we’ve done in the past.”

The Pacific Northwest could also face an easier flu season compared to other parts of the country because of stricter COVID-19 restrictions, which will likely provide more flu protection for residents here, Chu said. In Florida, Texas, Oklahoma and Wyoming, for example, where masks are no longer mandated statewide, the highly contagious delta variant has driven a recent COVID-19 surge that’s hit communities particularly hard.

“It’s really worrisome for winter in those places,” Chu said.

She still recommends all Washingtonians get their flu shot — which requires about two weeks for antibodies to develop — as soon as possible this year, particularly because the region’s health care system is under strain.

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While COVID-19 hospitalizations are beginning to trend downward, hospitals in King County and across the state are still at very high occupancy and admission rates.

Statewide, about 37% of intensive care unit beds are occupied by COVID-19 patients, with an average hospital admission rate of about 16.7 per 100,000 people.

A typical flu season, Spitzer said, can lead to 500,000 or more hospitalizations annually nationwide. “Adding that burden to an already overstretched health care system is not a scenario we want to be in,” he said.

The Centers for Disease Control and Prevention has given the go-ahead for people to receive a dose of the COVID-19 vaccine and other vaccines, including a flu shot, at the same time, even on the same day. The advice marks a change from a previous recommendation to wait a minimum of 14 days between different vaccinations.

“We don’t have anything else,” Chu said, referring to the influenza vaccine. “Nothing else will prevent us getting really sick from the flu.”

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Where to get your flu shot

Seattle Public Schools is partnering with the Seattle Visiting Nurse Association to provide flu shot clinics for the public through Oct. 21. Six of the clinics will also offer COVID-19 vaccinations for those 12 and older. More information about the time and location of each clinic is available at seattleschools.org.

Lake Washington School District is also providing free flu shots at schools in Redmond, Kirkland and Sammamish through mid-October. More information about the clinics is available on the district’s Twitter account.

Shots are also available at pharmacies, including Bartell Drugs, CVS Pharmacy and Walgreens, throughout the region.