As experts warn of a potential “tripledemic” this winter—the convergence of COVID, flu, and RSV (also known as respiratory syncytial virus), COVID hospitalizations rates are climbing for the first time since July. But it’s not the only virus on the rise.

The recent surge in RSV is causing concerns for doctors. Each year, approximately 58,000 children under 5 are hospitalized due to RSV infection, according to the Centers for Disease Control and Prevention. And with the recent surge, many children’s hospitals are already at capacity.

“These viruses are not new, but we have had less exposure to them in the past couple of years due to masking and quarantining measures,” says Dr. Anh Le, a California-based pediatrician with One Medical, a membership-based primary care practice. “Now that people have started to go back to normalcy, with in-person schooling and office work, we have more opportunities for exposure. What this means for us in trying to approach this triple threat is that preventative measures and precautions are more important than ever.

The CDC reports a 1% increase in new admissions of patients with confirmed COVID-19 in the U.S. The state with the most COVID hospitalizations is Maine even though it has one of the country’s highest full vaccination rates, which means a person has received their primary series of vaccinations (whether that’s one or two doses) and two weeks have passed since their last dose.

According to data from the United States Department of Health and Human Services, 10% of Maine’s inpatient beds are being used for people who have confirmed or suspected cases of the virus. North Carolina and Delaware follow, with 8% and 7% of hospital beds being used for COVID patients, respectively.

While getting vaccinated and boosted against COVID reduces your risk of severe illness, hospitalization or death, it does not prevent you from getting the virus altogether; however, both COVID and flu shots are highly encouraged as America enters flu season.

“Preventive efforts also include wearing a mask when in close contact with others in the public and the workplace, and when around anyone who has symptoms of an upper respiratory tract infection,” says Dr. Mark T. Loafman, a family physician based in Chicago, Illinois. “With the goal of protecting infants and other populations who are most vulnerable right now, I would recommend focusing on avoiding contact with anyone who is ill or who has been in recent contact with someone ill, along with strict hand hygiene and surface cleansing when there is any risk of contamination.”

States with the most COVID hospitalizations:

1. Maine

2. North Carolina

3. Delaware

4. Maryland

5. Minnesota

6. New York

7. Vermont

8. Connecticut

9. Michigan

10. Missouri