COVID-19 is starting to circulate more in the Boston area, according to wastewater data, with increases over the last couple weeks that have also been seen across much of the country.

“We’re in a very different place than we were two-and-a-half years ago,” said Sabrina Assoumou, an infectious disease physician at Boston Medical Center. “We're not seeing a large number of people who are presenting to the hospital with severe cases. That's really good.

“But in terms of how we are doing right now, one of the most helpful metrics is looking at the wastewater,” she said. “And if you actually look at the trend, it is going up.”

For now, Marisa Donnelly, an epidemiologist at the wastewater analysis company Biobot Analytics, says levels of COVID-19 in the Boston area’s wastewater are slightly lower than they were at this time last year.

“That indicates to us that there's slightly less COVID activity currently than there was at the same time last year,” she said. “But we do see it consistently increasing. So that's something to keep an eye on, to see if we do get to levels that we saw last year.”

While Donnelly lauded wastewater detection as a public health tool, she cautioned that its detection can’t show how sick people are getting — just the virus’s transmission.

Experts who spoke to GBH News recommend taking a common-sense risk-reduction approach to your health. That includes staying home when you feel sick, testing for COVID-19 when you’ve been exposed to someone with the virus, washing your hands, masking to prevent transmission and maintaining your basic health — with good sleep, good nutrition and stress management. And their top recommendation is getting the updated COVID-19 vaccine that was approved by the U.S. Food and Drug Administration in mid-September.

“We still have about 200 people were dying every day from COVID-19 in this country,” Assoumou said. “We lose sight of that.”

About 20-30 people have died each week related to COVID-19 going back to September in Massachusetts. Last week, 1.5% of emergency room visits were related to COVID-19. For comparison, the virus accounted for 3.1% emergency visits in 2022, and at omicron’s worst in January of that year, about 18% of emergency visits were due to COVID-19.

A key protection during the holiday, experts agree, is getting the most recent vaccines — for all respiratory viruses.

A little over 16% of people in Massachusetts have gotten an updated COVID-19 vaccine since July.

Donnelly says that, nationwide, the two variants most commonly showing up in wastewater are HV.1 and EG.5, two descendents of the omicron variant that tore through the country starting at the end of 2021. The latest vaccine offers strong protection against both, she says, so that even for those who do get infected, it won’t be as severe.

But, in respiratory season, both the flu and RSV also pose a threat. Assoumou spoke with GBH News just after she’d left a shift at the hospital.

“[I] saw, unfortunately, some complications of influenza — people getting admitted to the ICU,” she said. “And to me, every time I see a case like that, I feel a little sad because I know that this could have been prevented by a vaccine.”

About a third of Massachusetts residents have gotten their flu shot this fall. It’s safe to get a flu and COVID-19 vaccine at the same time, though the Centers for Disease Control warn that side effects may be more severe. Shira Doron, a hospital epidemiologist at Tufts Medicine, pointed out that there are some indications that getting the two at the same time could even make the COVID-19 vaccine more effective.

While the flu season is just getting underway, national experts say that another respiratory illness, RSV, may be peaking in the next week or two. Assoumou pointed to new RSV vaccines available this year for people who are 60 or older and pregnant people.

When it comes to testing, Doron suggested that people who are experiencing symptoms should take multiple at-home tests over several days. Now that several years have passed since the first COVID-19 infection, many people have been vaccinated or previously infection, which means it’s likely fewer antigens will be detectable in newly infected person’s system.

She pointed out there’s another round of free COVID-19 tests released by the federal government starting Nov. 20, with four tests that can be sent to your home.

As symptoms develop, Doron added that it’s important to test early — especially for people who qualify for the COVID-19 treatment Paxlovid due to a long list of risk factors that include: being age 50 or older, obesity and health conditions such as cancer, sickle cell disease, and a previous stroke. Starting treatment within the first five days of symptoms makes it most effective, she said.

“We are in the thick of the respiratory season,” Donnelly said. “We see it in wastewater data. We see it in clinical data and hospitalizations. So, now is just a really important time, I think, to think about your individual health but also your community's health and the actions that you can take as an individual to keep people healthy.”