The city has issued an advisory urging New Yorkers to mask up as the “triple threat” of COVID-19, flu and respiratory syncytial virus, known as RSV, becomes a reality. 

The five boroughs are seeing an “unusually high” simultaneous spike in infections caused by the three respiratory viruses, the city’s health commissioner, Dr. Ashwin Vasan, said in a press release Friday. 

Those who are immunocompromised, or age 65 and up, should pay special heed to the advisory, which encourages all New Yorkers to wear masks in public indoor settings and crowded outdoor spaces, Vasan noted.

“The holiday season is about togetherness and there is a way to gather safely — even as respiratory viruses in our city are unusually high. It starts with protecting yourself,” the commissioner said in a statement. 

“Vaccination and boosters are critical, but so are common sense precautions like masking when indoors or among crowds and staying home if you don’t feel well,” he added. “Also, get tested before getting together, and get treated quickly if you test positive.” 

While respiratory viruses are spreading at high levels in NYC, there are common-sense ways to protect yourself and your loved ones this holiday season: vaccination, boosters, wearing a mask indoors or among crowds and staying home if you don't feel well: https://t.co/sQgAPLhjMo https://t.co/nmYf7bJiVq

— Commissioner Ashwin Vasan, MD, PhD (@NYCHealthCommr) December 9, 2022

The advisory came a little over a month after health officials began warning that the simultaneous circulation of flu, RSV and COVID-19 could pose a “triple threat” in the fall and winter months.

As of Friday, the city’s seven-day COVID-19 infection rate stood at 13.6%, with its daily average case count on the rise. 

Flu activity, meanwhile, was at an “elevated” level the week of Thanksgiving, according to the Department of Health and Mental Hygiene’s most recent influenza surveillance report.

The city’s RSV case count hovered around 3,300 that week, up from around 2,200 the week of Oct. 22, the report said. 

While most counties in New York state were reporting low or medium “COVID-19 community levels” as of Thursday — a Centers for Disease Control and Prevention designation that factors in metrics including infection rates and hospital admissions — all five boroughs had high community levels.

The Bronx’s infection rate stood at 13.95% on Tuesday, Brooklyn’s stood at 11.32%, Manhattan’s stood at 12.34%, Queens’ stood at 16.56% and Staten Island’s stood at 12.99%, per health department data. 

In its advisory, the health department also encouraged New Yorkers to “stay up to date on their COVID-19 vaccinations, even if they have been vaccinated against these viruses previously.”

“For COVID-19, all eligible people should get the updated bivalent booster shot, even if they have had COVID-19 or received COVID-19 booster shots previously,” the department said.