The flu epidemic sweeping across America is gaining steam, even as a political standoff in Washington threatens to shut down the government and suspend the nation’s influenza program. The timing, in other words, couldn’t be worse.

The outbreak expanded in the second week of January, with 32 states and New York City reporting high rates of influenza that have sent people to their doctors with complaints of fever, muscle aches, cough and fatigue, according to the U.S. Centers for Disease Control and Prevention. Just three states—Delaware, Maine and Montana—reported minimal circulating levels of the virus, which typically emerges in southern states and moves north.

Flu season could get worse before it’s over

The flu season’s severity, with 6.3 percent of all American doctor visits attributed to the virus in the week ended Jan. 13, has already surpassed all recent outbreaks. This year’s epidemic is especially difficult to contain thanks to the resilient H3N2 virus, the predominant strain, said Lynnette Brammer, who leads the CDC’s domestic flu surveillance team. This year’s flu vaccination was ill-suited to combat H3N2. Brammer said it’s too soon to know how bad hospitalization and mortality rates will get, but it’s still early in the season and there are indications that, with new strains yet to emerge, this year’s ordeal may get even worse before it gets better.

“We don’t know if we are at peak yet or close to peak,” she said. “We won’t know in the end how severe it will be until the season is over. To find a year that’s higher than this, you have to go back to 2003/2004” when 7.6 percent of doctor visits were attributed to the flu, Brammer said. An exception to that 14-year record is the swine flu outbreak that peaked in the fall of 2009, an unusual circumstance in which a new virus emerged and spread quickly because people had never been exposed to it.

It might be difficult for the CDC to continue tracking the outbreak if Congress is unable to pass legislation to continue funding government operations this weekend. If a temporary extension isn’t put in place, the Department of Health of Human Services said it would furlough half its workers and suspend the CDC’s influenza program at midnight.

The shutdown risk comes as deaths attributed to influenza are accelerating. The number of flu-associated pediatric deaths rose to 30 during the second week of January, up from 20 deaths at the start of the year.

Influenza and pneumonia were responsible for 8.2 percent of all American fatalities during the last week of 2017, above the epidemic threshold of 7.1 percent.

The number of deaths typically trails infection rates, and the CDC often must go back and update the numbers as reports come in from state and local hospitals and governments.

“If you think about the sequence of events, people get sick first, a portion are hospitalized, and unfortunately a portion of those go on to die,” Brammer said. “We don’t know how bad the hospitalizations and mortality will get. We don’t know how severe the season is until we’re out of it.”