Michigan’s COVID-19 caseload remains relatively low compared to national rates, and leaders in Detroit have touted the city’s low positivity rate. But fall, fast approaching, means a whole new problem: the flu.

Nationwide, experts have been predicting cases could rise in late fall and winter, magnified by school reopenings and less willingness to limit indoor gatherings with colder weather. But there’s a particular concern about seasonal influenza.

“The real risk is that we’re going to have two circulating respiratory pathogens at the same time,” Dr. Robert Redfield, Director of Centers for Disease Control and Prevention (CDC) told TIME Magazine in June. “We know flu by itself can cause substantial morbidity and mortality and hospital utilization,” particularly for people who are older and have underlying health issues, also risk factors for COVID-19. 

In Detroit, that means preparing for a potential “second wave” of COVID-19 cases alongside flu season, Detroit Health Department Director Denise Fair told Detour earlier this month. 

“We think the second wave is going to come probably around late September, early October,” Fair said. “We’ve never had flu with COVID and so we’re preparing — that planning is starting right now.”

In Detroit, Michigan and beyond, that means leaders are pushing people to get the flu vaccine like never before. On Tuesday, Gov. Gretchen Whitmer actually received her flu shot during a press conference, as the state launched a “Facing the Flu Together” media campaign. 

“Every flu-related hospitalization we see this season will put an additional strain on Michigan’s economy and our health care systems and hospitals,” Whitmer said in a press release. “Our hospitals are still reeling from the spring COVID-19 hospitalizations and are working to prepare for a potential second wave of the virus. I encourage everyone to get their flu vaccine, and tell your friends and family to do the same.” 

Meanwhile, the Detroit Health Department is “working on a strategy to provide widespread vaccinations for the city,” Fair said. A department spokeswoman said Wednesday that the plan is still in development. 

The city is also continuing to offer free COVID-19 testing at the State Fairgrounds site to residents of the tri-county area without a prescription or symptoms, the spokeswoman said — despite new CDC testing guidelines that excludes people without symptoms (a move questioned by public health experts).  

Whitmer said Tuesday she’s aiming for an additional 1 million Michiganders to receive flu shots, which can prevent recipients from contracting the most common influenza viruses or lessen symptoms. About 3.2 million people in the state got a flu shot last year. Nationwide, the CDC estimates there were more than 39 million flu illnesses and 24,000 flu deaths in the 2019-2020 season.

Detroit’s most recent quarterly immunization report card, released by the state on June 30, shows lower vaccination rates than state and national averages for most types of immunizations. The flu vaccination rate for Detroiters ages 18 and older was 13.4%, compared to 31.4% statewide. 

Fair added that her department was also working to increase vaccination rates in general, with immunization clinics for children offered in partnership with the Parks and Recreation Department, as well as a vaccination program for adults. 

You can call your doctor or pharmacy to see if they’re offering flu vaccines yet. The CDC also promotes vaccinefinder.org.

Read more: How Denise Fair made tough calls for a city in crisis