The echo of coughing and crying reverberates in the bright waiting room of Just for Kids clinic at St. Joseph's Health Center in Toronto.

Dr. Ann Wormsbecker, head of pediatrics at the hospital, said it is clear that this year's respiratory virus season has already begun.

Although most children who come to outpatient clinics are not tested to determine the virus causing their illness, Dr. Wormsbecker said that in hospital units where patients are tested upon admission, there is a sudden trend. She said, "In the past two weeks, the rate of respiratory syncytial virus (RSV) has increased."

National data also showed an increase in RSV. Since the end of August, 1,220 cases have been detected, and about 5% of the tests came back positive, according to the latest respiratory virus report from the Public Health Agency of Canada.

The report stated, "RSV activity is increasing and is slightly higher than expected levels for this time of year."

The virus usually causes cold symptoms, but it can become severe in children and the elderly.

There are four main vaccines available for seniors this fall, including an updated COVID-19 vaccine and the first vaccine for respiratory syncytial virus in Canada.

Health Department data shows that SARS-CoV-2, the virus that causes COVID-19, continues to spread, and influenza activity is also increasing, although it remains within typical levels for November.

After fluctuations in viral dynamics during the pandemic - including the period when influenza almost disappeared, followed by an unusual increase in RSV last year - some say this season could represent a return to relatively normal life, but with SARS-CoV-2 now firmly in this mix.

But "normal" does not mean it will be smooth sailing for Canadians and healthcare teams, who are under great pressure, says Dr. Donald Vinh, an infectious diseases specialist at McGill University. He said, "The pattern we are seeing is not new, but a return to what we are used to, with the overlap of COVID."