Sara McCray is tired of it — the nagging, dry cough that pops up unexpectedly at the grocery story or a staff meeting at her school.

It has been weeks, the Warren special education teacher said: “And I become that person — everyone is fearful to be around you, like you’re going to be a superspreader.”

A few months ago, health experts predicted a return to a normal cold and flu season this year. It has arrived in all its yucky misery, filling Michigan’s emergency rooms and doctors’ offices.

Patients with sore throats, runny noses, headaches and fevers — an assortment of common colds, COVID and flu cases — are filling Dr. Beena Nagappala’s waiting room at Garfield Family Practice in Clinton Township, where she works with a half-dozen other clinicians.

“Some days we are so booked up, we have to tell (patients) to go to urgent cares,” said Nagappala, who is also the president of the Michigan Academy of Family Physicians, “but I’m sure the urgent cares are booked up too.”

The office tries to keep some free appointments for emergencies, she said, but “even they fill up by 9am.”

As often happens during Michigan winters, some hospitals are warning of longer wait times in the emergency rooms, too.

Corewell Health, with its hospitals throughout much of the state, is “quite busy,” Dr. C.J. Gibson, vice president of medical affairs at Corewell Health West Michigan, told reporters on a call Monday.

He urged patients with mild to moderate symptoms to contact their primary care physician, use a virtual doctor service or urgent care before going to the emergency room.

“This amount of volume this fast does put strain on our hospital system,” he said, noting “significant” wait times at some of Corewell’s emergency rooms. Even walk-in clinics, he said, are reporting two- and three-hour waits.

Michigan ended 2023 with “high” flu activity, according to the most recent data available through the U.S. Centers for Disease Control and Prevention. That may change quickly; Ohio reported “very high” flu activity during the same period, according to the CDC.

The Michigan Department of Health and Human Services did not have anyone available to comment for this story, but spokesperson Chelsea Wuth urged Michiganders to be vaccinated.

The state is far short of its goal to vaccinate 4 million residents during the 2023-2024 flu season. As of Dec. 30, just more than 2.6 million doses had been administered, according to state data.

COVID cases, which fell 3% to 7,414 this week, are the highest they’ve been since last January. Even though the severity of the pandemic has waned significantly, it’s still deadly, with 65 reported deaths this week, state numbers show.

Even short of hospitalization, COVID can be awful, Nagappala said.

“Certainly it’s not the same COVID from a couple, three years ago, but it can still bring you down,” she said.

Gibson and Nagappala both said they are also seeing a smattering of respiratory syncytial virus, or RSV, cases as well. For the first time this season, there are vaccines and treatments for infants, pregnant people, and for people over 60 to protect against RSV.

Not every part of Michigan is getting hit the same.

In the eastern Upper Peninsula, the local hospital — MyMichigan Medical Center Sault — has seen a slide in flu and COVID cases since last month, said Mitch Zaborowski, the hospital’s infection control officer.

That could be because the lack of snow has kept winter enthusiasts from visiting as they would another year, he said.

But he worries as students return to class: “The next weeks — that’s going to be interesting.”

For her part, McCray, 42, says she hasn’t been terribly sick — just annoyed with the cough that she likely caught the cold from wiggly twin daughters, 3-year-old Georgia and Cecelia who, in turn, may have caught it from other relatives.

But really, McCray said, who knows?

At Fraser High School in Macomb County, where she’s a teacher, “our absences have been crazy. You’ll have these kids out this day, then those on another day, and it just feels like it’s all getting recycled.”

And while the McCray family’s illnesses have meant two trips to the family doctor, several emails with their doctor and a virtual medical visit, it’s not clear what pathogen has caused the illnesses which have lingered since before Thanksgiving, McCray said.

In some ways, it doesn’t matter, said Corewell’s Gibson.

“Once you rise to the level of needing to see health care a lot of the treatment is the same,” he said.