Health officials in the United Kingdom are warning that this year’s flu season for the Northern Hemisphere is looking like it will be particularly rough—and the US is not prepared.

The bleak outlook is driven by a new strain of H3N2, which emerged over the summer (at the end of the Southern Hemisphere’s season) sporting several mutations. Those changes are not enough to spark the direst of circumstances—a deadly pandemic—but they could help the virus dodge immune responses, resulting in an outsize number of severe illnesses that could put a significant strain on hospitals and clinics.

In the UK, the virus has taken off. The region’s flu season has started around five weeks earlier than normal and is making a swift ascent.

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