Flu and RSV Season 2026-27: How Clinics Should Plan Specimen Courier Pickups

For the 2026-27 season, clinics should plan specimen courier pickups around a flu and RSV peak that CDC expects to look a lot like last winter, with flu hospitalizations typically peaking between December and February. That means setting extra pickup windows, confirming lab cutoff times and locking in holiday schedules in October, before swab volume climbs, instead of scrambling in the week of Christmas.

A flu season specimen courier plan doesn’t need to be complicated. It needs to answer four questions ahead of time: how many extra pickups you’ll need, what time specimens must leave to make the lab’s cutoff, what happens on and around holidays, and who calls whom when something goes wrong.

Below, each one is covered with the handling rules behind it, plus a month-by-month timeline.

What CDC expects for 2026-27

CDC’s 2026-2027 Respiratory Disease Season Outlook came out on September 23, 2026. Its headline is that the combined peak hospitalization rate from COVID-19, influenza and RSV will likely be similar to last season, within 20 percent of the 2025-2026 peak. CDC rates its confidence as low to moderate.

For flu, CDC expects a season of moderate severity across all ages and notes that flu hospitalizations have typically peaked nationally between December and February. For RSV, it expects a peak similar to last season’s. RSV usually peaks in late December or early January, but the 2025-2026 season peaked later than usual, in the week ending February 21, 2026.

COVID-19 is expected to peak in early to mid January if no new variant takes hold, with a higher and later peak if a variant with moderate immune escape shows up.

For a clinic, the takeaway is practical. Plan for heavier respiratory testing from December through at least February, and don’t assume volume drops right after New Year’s. Last season, RSV was still climbing in February.

Flu season specimen courier pickup windows and cutoffs

Many clinics run one or two scheduled pickups a day for most of the year. During a busy respiratory stretch, that often isn’t enough, for a simple reason: swabs pile up in the refrigerator between runs, and the late-day batch misses the lab’s receiving cutoff.

Start with the lab’s cutoff, then work backward. If your reference lab needs specimens by 5:00 p.m. to run them that night, and the drive takes 45 minutes in December traffic, the last pickup has to leave your office with margin to spare. Anything collected after that pickup waits until tomorrow.

Adding a midday window is the simplest fix. A morning run clears overnight and early-morning collections, a midday run takes the late-morning surge, and an afternoon run catches everything collected before the cutoff. Clinics with walk-in or urgent care hours may need a fourth pickup on peak days.

Plan for the days when even that isn’t enough. Agree in advance with your courier on how you’ll request an extra run, how much notice they need, and when a STAT call makes sense instead of waiting for the next scheduled stop. Most flu specimens don’t need STAT, but a hospital admission decision or an outbreak investigation sometimes does.

Put the new schedule in writing and post it where staff who pack specimens can see it. A common miss in a surge is a full bag sitting at the front desk because nobody knew the midday run existed.

Respiratory specimen temperature and timing rules

Pickup frequency matters because respiratory specimens have limited time outside the lab. The exact limits come from the test and the lab, so treat the examples below as a starting point and follow your lab’s test directory.

CDC’s influenza specimen collection guide says specimens should go into viral transport media and straight onto refrigerant gel packs or into a refrigerator, then stay at 2 to 8°C (26 to 46°F) until shipping. It says to ship as soon as possible, freeze at -70°C if delivery will be delayed more than 3 to 4 days, and make sure the lab will receive the package during normal business hours.

RSV windows can be tighter. WHO’s RSV specimen guidance says specimens should be placed at 4°C right after collection and frozen at or below -70°C if they can’t be processed within 48 hours, and that repeated freezing and thawing must be avoided. Labcorp’s RSV immunoassay listing allows refrigeration for 72 hours and lists prolonged transport delay, usually more than 72 hours, as a rejection reason.

Flu and RSV swabs sent for diagnostic testing normally ship as UN3373, Biological Substance, Category B, in triple packaging. Our bio-medical courier page covers the packaging side. For frozen specimens on dry ice, remember that the dry ice itself is regulated and the package has to vent carbon dioxide under 49 CFR 173.217.

Holiday lab schedules and frozen specimens

Holidays are where respiratory season plans usually break. Lab receiving, courier routes and air carriers all run reduced schedules, and a specimen collected on the wrong afternoon can sit for three or four days.

This season’s calendar is unusual. Thanksgiving is Thursday, November 26, 2026. Christmas Day is Friday, December 25, and New Year’s Day is Friday, January 1, 2027. Two Friday holidays mean three-day weekends in consecutive weeks, right as flu volume typically climbs.

Labcorp’s central laboratory holiday shipping guidance, written for its clinical trial lab network, lists Thanksgiving (November 26 and 27, 2026, with limited operations) and Christmas Day among its observed 2026 U.S. holidays. Its recommendations translate well to clinic planning:

• Expect couriers to set earlier pickup times around holidays, and schedule pickups before the holiday where possible.
• Don’t ship frozen specimens the day before an observed holiday. Send them on the next business day.
• Don’t collect specimens with short stability on the day before a holiday.
• When a holiday falls on a Monday, avoid collections on the preceding Saturday.

Other labs publish similar notices. Michigan Medicine’s MLabs, for example, announced for Thanksgiving 2025 that its patient service centers would close on the holiday and that temperature-sensitive packages should be shipped to arrive Monday through Wednesday by 5:00 p.m.

Your reference lab will have its own version. Ask for it in October, not the week before Thanksgiving.

Packaging supplies to stock before November

A surge uses supplies faster than your usual reorder cycle. Running out of viral transport media or specimen bags in December can stall collection, and suppliers get busy when every clinic reorders at once.

Check stock of swabs and transport media, 95 kPa specimen bags with absorbent pads, UN3373-marked outer boxes, gel packs, and insulated coolers for refrigerated runs. If you send frozen specimens, confirm who supplies dry ice and how much lead time they need over holidays. Some reference labs supply their own collection kits and packaging, so ask what they’ll provide and what you have to buy.

Set a par level for the peak months, based on last season’s heaviest week plus a margin, and reorder when you hit it.

October to March planning timeline

The table below is a template. Shift the months if your region’s season runs earlier or later.

Month	Specimen and lab tasks	Courier tasks
October	Get the reference lab’s holiday schedule and receiving cutoffs. Review last season’s peak volumes. Order supplies to par.	Agree on added pickup windows, surge request process and holiday pickup times.
November	Brief staff on packing, labeling and frozen specimen rules. Set Thanksgiving week collection limits.	Confirm Thanksgiving week schedule, including Wednesday, November 25.
December	Watch stock weekly. No frozen shipments on December 24. Plan collections around the Christmas weekend.	Start midday pickups if volume calls for it. Confirm Christmas Eve and Christmas weekend coverage.
January	Plan around New Year’s Day (Friday) and any Monday holidays your lab observes.	Confirm New Year’s Eve pickup times. Keep surge windows active.
February	Keep RSV testing supplies up, since last season peaked in late February.	Review missed pickups and late arrivals. Adjust windows.
March	Compare this season’s volume to last. Note what ran short.	Step down to normal schedule once volume drops. Record lessons for next October.

Keeping the reference lab in the loop

Your reference lab receives specimens from many clients, and it plans staffing around what it expects to receive. Tell it if you’re adding pickup windows, testing more patients or sending specimens it doesn’t usually see from you.

Ask three things. What are the receiving cutoffs for same-day testing, and do they change in winter? Which specimens can be held refrigerated over a holiday weekend and which must be frozen? And who should you call if a shipment is late, so the lab can decide whether it’s still testable?

Share your courier’s contact with the lab too. When a driver is stuck in traffic at 4:45 p.m., dispatch calling lab receiving directly beats a relay through your front desk.

Setting up the plan with your courier

Book a short planning call with your courier in October. Bring last season’s heaviest weeks, your lab’s cutoffs and holiday schedule, and a list of the days you expect to need extra runs.

Ask how they handle same-day surge requests, what notice they need for an added pickup, how holiday pickup times will be set, and how they keep refrigerated and frozen specimens separate. Our medical courier page covers scheduled and on-demand clinic runs, and the STAT courier guide explains when an urgent run is worth it. Practices in Southern California can see local coverage on the Los Angeles medical courier page, and Arizona clinics on the Phoenix courier page.

Get the plan in writing, including holiday times, and share it with every staff member who packs specimens.

Related guides: our overview of biological sample courier requirements explains UN3373 packaging in more detail, and what a medical courier costs helps you budget for extra pickup windows. Before adding a new vendor for the season, run through the HIPAA courier checklist.

Frequently asked questions

When should a clinic start planning for flu season courier pickups?

October is the practical start. CDC says flu hospitalizations have typically peaked between December and February, so planning in October gives you time to order supplies, get your reference lab’s holiday schedule and agree on added pickup windows with your courier before volume climbs. Waiting until December usually means changing schedules while already short on time and supplies.

How long can a flu swab sit before pickup?

It depends on the test and the lab, so check the test directory first. CDC’s influenza collection guide says to keep specimens refrigerated at 2 to 8°C and ship as soon as possible, freezing at -70°C if delivery will be delayed more than 3 to 4 days. RSV guidance can be tighter, with WHO citing a 48-hour processing window before freezing.

Should we ship frozen specimens before a holiday?

Generally not the day before. Labcorp’s central lab guidance says frozen specimens should not ship the day before an observed holiday and should go out on the next business day instead. If frozen specimens sit over a long weekend, confirm with your lab how they should be stored and whether dry ice supply will hold.

Do flu specimens need a STAT courier?

Most don’t. Routine flu and RSV swabs usually travel fine on a scheduled pickup, refrigerated, as long as they reach the lab within its window. STAT makes sense when a provider is waiting on a result for an admission or treatment decision, or when a public health lab has asked for a specimen urgently.

How many pickups a day does a clinic need in flu season?

There’s no fixed number. It depends on your testing volume, the lab’s receiving cutoff and drive time. A common approach is adding a midday run to a one- or two-pickup schedule during peak weeks. Look at when specimens pile up and when late batches miss the cutoff, then add windows there.

What happens if a specimen misses the lab cutoff?

It usually waits until the next receiving window, stored at the temperature the test requires. If that pushes it past its stability limit, the lab may reject it and the patient may need recollection. Call the lab to ask whether the specimen is still testable, and review your pickup times so it doesn’t repeat.

Sources

• CDC: 2026-2027 Respiratory Disease Season Outlook
• CDC: Influenza Specimen Collection reference guide
• WHO: RSV surveillance, collection, transport and storage of clinical specimens
• Labcorp: Respiratory Syncytial Virus (RSV), Immunoassay (014548)
• Labcorp Central Laboratory Services: Packaging and Shipping, Holidays
• Michigan Medicine MLabs: Holiday Hours, Test Update 931
• 49 CFR 173.217, Carbon dioxide, solid (dry ice), 2025 edition (govinfo.gov)

Planning pickups for the season ahead? Call dispatch at (323) 744-1900 or request a quote.

Last reviewed: September 2026 by the Power House Courier dispatch team.