Last week, 21 people in North Carolina—including a 6-year-old girl in Wake County—died from the flu.

State health officials fear the worst is yet to come. According to the Wilkes Journal Patriot, Dr. Hayes Calvert, emergency department medical director at Wake Forest Baptist Health—Wilkes Medical Center in North Wilkesboro, says more and more patients in Wilkes County are testing ‘flu positive’ and the severity of symptoms has increased.

Calvert says there has been a 10 percent increase in patient volume and expects the numbers to climb next month.

Like many other health facilities, Wilkes Medical Center and all other Wake Forest Baptist facilities are restricting visitation. Only healthy adults and healthy family members age 13 and older can visit patients. Children 12 and under may visit patients only under extenuating circumstances with permission from a patient’s nurse.

To date, this flu season has claimed 67 lives across the state and as of mid-January, widespread influenza activity was reported in 49 states. According to the CDC, the flu has now reached epidemic status and could drag on into April and early May since a person can get the flu more than once.