As the holidays approach, Covid-19 cases and hospitalizations are once again on the rise. Combined with influenza and respiratory syncytial virus (RSV), many hospitals are currently overwhelmed, and experts say patients are "not going to get the same level of care" if they need medical help.

Is another winter Covid-19 surge on its way?

According to The Atlantic, another winter Covid-19 surge is likely on its way with both cases and hospitalizations increasing significantly over the last few weeks. In the last two weeks, new Covid-19 cases have increased by 53% while hospitalizations have grown by 31%.

Although cases are rising across the country, the South and West have seen particularly large increases. In Mississippi, Georgia, Texas, South Carolina, and Alabama, the daily average of reported cases has doubled over the last two weeks. And while hospitalizations have risen more slowly, daily hospitalizations have increased 57% in California, reaching higher levels than any other state.

With colder weather, as well as holiday travel and gatherings, the current rise in cases is expected, experts say. However, whether the increase will result in another winter wave or just an intermittent rise in certain areas is still not clear, and health experts have expressed mixed opinions on the matter.

"I think it will continue," said Gregory Poland, a professor of medicine at the Mayo Clinic. "We will pour more gas on the fire with Christmas travel."

On the other hand, Susan Kline, an infectious diseases expert at the University of Minnesota Medical School, said that she hasn't "seen a big enough change to call it a wave."

Similarly, Anne Rimoin, an epidemiologist at the University of California, Los Angeles, said, "It's hard to know, but the case numbers are moving in the wrong direction."

Although most health experts agree that a surge this winter would likely be less severe than surges in prior years, a lack of immune data also means it is more difficult to predict how the current rise in cases will unfold.

"We don't know anything about how long ago people were [vaccinated], and we don't know anything about hybrid immunity, so it's impossible to predict" just how bad things could get, said Denis Nash, an epidemiologist at the City University of New York.

So far, "[w]e can do little to predict how the ongoing surge might develop other than simply wait," according to The Atlantic. Last year, the omicron surge did not start growing rapidly until mid-December.

"We haven't even gotten to January yet, so I really think we're not going to know [how bad this surge will be] for two months," Kline said. Until then, "we just have to stay put and watch."

Hospitals are overloaded with respiratory viruses

Even if this year's winter Covid-19 wave is not as large or severe as previous ones, hospitals will likely still be overwhelmed. Aside from Covid-19, hospitals are also grappling with surges of other respiratory viruses, including influenza and RSV.

According to a CNN analysis of HHS data, hospitals are currently fuller now than they have ever been during the pandemic. Over the past two weeks, the number of hospital beds in use nationwide has increased by 8 percentage points to over 80%.

Throughout the pandemic, hospitals have been more than 70% full most of the time, but they have only hit 80% capacity during the height of the omicron surge in January. At the time, around a quarter of hospital beds were filled by Covid-19 patients.

Now, Covid-19 patients only make up around 6% of hospital beds, while many of the other beds are taken up by patients hospitalized for other respiratory viruses, such as the flu or RSV among children.

For the week ending Dec. 3, 25,906 patients were hospitalized with the flu, and the cumulative hospitalization rate, which is currently at 26 per 100,000, is the highest it has been for this time period since the 2010-2011 flu season.

"The [hospital bed capacity] rates are higher because we are seeing patients with the flu in many parts of the country and that has brought a lot of older adults and some young children into the hospitals," said Nancy Foster, VP for quality and patient safety at the American Hospital Association. "Additionally, RSV is filling pediatric beds and cribs along with patients who are sicker now due to putting off care during Covid-19, which has required more intensive and complex care."

"Workforce shortages have not only made it more challenging for hospitals, but also have diminished the number of patients who can be cared for in nursing homes and other post-acute care settings," Foster added. "Thus, patients are spending more time in hospitals, awaiting discharge to the next level of care and limiting our ability to make a bed available to a patient who truly needs to be hospitalized."

According to Poland, patients who need help with severe Covid-19 or any other medical issue are more than likely "not going to get the same level of care that [they] would have without these surges."

In a letter to the country's governors, HHS Secretary Xavier Becerra acknowledged that influenza and other respiratory viruses are "increasing strain" on the nation's health care systems. He also said the Biden administration "stands ready to continue assisting you with resources, supplies, and personnel," but stopped short of formally declaring a public health emergency for the current respiratory virus surges. (Tayag, The Atlantic, 12/9; McPhillips, CNN, 12/9)