As many of us begin to make plans for the fall and winter holiday season, it can be all too tempting to try and forget that there’s a global pandemic that’s still very much an issue. While it’s absolutely fantastic that the COVID-19 vaccine is more available than it was at this time last year, we also know that not everyone has gotten it, especially when we consider young children and people who can’t access the vaccine because of health issues (not to mention people who have fallen into the anti-vaxx movement). 

According to data from Johns Hopkins University, a number of states in the U.S. are actually seeing increases in daily COVID-19 cases as we approach Thanksgiving, including a seven-day average of nearly 95,000 new cases, as reported by CNBC. We’re also, sadly, seeing surges in hospitals again.

If this sounds surprising to you, it might be because case numbers did actually decline in late October. It’s hard to know precisely why things are changing, but when we look at the increases in the Midwest and Northeast, for example, it’s conceivable the cold, rainy weather has played a role—people want to be inside, where it’s safer and warmer, which makes sense, but this might also make it easier for the virus to spread.

People may have also gotten used to not wearing masks as often while outside, so they might have gotten more lax with precautions while inside, too. It’s also possible people are getting comfortable assuming a potential symptom is “just a cold” or “just allergies” and aren’t seeking tests (or preemptively self-isolating) with the speed they might have earlier in the pandemic. 

Whatever the reason, we know that an average of close to 50,000 people are currently hospitalized with COVID-19 in the U.S., according to Department of Health and Human Services data. In the aforementioned Midwest and Northeast, for example, hospitalizations are also up and have risen by 20% in the Midwest and 7% in the Northeast. CBS 4 Boston, for example, reports that several MedFlight helicopters brought critically ill patients to Boston area hospitals only to be turned away due to a lack of ICU beds. (Patients were instead brought to hospitals in surrounding states, including Connecticut, Rhode Island, and New Hampshire.) Children’s hospitals in Michigan are feeling the burn, too, when it comes to youth hospitalizations. 

And, frankly, headlines are starting to blur with similarities between states—COVID-19 hospitalizations are up in parts of California, Michigan, Pennsylvania, Arizona, Wisconsin … the list, sadly, goes on.

COVID-19 is still killing an average of 1,000 people per day in the U.S, as reported by NBC News. About 10% of children between age 5 and 11 have gotten their first dose of the vaccine, which is excellent, but not nearly enough to feel that everyone is protected. About one-third of older folks who are eligible for booster shots have gotten them so far. 

“For those who are at higher risk of severe illness from COVID-19 and who are eligible for a COVID-19 booster dose, go out now and get your extra booster dose to protect you,” CDC director Rochelle Walensky said on Thursday. Walensky urged people who haven’t gotten vaccinated to do so, as starting the process now will help you be fully protected by the end of the year. 

According to polling from Monmouth University released on Nov. 16, more than half of Americans intend to return to pre-COVID-19 norms for Thanksgiving celebrations. For the most vulnerable people among us, that’s a pretty concerning scenario, but luckily there is still time to make changes to make the holidays safer for everyone. Stick to small groups, get tested, keep track of who is seeing whom, and spend time outdoors as much as you can. Mask up, even if it feels inconvenient.

Oh, and don’t forget what should be an evergreen standard at this point: Wash your hands!