Respiratory disease cases are already rising in the United States.

Thanks to the proliferation of vaccines, the United States has returned to some semblance of normal from the full scale of the COVID-19 pandemic. That said, as the cold season approaches, respiratory disease cases have begun ticking back up, and as some individuals have passed on further COVID booster shots, hospitals fear we could be in for not only fresh COVID surges, but flu outbreaks as well.

“If you go around the nation and ask hospitals how busy they are, every single one of them will tell you: They’re busy,” Dr. Carlos del Rio, an executive associate dean at the Emory University School of Medicine and Grady Health System in Atlanta, told NBC News.

While things aren’t as bad as the height of the pandemic, hospitals are still stretched thin dealing with the COVID cases they’re still getting, and they’re filling up as winter approaches. Medical personnel are actually quitting at higher rates now than they were during the height of the pandemic.

“Nurses were on the front line, and some of them burned out and quit,” said Dr. James McDeavitt, executive vice president and dean of clinical affairs at Baylor College of Medicine in Houston. “Others that were in their 50s and 60s who maybe thought they’d be working for another five years took an early retirement.”

According to a report from the Mayo Clinic, fresh COVID cases are expected to begin ticking upward in the next several weeks. “We’ll see an increase in Covid cases — probably not to the extent that we saw in the winter of 2020 and winter of 2021 — but we will see a rise,” said Matthew Binnicker, director of clinical virology at the Mayo Clinic. “Most of those will be infections that lead to mild to moderate illness.”

The CDC recommends that all eligible individuals receive this year’s flu shot as soon as possible, and to ensure they’re up to date on their COVID vaccinations.