State health officials are warning people that time is running out to get vaccinated before gathering with family over the holidays as Covid-19 cases surge nationwide alongside unseasonably severe waves of flu and respiratory syncytial virus.

The guidance comes after two excruciating holiday seasons that sent Covid-19 cases and deaths skyrocketing. And it underscores the ongoing struggle of public health officials at the state and federal level to get Americans vaccinated against the flu and Covid.

While public health experts say this winter’s Covid-19 surge may be more mild, they worry whether hospitals — already dealing with staffing shortages — can handle the increased caseload from Covid on top of the strain they’re experiencing with RSV and the flu.

Nearly 30,000 people currentlyin the hospital have tested positive for Covid-19, according to the CDC, up 30 percent since Thanksgiving — with New York, Arizona and New Mexico among the hardest hit.

“The situation in the hospitals is grim,” said David Scrase, secretary of the New Mexico Health and Human Services Department. “The death toll from this very serious virus continues to go up and really, hopefully, will create a sense of urgency in individuals and families to think about getting access to vaccines and also to treatments, should you test positive for coronavirus.”

A little more than 13 percent of Americans over the age of 5 have gotten their updated booster vaccine since it was released in September — including about a third of seniors, the group most susceptible to hospitalization, according to the CDC. Case counts in nursing homes are also up more than 30 percent since Thanksgiving.

And while the Omicron subvariants currently circulating are less lethal than previous variants, about 426 people are dying, on average, from Covid-19 each day — a nearly 62 percent increase from last week, according to the CDC.

“Most of the population — unfortunately — has forgotten about Covid-19 and moved on. As a result, we’re seeing a rise in cases and a rise in hospitalizations, and that worries me,” said Ali Mokdad, professor of global health at the Institute for Health Metrics and Evaluation at the University of Washington. “Right now with the rise of flu, RSV and Covid, our health professionals are exhausted.”

In Louisiana, state health officials are recommending people consider getting tested before attending holiday gatherings.

In Mississippi, the state is down to 65 ICU beds and is now transferring some patients to other states, though Tennessee and Alabama have stopped taking out-of-state transfers.

In Arizona, hospitals have asked the state for additional resources, such as pediatric cribs.

And in Oregon, Gov. Kate Brown signed an executive order on Wednesday in response to the RSV, flu and Covid-19 outbreaks.

Respiratory Therapist Nirali Patel works with a Covid-19 patient in the ICU at Rush University Medial Center on Jan. 31, 2022, in Chicago, Ill.