AUSTIN (KXAN) — Austin’s top doctor is sounding the alarm as COVID-19 cases and hospitalizations rise again in Central Texas.

On Tuesday, Dr. Mark Escott shared projections from the University of Texas in a briefing with Travis County commissioners.

A week ago, those projections showed a 66% chance that cases would increase in the coming weeks. As of Tuesday, it has grown to almost a 90% chance of the pandemic worsening in Central Texas.

“This disease hasn’t changed. What’s changed is us, and that we have this pandemic fatigue,” Escott said Tuesday.

Austin Public Health reports an increase both in case numbers and hospitalizations, especially among the elderly, over the past month.

Escott said at the current rate Central Texas is moving, models predict the area will be at the same mark as it was this summer, when health officials were concerned about running out of space in hospitals.

However, this fall, flu cases will be also be a factor, meaning surge capacity in hospitals will be lower than it was in the summer.

“Thanksgiving’s going to be ugly if we don’t change our actions now,” Escott said.

He warns families should be cautious this Halloween to prevent a spike in cases related to the holiday. APH is asking families not to trick-or-treat door-to-door this year.

“Create a new tradition this year,” Escott suggested. “Some folks are doing a candy hunt similar to an Easter egg hunt this year. My family’s doing a piñata. So, there are lots of options for recognizing the holiday and doing fun things. Virtual Halloween costume contests are another popular choice for folks.”

Beyond celebrating holidays, Escott said Central Texans will need to curb unsafe behavior resulting from pandemic fatigue if they want schools and businesses to stay open.

APH data shows hospitalizations of elderly patients are climbing. Escott said recent spikes in cases in people ages 10-19 and 20-29 are partly to blame. He said the effects of younger age groups gathering, spreading the virus, then transmitting it across the community will continue to present in hospitalizations and fatalities among older community members in the coming weeks.

He urges anyone visiting the elderly, especially in long-term living facilities, to take extra precautions.

“I would strongly advise that for the previous 14 days prior to that visit that they are very protective of their interactions, that they not go to gatherings, that they avoid public places as much as possible to really limit the potential for spread to this vulnerable population,” Escott said.

The health authority said this week, Austin-Travis County and surrounding areas are closer to the middle of Stage 3 than in weeks past, with the potential the community will move back into Stage 4 of its risk-based guidelines in the coming weeks if people do not take more precaution.