AUSTIN (KXAN) — If cases and hospitalizations for COVID-19 keep rising, health officials say a return to Stage 4 restrictions are possible.

Dr. Mark Escott, Austin-Travis County Public Health’s interim health authority, addressed the Travis County Commissioners Court with a warning — if the area can’t flatten the curve again, “Thanksgiving is going to be bad, and Christmas may look worse.”

Dr. Escott said there has been a 140% increase in the rolling average of active cases since Oct. 4, from 64 to 154 in the span from then to present, and Monday was the first time since Sept. 10 the area has reported more than 200 new cases in a single day. Monday’s new case count was 214, Dr. Escott said.

In just the past week, cases have gone up 60%, Dr. Escott said. All of the key indicators health officials look at to determine what risk stage to place on the area have been increasing, and with a potential medical personnel shortage in the area, moving from Stage 3 (our current stage) to Stage 4 may happen sooner than numbers dictate.

“In discussions we think it’s more likely that a surge capacity of 200 beds for the ICU is more reasonable given the situation happening around the state,” Dr. Escott said. He said typically 350 intensive care unit beds would be the threshold, but since medical workers have been dispatched to El Paso, Lubbock, Amarillo and other places to help those areas with surges, our area may not have the people to handle the usual amount of ICU beds.

“My concern is in the next week to two weeks that we may need to transition into stage four so that we can flatten the curve again,” Dr. Escott said. “Where we are right now is very similar to where we were around June 17-18, where we were two weeks away from hitting our peak.”

He said it’s important for people to not relax mask-wearing, hand washing, social distancing and all the other steps they’ve taken to help slow the spread of COVID-19. If the area can get a handle on this spike, it’s going to make the holidays a whole lot better.

He reiterated the fact that COVID-19 isn’t being transmitted in classroom settings at schools, but rather extracurricular activities and other social gatherings outside of school. Across nine area schools districts, plus charter and private schools, there have been 101 positive cases reported from Oct. 26 to Nov. 8.

“I think this is a testament to the efficacy to the protections that are put in place by our school districts,” he said. “Our schools seem to be operating safely.” He said most the area schools are at or near 50% for in-person classes, with the exception of Austin ISD at around 27%.

Dr. Escott also talked about the beginning of the flu season, and that was something he was encouraged about because cases are much lower than in previous seasons.

He said if anyone hasn’t gone out to got a flu shot yet, the time is now.

“Not tomorrow, not next week, get one today,” he said. “Do what you can to help prevent a surge.”

On Tuesday afternoon, the Austin-Travis County Health Authority announced it extended the emergency orders and rules intended to protect residents from the spread of COVID-19 through the end of the year, Dec. 31. Those rules and orders can be found online here. They were previously set to expire on Dec. 15.