Despite the good news of a COVID-19 vaccine being administered in Austin starting today, local health officials painted a grim picture of disease spread locally that they attributed to the "Thanksgiving effect"—and warned that Christmas gatherings could cause a case surge on par with El Paso.

During Tuesday's Travis County Commissioners meeting, Austin-Travis County Interim Health Authority Dr. Mark Escott said that if Austinites didn't start making safe decisions now, the next two or three weeks could produce an aggressive surge.

With the effects of Thanksgiving gatherings giving way, Austin's moving case average hit 339 today, a 45% increase from the beginning of the month. Escott said the Thanksgiving surge was very concerning for health authorities and a repeat around Christmas could be disastrous.

"It is a concern for us because if we see surge happening now because of Thanksgiving and we see a repeat of that activity during Christmas. We really have the risk of having an El Paso or Lubbock type of substantial and catastrophic surge," Escott said. "We really do need folks to be more cautious."

Furthermore, with cases still rising, Escott said Travis County might be heading for a Stage 5-level shutdown before the end of the year. Travis County is expected to exceed 50 daily average ICU admissions by the end of this week, the threshold for Stage 5.

"This is not a forecast of what will happen," Escott said. "This is what could happen. This is the most likely scenario if disease transmission stays the way it has been."

Though Travis County still has the lowest amount of active cases and deaths than a lot of other major counties, COVID-19 will become the third leading cause of death for 2020 by the end of the year.

Looking at projections of age groups, every age range is higher than the threshold should be. However, Escott pointed out that even though 20-29 and 30-39 groups have seen a spike in cases, the hospitalization rates in those groups are very low.

Members of the 20-29 and 30-39 age groups are most likely to attend social gatherings and go to bars, where Escott said the risk is greatest. Escott said that is where a lot of virus transmission originates.

"This is what we were concerned would happen and it's in fact happening," Escott said. "We cannot sustain this kind of growth in cases for much longer. We certainly can't sustain this kind of impact post-Christmas."

Escott said the most efficient way to stop the spread is to return to the roots of the pandemic: staying home, avoiding social gatherings and not taking your mask off in front of anyone that you don't live with.

As of today, Austin hit a 9% positivity rate, up from 7.4% last week. Plus, Escott said with increased testing and new data coming in, they expect the number to go higher.

"I really don't know how to make the message any more clear that what we're doing now as a community is not working," Escott said. "This is going to be a memorable Christmas for folks for the wrong reasons. We are going to see unprecedented levels of cases and deaths in this community between now and the end of January if we do not take action right now."