The surge of hospitalizations continues in the Delaware Valley with about 7,000 people hospitalized in the tri-state area.
On Thursday, Pennsylvania Health Secretary Dr. Rachel Levine talked about the disturbing milestone.
"There are just under 5,000 people hospitalized with COVID-19 in Pennsylvania and, of course, this number is of significant concern. In addition, there are more than 1,000 COVID-19 patients in the ICU," she said.
John Chapman is a critical care nurse at St. Mary Medical Center in Bucks County. He said the surge is very real and is seeing a five to one ratio - nurse to patient - compared to a three to one ratio in the spring.
"These COVID-19 patients require so much monitoring and care, when you start getting into the five or six (to one) ratios, the nurses can't monitor patients as closely as they should be," he said.
RELATED: Pennsylvania health officials report 11,406 new COVID-19 cases marking highest 1-day total
According to 6abc's Data Journalism Team, there are currently 7,000 patients in the tri-state area hospitalized with COVID-19.
Montgomery County Commissioner Val Arkoosh said during a recent press briefing that space for patients in hospitals is becoming scarce and the demand for healthcare workers is increasing.
"Almost every hospital is at capacity. There are two that aren't but the remainder are quite full, " said Arkoosh. "That is usually triggered with the Emergency Room being full...the reason the Emergency Rooms (are) full is because they can't move patients out of the ER."
Open beds and available staff are quickly dwindling. And unlike in the spring, medical staff from the National Guard or other states aren't available to help.
"There's no one else to come. As you've seen on the national news, hospitals everywhere are having this problem," said Arkoosh.
Some hospitals, like those operated by Main Line Health, have had to occasionally divert new emergency patients since COVID-19 patients are filling their beds.
But Chief Medical Officer Doctor Jon Stallkamp with Main Line Health said the network has had time to prepare and collaborate and he is optimistic they can handle the expected winter surge if the public cooperates with social distancing guidelines.
"Please realize we are still in this pandemic. I know this has been going on for so long and people are getting tired and it's the holidays and we want to be with family and get together but we really can't right now," said Stallkamp.
Meanwhile, the White House Coronavirus Task Force has released its most urgent warning yet to state governors. The warning calls on people over 65 or those with significant health problems not to enter any public building where anyone is unmasked.
And while the warning is grim, there is a reason for hope.
A vaccine is potentially weeks away and Stallkamp said a higher percentage of his network's patients are recovering than when the pandemic began.
"Although we have more (patients in the hospital), they're not quite as sick. Our treatments have changed slightly for COVID so we don't have quite as many in the ICU as we did in the spring," said Stallkamp.
The White House Task Force's warning also emphasized those under 40 should assume they became infected during the Thanksgiving period if they gathered beyond their immediate household.
"You must isolate away from anyone at increased risk for severe disease and get tested immediately," said Stallkamp.
The task force warning goes on to advise those over 65 who gathered with extended family over the recent holiday to be tested immediately if they develop any symptoms.