MONTGOMERY, Ala. (AP) — Alabama notched almost a third of its coronavirus cases in December, an alarming bulge that echoed the warnings of medical experts who said the state would see some dark days before the widespread availability of a vaccine to fight the pandemic.

Alabama saw 109,000 of its 361,226 confirmed and probable COVID-19 cases reported in December. The surge came after the Thanksgiving holiday, and health officials said they are concerned caseloads will continue to grow in January from the fallout of Christmas and New Years gatherings.

“We are being overwhelmed right now," State Health Officer Scott Harris said. “I believe, unfortunately, we are going to see even worse numbers than we have now, and the ones we have now are pretty bad.”

The cumulative number of confirmed and probable cases was 251,787 on Nov. 30 and rose to 361,226 cases on Dec. 31. While there were some backlogged cases recorded in December, almost all of the reported cases were from December.

Dr. Jeanne Marrazzo, the director of the Infectious Disease Division at the University of Alabama Hospital, said the amount of travel that took place over Christmas will likely trigger another rise in cases.

“This is probably going to portend a spike on top of a surge on top of a spike,” Marrazzo said.

She emphasized UAB is still able to care for non-COVID patients, but said nonemergency procedures may have to be delayed if the situations worsens.

“We have tried to be cautious in our language and not to be scary or sensationalistic, but the reality is it’s scary enough right now. We are doing OK, but there is a possibility we won’t be OK in a couple of weeks,” Marrazzo recently told reporters.

Alabama ranked sixth on the list of states with the most new cases per capita over the past week, according to Johns Hopkins University.

The number of people in Alabama hospitals rose from 1,731 on Nov. 30 to a record 2,813 on Dec. 30.

“I think January is going to be worse at this point than we have imagined,” said Dr. Don Williamson, the former state health officer who now heads the Alabama Hospital Association.

Williamson said he watched several Christmas events online and was struck by the number of people not wearing masks.

“We will absolutely reap the whirlwind of new cases because of our unwillingness to simply do simple things,” Williamson said.

Williamson said 47% of beds in state intensive care units are occupied by COVID-19 patients.

Since the pandemic began, 4,827 people in Alabama have died from COVID-19, according to state numbers.

By comparison, in 2018, 1,269 people died from the flu and-or pneumonia; 13,473 died from heart disease; and 10,630 died from cancer, according to numbers from the Alabama Department of Public Health.

The uptick in cases also comes as what health officials hope is the light at the end of the tunnel with the arrival of the vaccine.

Alabama in December began vaccinating heath workers, and the vaccinations then began rolling out to nursing homes.

Vaccinations began Tuesday at Bill Nichols State Veterans Home, a facility where 46 deaths were attributed to the virus.

Harris estimated that the vaccine will be available to the next group in the state's vaccine plan — people over 75 and to certain essential workers in early 2021.

While most people who contract the coronavirus recover after suffering only mild to moderate symptoms, it can be deadly for older patients and those with other health problems.

Harris estimated that people who are not older and do not have health conditions or jobs that make them more vulnerable will be able to get the vaccine in “late spring or early summer at the best.”

He asked people to continue precautions to try to curb the spread of the virus.

“Most people aren't going to have vaccine for quite a while. We really need the public's help and cooperation in trying to protect our hospitals, our health care workers and our vulnerable people,” Harris said.

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