The COVID trend lines are inching up in Tennessee again. Cases and hospitalizations are on the rise, and the effects from Thanksgiving haven’t yet been felt.

It’s not a sharp spike like in July and August — more like a gradual swell. But COVID numbers have now been going up since early November. And hospitalizations started to inch back in the middle of the month — as of Tuesday, 828 statewide.

Neither key metric sank as low as they did during the early summer.

Dr. Tom Talbot, chief epidemiologist at Vanderbilt University Medical Center, says to brace for a greater uptick in the coming days, as people who fell ill during family gatherings get tested and data delayed by the holiday is released.

“We shouldn’t panic, but we should continue to be judicious and really promote the things that we know work — the things we may not want to do like masking and, for some folks, vaccination — but we need to do that,” Talbot says. “That’s what will get us through this.”

Amid the rise and fall of COVID metrics, Talbot says one figure seems to be holding steady in his hospital. Roughly 90% to 95% of the COVID patients being treated at Vanderbilt are unvaccinated.

We are seeing a steady rise in COVID-19 hospitalizations, which is especially concerning as we head into flu season.

Vaccinations to protect you and your family against COVID-19 and the flu are more important than ever. pic.twitter.com/57FwBm8ZbD

— Vanderbilt Health (@VUMChealth) November 29, 2021

It’s unclear if the November nudge upward is just part of the ebb and flow people should get accustomed to or the start of another COVID surge. Tennessee epidemiologists expect to eventually see the Omicron variant, which appears to be more contagious.

“We’ve been on a roller coaster,” Talbot says. “I don’t know if what is ahead of us is a small bump or a hill, and we’ll just have to continue to move forward.”