Public health officials are bracing for a new round of COVID-19 case spikes as many Americans traveled and held large family gatherings over the Thanksgiving holiday in defiance of mitigation guidance from the government, Dr. Anthony Fauci said Sunday.

Fauci, the nation’s top infectious disease expert, warned that as the nation heads into December, officials expect “we might see a surge superimposed on the surge we are already in.”

“I don’t want to frighten people except to say it’s not too late at all for us to do something about this,” he said on NBC’s “Meet the Press.” Fauci urged Americans to take precautions, including social distancing and wearing masks during and after travel back home.

Even with vaccinations likely to begin within weeks, Fauci said the nation is entering “really a precarious situation.” He noted that infected people may not develop symptoms for two weeks, and asymptomatic people can still spread the virus.

“We are going to have to make decisions as a nation, state, city and family that we are in a very difficult time, and we’re going to have to do the kinds of restrictions of things we would have liked to have done, particularly in this holiday season,” he said.

Fauci’s warning comes as more than 91,000 people are in treatment in hospitals for the virus, the most since the pandemic began. Twenty-six states have set records for COVID-19-linked hospitalizations this past week, CNN reported.

More than 13.2 million Americans have been infected and nearly 267,000 have died, according to Johns Hopkins University. CNN reported that the month of November alone saw more than 4 million new cases, with the fall surge producing more than 100,000 new cases nationwide for the last 26 consecutive days.

In Massachusetts, where newly reported case counts were down in the low hundreds two months ago, more than 2,900 new cases were confirmed on Saturday. More than 10,400 in Massachusetts have died; at least 214,000 have contracted the virus.

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