Hospitals and emergency rooms could be forced to ration care by the end of this month, the Centers for Disease Control and Prevention warned Thursday, saying recent trends in COVID-19 and influenza are now on track to again strain America’s health care system. The new COVID variant JN.1 is making up an increasing share of cases, the CDC’s tracking shows.

“COVID-19 hospitalizations are rising quickly,” the agency said in its weekly update. “Since the summer, public health officials have been tracking a rise in multisystem inflammatory syndrome in children (MIS-C), which is caused by COVID-19. Influenza activity is growing in most parts of the country. RSV activity remains high in many areas.”

The CDC has been urging people to get vaccinated as the peak of this year’s mix of three seasonal respiratory viruses — influenza, COVID-19 and RSV — is nearing.

In pediatric hospitals, the CDC says beds “are already nearly as full as they were this time last year” in some parts of the country. Data from emergency rooms published Wednesday tracked emergency room visits nearly doubling in school-age children last week.

JN.1 is now about 50% of cases worldwide, and at 50% it starts stressing hospitals according to variant trackers like JPWeiland.

The US, Canada, and UK will be at 50% in the next few weeks. Some states in the midwest might be at 50% already.

And all this on top of major flu and RSV outbreaks. In parts of Canada the flu season is the worst it’s been since the h1n1 swine flu pandemic in 2009, and last year was almost as bad.