President Joe Biden offered a grim prognosis for the coming months of COVID-19 on Thursday, predicting a surge in coronavirus cases and “a winter of severe illness and death” for those not inoculated against the respiratory virus. He urged people who are already vaccinated to get booster shots. “We are looking at a winter of severe illness and death for the unvaccinated—for themselves, their families and the hospitals they’ll soon overwhelm,” said Biden. “But there’s good news, if you’re vaccinated and you have your booster shot, you’re protected from severe illness and death.”

Biden’s dark remarks come as cases suddenly surged across the U.S., fueled by the more contagious omicron variant, including a record surge in New York City and as the country reached the staggering milestone of 800,000 dead of COVID-19 just a few days before.