"There is a piece of déjà vu to this isn't it," Hotez said. "The omicron variant is still going to spread and accelerate in Houston and Texas."
National IHME models predict Texas could see more than 260,000 daily cases by mid-January.
"It's pretty impressive how transmissible it is, and it's going up precipitously," Hotez said.
This latest omicron surge is coming at a time when the economy is continuing to rebound. on Thursday, new numbers show jobless claims holding at 52-year lows.
The Greater Houston Partnership forecasts Houston will create more than 75,000 new jobs next year. But inflation, supply chain issues and worker shortages continue to be challenging.
Health experts hope omicron won't make things worse.
"That's going to be the challenge of how we get through the next few weeks," Hotez said.
Hotez predicts a rough ride early in 2022 with hospitalizations and deaths higher than they need to be at this point in the pandemic.
"We'll be stressed once again, unfortunately," Hotez said. "It's not going to be an easy set of weeks. January and February will still be tough months."
Experts say too many Texas remain unvaccinated and that is still our Achilles heel.
"If you're unvaccinated, you're playing with fire," Hotez said.
Hotez isn't convinced a new year will mean less vaccine hesitancy. But if it does, 2022 could turn around quickly.
"The hope is once this big wave passes, provided we vaccinate the world, we'll be in a much better position," Hotez said.
The national IHME models show Texas peaking by Jan. 19, but it may not be until April when we see case counts back to where they were last November.