RAMALLAH, West Bank (AP) — Palestinians are facing a winter coronavirus surge driven by the omicron variant, placing stress on the medical system even though vaccines are widely available.

The Palestinian Authority's Health Ministry reported over 70,000 active cases in the Israeli-occupied West Bank, annexed east Jerusalem and the Gaza Strip on Thursday, more than twice the number at the height of previous surges.

The real figure is likely much higher, as omicron tends to cause milder symptoms, especially in vaccinated patients, and many people are testing at home.

At least 268 people have been hospitalized in the parts of the occupied West Bank administered by the Palestinian Authority, including 80 in intensive care and 24 people on ventilators. Gaza currently has at least 63 serious cases.

The PA has reported at least 4,859 deaths in the West Bank and Gaza since the start of the pandemic.

Dr. Mahdi Rashed, director of health services for the Ramallah governorate, where the PA is headquartered, says hospitals across the territory are at about 85% capacity. “It's a dangerous sign, and a sign that the worst is yet to come," he said.

The number of serious cases is not yet as high as during a surge last spring, before vaccines were widely available, but Rashed said the current surge hasn't yet peaked.

The outbreak follows a similar omicron surge in Israel, where the number of infections hit all-time highs and hospitals have been greatly strained. While infections remain high in Israel, the surge has begun to recede.

Israel launched one of the earliest vaccination rollouts in the world last year but initially declined to share its supplies with the PA. Last summer, it offered 1 million doses of vaccines that were about to expire, but the Palestinians refused, saying they didn't meet their standards.

Israel captured east Jerusalem, the West Bank and Gaza, territories the Palestinians want for a future state, in the 1967 Mideast war. It annexed east Jerusalem in a move not recognized by most of the international community. It withdrew from Gaza in 2005. Two years later, the Islamic militant group Hamas seized power there, and Israel and Egypt imposed a blockade.

Rights groups said Israel was obliged to provide vaccines as an occupying power. Israel denied having any obligation, citing past agreements with the Palestinians. Israel has provided vaccines to its own Arab citizens, Palestinians in east Jerusalem and tens of thousands of Palestinians who enter Israel to work.

The Palestinian Authority has meanwhile secured its own supply of vaccines, including through a World Health Organization program for developing countries, but only around half of Palestinians have received them. A vaccination center in Ramallah was mostly empty this week.

A testing center adjacent to it was far busier, with dozens of Palestinians coughing through their masks and showing other symptoms of the virus.

Dr. Abdelbasit Zeineddin said up to 2,000 people show up each day, with around half testing positive.

“The numbers are much higher than before,” he said.

Lama Abu Hilou, 22, has had two vaccine doses but started showing symptoms of the virus this week. She said she came to be tested because she fears it spreading among her extended family. Like many Palestinians, they live in the same apartment building and often gather together.

“It’s not just one person getting it, you hear about entire families, the mother, the father, the children, all infected," she said.

In Gaza, where the health system has been battered by years of conflict, including last year's war, the Health Ministry is predicting an “unprecedented number of cases” in the coming weeks.

But Dr. Majdi Dhair, the director of preventive medicine at the ministry, said authorities are confident they can overcome the surge, given the relative youth of Gaza's population of more than 2 million Palestinians.

“Our main concern is infections among health workers that may lead to a staff shortage," he said.

Associated Press writers Nasser Nasser in Ramallah, West Bank, and Fares Akram in Hamilton, Canada, contributed to this report.