Grady's Chief Medical Officer Dr. Robert Jansen says their current ICU numbers are as high as they were during their winter peak last January.
This time around, Dr. Jansen says, their COVID-19 patients are younger, sicker, and largely unprotected from the fast-spreading delta variant.
"Almost all of them are unvaccinated," Jansen says. "Approximately 90% are unvaccinated, and of those, they're the ones who are in the ICU."
As of Wednesday, 5,502 COVID-19 patients were hospitalized across the state, according to the Georgia Department of Public Health.
LIVE MAP: Tracking COVID-19 in Georgia
That is nearing the record of just over 5,700 patients back in January.
ICU beds statewide are now 90% full, and a record-high 1,834 ventilators, 48.6% of the state's supply of the machines, are being used.
Dr. Jansen says those numbers really do not tell the full story of what is happening inside hospital ICUs like his.
FOX MEDICAL TEAM: As CDC urges pregnant women to get vaccinated, some have questions
"It's not just COVID patients that need to come to the hospital," Jansen says. "It's the stroke patients. It's the trauma patients. It's the burn patients. Those patients need critical care just as much as our COVID patients."
The demand for critical care, he says, is stressing the system and forcing non-COVID-19 patients who need critical care to wait for a bed.
Across the city, Wellstar Health System has 638 COVID-19 patients in its hospitals.
In a tweet, Wellstar said 580 of the 638 COVID-19 patients are unvaccinated.
Of those, 140 are in the ICU (133 unvaccinated) and 101 are on ventilators (97 unvaccinated), according to the hospital system.
Children's Healthcare of Atlanta has 36 patients hospitalized with COVID-19, up from their previous peak of 21 patients back in January.
Most of the children hospitalized were either too young to be eligible for the COVID-19 vaccines or have underlying health conditions that raise their risk of complications from the virus, according to a statement released by the hospital system.
Piedmont Healthcare would not release its COVID-19 numbers but acknowledged their resources are also being stretched thin, especially at Piedmont Henry Hospital, where the Georgia National Guard is providing assistance.
Ambulances parked outside Grady Memorial Hospital in Atlanta. (Eli Jordan, FOX 5 Atlanta / FOX 5 Atlanta)
Back at Grady, Dr. Jansen says his team is short-staffed, exhausted and and discouraged by this fourth wave of hospitalizations.
With no end to the surge in sight, he is pleading with Georgians to get protected, so they do not end up in a hospital bed.
"Vaccines may not be perfect, they may not be 100% protective, but the reduce the severity of illness, they reduce the length of illness, even if you do get infected," Jansen says. "And, they will protect you and your loved ones."
He says Grady gets calls every day from smaller hospitals with critically ill COVID-19 patients who need a higher level of care.
Right now, he says, they cannot accept them because they are full.
Download the FOX 5 Atlanta app for breaking news and weather alerts.