As the fifth winter of war in Syria begins, the Special Adviser to the United Nations' Special Envoy for Syria, Jan Egeland, says he fears it will be a real killer in many places.
But nowhere is the situation more desperate than in the crippled city of Aleppo, where the story is about the coming week, not the coming winter.
"The report we have now from within east Aleppo is that the last food rations are being distributed as we speak. There will not be more to distribute next week. Some families have not had any distributions -- families in need of relief have not had any distributions now for several weeks already."
Mr Egeland says, despite a massive humanitarian operation that he calls the world's largest, the United Nations has still not reached hundreds of thousands of people ahead of winter.
But the United Nations sent a plan in recent days to all parties involved in the conflict, covering delivery of food and medical supplies, medical evacuation and access for health workers.
Mr Egeland says he is confident Russia will cooperate to allow in the aid.
"We are in continuous contact with Russian diplomats and military, and it is my clear impression that they are willing to continue the pause in air operations and that they are actively looking at -- and I really hope to have soon the green light for -- our four humanitarian initiatives as part of this larger one."
The UN refugee agency says a survey based on nearly 400 interviews in eastern Aleppo has found more than 40 per cent of the people wanted to leave if they had a secure route.
It found 40 per cent wanted to stay for reasons such as family, having no safe place to go, the cost of moving or fears they would not be able to return.
Despite the gravity of the situation, Mr Egeland says the United Nations should manage to avoid mass hunger.
"I do believe that we will be able to avert mass hunger this winter. I think we will be able to get both supplies in and evacuations out, and none of the two should be conditioned on the other."
Mr Egeland says diplomatic talks in Syria are dependent on uninterrupted, full engagement by the United States and Russia.
That comment is a reference to the impending change of leadership in the United States.
When asked, he said he expects continued, uninterrupted US help and engagement under President-Elect Donald Trump.
But in footage uploaded to social media, some Aleppo residents have not reacted the same way to Mr Trump's win.
"An American president that admires Vladimir Putin is really a setback for America as a great country in the world. Regarding Syria, he definitely stated that he is in favour of keeping (Syrian president) Bashar al-Assad. He is against any movement which he labelled 'disobedience.' He described the great Syrian revolution as 'disobedience' against the ruling of Syria and against Bashar al-Assad."
