Based not only on the end of tonight's episode, but the preview of next week's, it's pretty clear that Rick Grimes and his group of survivors are set to launch an attack on Grady Memorial Hospital in the hopes of rescuing Beth and Carol.
The hospital is fairly well-fortified, surrounded by walkers and locked down, with a crazy lady holding onto the keys. So...not the easiest place to get into quietly.
Now, while the trope was averted with Carol's badass attack on Terminus, it's generally true that these kinds of sieges don't happen without at least one member of the group losing their life in the process. So...who's the most likely to go?
There are a lot of suspects, especially in a season where the producers keep emphasizing fidelity to the comic book source material and a lot of characters left who either never existed in the comics, or were dead by now in the books and aren't on TV.
We'll start from the first principle that it's unlikely characters like Rick, Glenn, Maggie or Carl are going to die anytime soon, and take a look at the handful of suspects we figure are more likely to go.
And, yeah, typical disclaimers apply. Spoilers ahoy, and it could be more or less than one person we eventually lose, yadda yadda yadda.
It's hard not to start with Beth; she's been missing for so long that while fans and characters would "feel" her death, it woudln't change the trajectory of the show very much. The survivors have been doing their thing without her for a while, and so the show could continue pretty much as it had been without Beth in it -- because how it's been is "without Beth in it."
If she were to sacrifice herself to save someone, or go out in a blaze of glory, it would serve as a fitting end to her arc. Heck, if the last thing we'd seen of her before an offscreen death had been the smile above, it wouldn't have been particularly satisfying, but it would have served that same purpose. She's come a long way, and while her first major act was to try and kill herself, a heroic sacrifice would be a poetic counterpoint to that.
Just like Beth, she's been isolated from the group for a while, and while she's returned recently and her loss would be felt more sharply than would Beth's, she's also in the hospital and -- if you watched that clip from next week's episode aired on Talking Dead -- apparently in pretty rough shape.
The thing about both Carol and Beth is that they have sizable, vocal fan bases, in no small part because of the shippers who want them to end up with Daryl. The death of either would shake up the audience in a big way without dramatically altering the creative direction of the show, so that's appealing from a practical point of view.
Losing Carol would also be a major blow to the group in terms of their badassery. Yeah, there's Rick and (assuming they meet back up) Abraham, but Tyreese isn't nearly as intimidating in the show as he was in the comics, and a loss like Carol or Beth could make Daryl retreat back into himself a bit, making him somewhat less effective. That's all an argument in favor of the thing screenwriters always say about deaths: the drama you can get out of it is what justifies losing the character.
This one is basically not going to happen, but you always have to look at the possibility. After all, Robert Kirkman has repeatedly said that the "If Daryl dies, we riot" fans will get him killed.
Like Beth, he didn't exist in the comics, and so his loss wouldn't do much to inhibit them following the books closely. Unlike Beth or Carol, though, he's been a crucial part of the team all along and hasn't vanished for more than an episode or three since the start of the series.
We know so little about Noah at this point that there wouldn't be a huge dramatic impact to his death -- but then again, it could give him kind of an arc that he started out so aggressive toward Daryl and Carol and ended up saving the group if that were to happen.
There's also a long history on the show of people joining the group, getting a little development and ending up dead fairly quickly (see also: Axel, the Woodbury survivors, etc.).
That said, there's something about Noah that feels like he'll last. The culture shock he'd get out of no longer existing in the clean, dictatorial world of the hospital and instead ending up on the road with a more chaotic, democratic group of survivors like Rick's. Again, it feels like there's a lot of story to be had in going one particular direction.
Tyreese or Sasha
It's hard to tell which one is leaving and which one is staying, but it appears that the two are separating when they hug in the trailer for next week's episode (check it out above).
There's a shot in there where it looks like Tyreese, Sasha and Noah are all with Rick and Daryl en route to the hospital, but that hug...I dunno. Something about it looks like something is about to go down. I'm guessing that one of the two won't make it out, and that will be their final moment together...but who knows? That's very little to base such an assumption on.
That said, again, they're characters who have often been separated from or tangential to the main group, and who were long gone at this point in the comics. Their loss would weigh on the group (and particularly on whichever sibling survived) but it wouldn't much impact their destiny.
If it's one of these two, my money is on Sasha; it seems likely we'll still eventually get a version of Tyreese more like the one we saw in the comics, and probably a suitably awesome sendoff. This hospital thing? It just seems less epic than you'd need. These guys have much the same setup as Terminus, with a gated community providing "help" and offering a semblance of society inside its walls. It's hard to imagine anyone who survived Terminus seeing this as an adequate sendoff.
The Hospital Staff
Yeah, plus/minus one or two who might join up with the cast for a time, I'd say the hospital staff is pretty much toast.
Why? Well, our heroes tend to bring carnage and destruction in their wake. Everywhere they "visit" falls, from Woodbury to the prison to Terminus. There's really no reason to think this will be different, because while they might want to go in quiet, by the time they're ready to leave, it seems likely there will already have been blood and ramming a truck through the gate to let walkers in will be an afterthought.