COVID-19: 'Major incident' declared in London due to hospital pressure

Mayor of London Sadiq Khan has declared a "major incident" in the capital due to rising coronavirus cases threatening to overwhelm hospitals.

City Hall said growing infection rates are "putting immense pressure on an already stretched NHS", with the number of people on mechanical ventilators up by 42% - from 640 to 908 - in the week up to 6 January.

There are 7,034 people currently in hospital with COVID-19 in London - 35% higher compared to the first peak of the pandemic in spring.

A "major incident" signifies a situation that poses a "serious threat to the health of the community" and means resources can be redeployed and the city can request help from national government.

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Severe pressure has also spread to other emergency services.

The London Ambulance Service is taking up to 8,000 emergency calls a day now, compared to 5,500 on a typical busy day.

Meanwhile, the UK's reproductive or "R" rate - the average number of people someone with coronavirus passes it on to - has risen slightly, from between 1.1.-1.3 to 1.0-1.4.

It is based on data up to 4 January, but the government cautioned the latest rate "cannot account for the impact of recent policy changes" such as the lockdown in England.

Dr Rupert Pearse, an intensive care doctor in London, told Sky News: "This second wave has been going on and on and on... and it doesn't look like it's going to stop until right at the end of January - if we're lucky.

"Maintaining this response for that period of time is proving absolutely exhausting for NHS staff."

Mr Khan announced he is "declaring a major incident because the threat this virus poses to our city is at crisis point".

He warned: "If we do not take immediate action now, our NHS could be overwhelmed and more people will die.

"Londoners continue to make huge sacrifices and I am today imploring them to please stay at home unless it is absolutely necessary for you to leave.

"Stay at home to protect yourself, your family, friends and other Londoners and to protect our NHS."

Mr Khan impressed on people the seriousness of the situation in an interview with Sky News, saying: "It's like a theatre of war... Unless we reduce the spread, the NHS will run out of beds...

"I've never been more concerned than I am now."

More than 800 patients a day are being admitted to London hospitals with COVID-19, the chief executive of NHS England, Sir Simon Stevens, warned at a Downing Street briefing on Thursday.

"That's the equivalent of a new St Thomas' hospital, full of COVID patients every day," he said.

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The rate of new hospital admissions in London is the highest in England, followed by the South East and the South West - all above their own April peaks.

Ministers have blamed the dramatic rise in cases on a new variant discovered in the UK that is up to 70% more transmissible, meaning it is easier to catch.

A spokesperson for the London branch of the Royal College of Nursing said the situation in the capital was "dire" and nursing staff were "beyond breaking point".

One London nurse described how some of her colleagues were "so burnt out they can't eat" or "bring themselves to come into work".

Ameera Sheikh, 28, a Unite union representative, continued: "Some (patients) are openly admitting that they're breaking the rules, some people are just giving some vague responses. This is being told to me by friends who work in the emergency department, not only in London but across the UK.

"During and after the first wave, a lot of staff had handed in their resignation, and that's across many hospitals in the UK."

An intensive care registrar and president of the Doctors Association, Dr Samantha Batt-Rawden, also said her "heart is broken" by the scenes in London.

"We tried. We really tried. NHS staff pleaded with people that Christmas is not worth it. Now one in 30 people in London have COVID and ICUs are overwhelmed," she said in an exasperated tweet.

Analysis: What a 'major incident' is and what will happen now
By Tom Rayner, political correspondent

A major incident is a specific term, defined by the Civil Contingencies Act as an occurrence that presents "serious threat to the health of the community" or "causes such numbers or types of casualties as to require special arrangements to be implemented".

The decision to declare a major incident reflects the extreme pressure being put on the NHS and emergency responders from the rapidly increased spread of the virus, but also as a result of staff themselves being ill or forced to self-isolate.

London's Strategic Coordinating Group, chaired by Sadiq Khan, will now step up its multi-agency response involving hospitals, GP surgeries the local councils and emergency services.

This will involve redeploying resources in areas that are stretched, such as using firefighters to drive ambulances.

It also means that there can be a request for further resources and assistance from the national government.

Sussex and Surrey also declared major incidents yesterday, following Thames Valley four days ago, and Essex last week.

All these areas are now on an emergency footing as a result of concerns that their services cannot operate as normal.