Simon Stevens, NHS chief executive, said that since Saturday ‘we’ve filled another two hospital equivalents with more desperately sick Covid patients’ © Victoria Jones/AFP

The NHS in England will return to its highest level of emergency preparedness from midnight on Wednesday as it copes with a surge of coronavirus patients that in some areas exceeds the numbers seen at the height of the pandemic in April.

Simon Stevens, NHS chief executive, coupled his announcement that the “level four” status that prevailed in the NHS from the end of January to the end of July would be reimposed, with a warning that routine operations were already being cancelled in some areas under the pressure of Covid-19 cases.

His comments came a few hours before the government announced that the number of Covid-19 deaths reported in the UK had risen by nearly 100 to 492 in the latest 24-hour period — the highest number since early May, and up from 397 on Tuesday and 136 the day before. The number of cases reported also rose to 25,177, the highest since October 21.

About 11,000 Covid-19 patients were now being treated in hospital, more than 50 per cent of the peak number of cases seen during the spring and “the equivalent of 22 of our hospitals full of coronavirus patients”, Sir Simon said. There are 1,257 hospitals in the UK, according to the NHS website.

Even since Saturday “we’ve filled another two hospital equivalents with more desperately sick Covid patients needing our specialist care”, he told a news conference.

Asked about his message to MPs preparing to vote on Wednesday on new national lockdown measures, Sir Simon said the outcome was a matter for parliament, but added: “Our job in the NHS is just to set out the, frankly indisputable, facts about the number of coronavirus patients we are looking after and the consequences if infection continues to grow.”

Stephen Powis, NHS national medical director, said projections produced by scientists advising the government suggested that demands on hospitals were set to exceed “the peak usage” seen in the first wave without action to “bend the curve” of infections.

While the highest number of admissions was in the north, numbers were now beginning to rise “in the south of the country too . . . and we are now seeing numbers admitted to hospital higher than those we saw in the peak in mid-April”, Prof Powis added.

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Asked to rate the NHS’s readiness to administer any approved coronavirus vaccine, Sir Simon said its “central planning assumption” was that it would be the start of next year before the bulk of a vaccine would become available.

But he added: “We are planning on the off-chance that at least some vaccination is available before Christmas.” Different vaccines would pose different logistical challenges, with some having to be kept at -70C, he noted.

GPs, pharmacists and nurses would all play a role. He also raised the possibility of mass inoculation centres being established, potentially using the Nightingale hospitals and “roving teams” of staff to administer the vaccine in care homes.

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