London: "I'm watching whole families getting wiped out here, and it's got to stop."

The plea, made by intensive care doctor Hugh Montgomery, was the most powerful yet.

A mural depicting NHS nurse Melanie Senior in Manchester. The NHS is said to be close to collapse in the UK.Credit:Getty Images

But there is little evidence that Brits will be scared, cajoled or guilted into saving the National Health Service (NHS) from breaking point, which insiders fear could come this January.

"We're in a lot of trouble in UK intensive care now," Montgomery told BBC's Radio 5 Live in an interview that has gone viral across Britain.

"It's making me actually very angry now that people are laying the blame on the virus and it's not the virus – it's people.

"People are not washing their hands, they're not keeping two metres' distance, they're not wearing their masks," he said.

A message of support from the Queen in London’s Piccadilly Circus. Many Britons stand accused of not taking COVID-19 restrictions seriously.Credit:Bloomberg

By New Year's Eve, intensive care units of three London hospitals were full on New Year's Eve, forcing patients to be transferred to other hospitals for critical care, and the 'Nightingale' emergency field hospitals built by the military – barely used since the start of the pandemic – have now been pressed into action.

Britain ended 2020 by recording its highest-ever number of COVID-19 infections in a day – nearly 56,000. Just a week earlier, daily infection reports of more than 30,000 were a record.

For the final two days of the year the number of deaths reported in a single day exceeded 900. The death rate is now in the same territory as at the peak of the first wave in April, when more than 1000 people died in a single day.

But what is remarkable is how little attention is now given to the daily data compared to the first wave. Critics of lockdown have said that first-wave numbers were framed in a distorted way by the media and used to justify draconian infringements.

Then the country was in the grip of what has been its toughest lockdown to date.

Currently, most of Britain is under severe restrictions, with gyms, hospitality and non-essential retail shut. On New Year's Day, the government decided to close all London primary schools, reversing a decision made just two days ago.

"Children's education and wellbeing remains a national priority," Education Secretary Gavin Williamson said. "Moving further parts of London to remote education really is a last resort and a temporary solution."

But people can still visit their work sites, secondary schools are likely to reopen and the Premier League is still running, despite two fixtures being cancelled after outbreaks in the Fulham and Manchester City football clubs.

If the world watched Europe's first-wave COVID-19 crisis with horror, January is likely to be even worse. The mutated version of the virus currently spreading across England transmits more easily, and while it does not cause more death or the disease to manifest more severely, it reaches those at risk faster.

There is already what medics are describing as a "tsunami" of COVID-19 cases presenting at hospitals. At the peak in mid-April, 21,863 patients were in hospital. That has already been exceeded, with nearly 24,000 people filling up wards.

The number of daily infections in Britain continues to break records, reaching 56,000 on New Year’s Eve.Credit:Bloomberg

This is a sign of a health system coping but that the NHS has broken, according to one highly-placed source.

"The NHS is under significant pressure," Professor Stephen Powis from NHS England told a Downing Street press conference this week. "It's only by reducing infection rates that a couple of weeks later we will start to see a similar reduction in hospitalisations."

For Britain, managing its COVID-19 outbreaks has never been about elimination but always about avoiding scenes of overflowing hospitals and morgues as occurred in Italy, the European epicentre of the pandemic.

If the NHS is indeed pushed to breaking point the blame will inevitably be laid at the feet of Prime Minister Boris Johnson for not locking down sooner.

But Montgomery says that will be self-serving. Rule-breaking has been rife since the end of the first lockdown, with house parties, secret raves and widespread flouting of quarantine.

This reporter was in the Croatian port city of Dubrovnik in August when the British government announced it was putting Croatia on its quarantine list after a sharp rise in the number of cases there. An estimated 20,000 British tourists were in Croatia at the time.

"I hope when we get back we don't get caught breaking the quarantine," a young British woman seated near me told her partner over dinner.

It is this sort of behaviour that has infuriated NHS staff, including Montgomery.

"I'm absolutely not an apologist for this or any other government or political party, this is not a political statement but the problem here, I can't reiterate enough, is people.

"Anyone … who doesn't wear their mask and behaves like this, they have blood on their hands, they're spreading this virus and people will die."

With around a 10-day lag between infections and the need for hospitalisation, the race is on to vaccinate the population before case numbers, already out of control, catapult into triple figures.

Even after vaccination, it takes between two to three weeks for the body to develop the antibodies required to fight the virus.

But there are serious concerns that the British government may be poised to make another potentially catastrophic mistake.

Because the virus is spreading so fast, the government is trying to give first doses of the vaccine to as many Britons as possible. But this means that there will be a longer wait for the second top-up dose – 12 weeks.

After the independent Medicines and Healthcare products Regulatory Authority (MHRA) last week approved the Oxford/AstraZeneca jab, 530,000 doses of it will be rolled out from next week.

AstraZeneca has said it can roll out millions of doses of vaccine for Britons “very rapidly”. But is the government right about how best to roll the doses out?Credit:University of Oxford

But this is nowhere near the millions needed for the population to build up the herd immunity that might result in a restoration of normal life by April, as Johnson has promised.

Health Secretary Matt Hancock said two million people can be vaccinated per week if supplies are there. AstraZeneca says it can produce that number "very rapidly".

Johnson, who has a history of making false promises about the state's ability to manage the pandemic, said this week that "tens of millions" of doses would be ready by the end of March.

Already, 944,539 people have been given their first jabs. But they have taken the Pfizer/BioNTech vaccine. The government's plan to stretch out the timing of the second jab to 12 weeks alarmed Pfizer, which said in a statement: "There are no data to demonstrate that protection after the first dose is sustained after 21 days.

"Data from the phase 3 study demonstrated that, although partial protection from the vaccine appears to begin as early as 12 days after the first dose, two doses of the vaccine are required to provide the maximum protection against the disease, a vaccine efficacy of 95 per cent."

The change also took doctors by surprise, given they are already administering the second doses, including to 91-year-old Margaret Keenan, the first person in the world to take the vaccine on December 8.

"The British Medical Association believes these are patients that have already been promised … that they will receive a second dose of Pfizer vaccination next week; they have given their consent to receive it and, quite rightly, are expecting to have it," the BMA said.

Opposition health spokesman Jonathan Ashworth said the policy was causing "concern and distress".

"I urge ministers to honour existing appointments and go all-out to accelerate the distribution of at least 2 million jabs a week ASAP," he said.

"With the AstraZeneca development this week, this should be doable."

It is an indication of Britain's "dangerous situation" – as England's deputy chief medical officer, Professor Jonathan Van-Tam, described it – that its government is being forced to choose from a menu of bad options.

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