LONDON — The pandemic is gathering strength in Britain fed by a mutant strain of Covid-19, and the country's health care workers are paying a hefty price.
The virus has already killed more than 76,000 people in the U.K. — the worst death toll in Europe and the fifth worst in the world, according to Johns Hopkins University. Hospitalization numbers are reaching new highs.
A further 68,053 confirmed cases were announced by the government on Friday — the highest single day figure so far — making it the eleventh day in a row that more than 50,000 new cases had been reported.
"It's gone completely crazy," said Ben Schischa, a paramedic with eight years' experience, who works in and around London and has been on the front lines of the pandemic since March.
Schischa, 39, said emergency calls from people confirmed or suspected to have Covid-19 have "exploded exponentially" compared to even a week or two ago.
Schischa said he has seen patients wait in ambulances for hours until the hospital had enough space for them. One patient he picked up had waited six hours outside a hospital the previous day, he said.
"That's just an example of what's going on at the moment. And that's the same everywhere — London, Kent, Essex," Schischa said, referring to counties in southeast England that are among the hardest hit. "It's become like a war zone again."
The worsening crisis and the news of the new strain are taking a psychological toll. The thought that he will take the virus home to his family plagues him. "You just don't know what's going to happen," he said.
England and Scotland entered new national lockdowns to curb the spread of the mutant strain and to try to prevent Britain's beloved, taxpayer-funded National Health Service from collapsing on Monday.
"Our hospitals are under more pressure from Covid-19 than at any time since the start of the pandemic," British Prime Minister Boris Johnson said, announcing the new restrictions.
By Friday, London Mayor Sadiq Khan declared a "major incident" in the capital city's hospitals and admitted that health services are "at risk of being overwhelmed." Hospitals would run out of beds in two weeks unless the spread of the virus slows, he warned.
Download the NBC News app for breaking news and politics
"Everyone is very stretched. Hospitals are very busy," said Dr. Jon Williamson, an anesthesiologist who has been redeployed to help handle Covid-19 patients in the intensive care unit at Whittington Hospital in north London.
With the unit filled with Covid-19 patients, he said, the latest wave is very similar to what he saw in March; patients arrive very sick and need high-level care.
"There is constant pressure on intensive care," said Williamson, who — with the hospital's permission — has been documenting the Covid-19 crisis with his camera and posting the results on his Instagram account.
He said he and his colleagues are able to manage the situation by transferring critical patients to other hospitals if they run out of beds. But he is worried about what could happen in the weeks ahead, when hospitalizations and deaths catch up with skyrocketing case numbers.
"You will suddenly reach a point where they all fail together, and the whole system will suddenly reach capacity," he said. "The system has not failed yet, but it's incredibly stretched."
On Monday, the U.K.'s medical chiefs said many parts of the health care system were under immense pressure, with substantial numbers of Covid-19 patients in hospitals and in intensive care.
"We are not confident that the NHS can handle a further sustained rise in cases," they said in a statement. "And without further action, there is a material risk of the NHS in several areas being overwhelmed over the next 21 days."
It's not just other people's health they're worried about.
During the first wave last spring, more health care workers died from Covid-19 in the U.K. than almost anywhere else, according to figures compiled in July by Amnesty International. The watchdog agency found more than 540 health care and social worker deaths in England and Wales — behind only Russia.
And almost 60 percent of doctors are suffering from some form of anxiety or depression, with 46 percent saying their conditions had worsened since the start of pandemic, according to a survey released last week by the British Medical Association.
Nearly 70 percent said their levels of fatigue and exhaustion are higher than normal as they tackle record daily case numbers and a growing backlog of care.
The NHS is facing "a perfect storm" of immense workload and staff burnout, the association's council chair, Dr. Chaand Nagpaul, warned Monday.
"Doctors are desperate," he said.
A spokesperson for NHS England said in an emailed statement Monday that the rise in Covid-19 case numbers across the country means all hospitals remain "extremely busy."
Dr. Rachel Clarke, a palliative care specialist at a hospital in Oxfordshire, a county northwest of London, remembers being horrified by images coming from New York City in April of hospitals overwhelmed and of people being treated in tents outside.
"I feel that as though now, to some extent, we are inhabiting that world," said Clarke, 48. "We don't have patients in tents, but we do have patients who are trapped in ambulances sitting outside the hospital because we can't physically get them inside the hospital."
Clarke said staff members at her hospital are distressed and exhausted, with many experiencing post-traumatic stress disorder symptoms from the first wave.
"They are in the same situation again," she said. "You are seeing patient after patient with the same symptoms, same illness, over and over again. And sometimes you are talking to them knowing that there is a very real chance they may be dead in the morning. It's so painful to be in this situation the second time around."
Dr. Julia Grace Patterson, a psychiatrist who runs the doctor-led advocacy organization EveryDoctor, said she is concerned about the mental health of first responders who are reliving the trauma of the early days of the pandemic.
"There has not really been a period of let-up or release or an ability to process any of those things," Patterson said.
Health care workers never really relaxed between the peaks of the pandemic as they were catching up on operations and appointments that were delayed or canceled during the first wave. "There really was no break for them," she said.
Adding another layer of distress is the amount of misinformation, said Clarke, who regularly tweets about what she sees on the front lines.
"From people saying you are a liar to it's a 'scamdemic,' it's not real and you are a disgrace," she said. "I have had death and rape threats for standing up and saying how serious Covid-19 is."
But despite being tired and desperate for things to be different, she said, health care workers still pull on their scrubs and put patients first — over and over again.
"They are giving all they have to patients," Clarke said.