Berlin - No other European country has been hard as hit by the coronavirus as Britain. The government says nearly 80,000 people have died of the virus since the pandemic began. The new variant in particular is causing problems for the NHS, the country's healthcare system. After Christmas, the number of ICU patients suffering from Covid-19 rose dramatically, and many hospitals are overstretched. London has declared a "state of emergency". We spoke to an intensive care doctor who works in a small hospital with 300 beds in the south of England. Although his name known to us, he asked to remain anonymous.

What is the situation like at your hospital at the moment?

In the last two weeks, it's been getting dramatically worse and this may be because of the mutation. Just before Christmas, we had less than 20 patients with Covid-19 in our hospital, now there are almost 100. We are a small hospital with an intensive care unit. When I came on duty just after Christmas the number of patients on the intensive care unit had already doubled, with new patients arriving every day. We have had to convert four operating theatres into intensive care units and all the predictions are that the numbers will continue to increase in the next month. I haven't experienced anything like it in 25 years in the NHS.

How old are the patients?

That's what worries me the most. In the first wave in the spring, those who came to the ICUs were mostly 60-70 years old, with many elderly patients dying on the wards. This time our experience is that the patients are younger, and this is reflected in the national data with more younger patients admitted for intensive care. Now we are getting patients who are around 50 and 60 years old, some are even in their 40s. People who have been previously fit and healthy are suddenly fighting for their lives. That is frightening.  

Is the new mutation more dangerous?

It is definitely more contagious, and it could be that it affects younger people. It does not seem to be that different clinically. My advice is that Germans should not be complacent and despite the many months of restrictions should increase efforts to reduce the spread of the virus as much as possible.  

What is the mood like among your colleagues?

Intensive care doctors are trained to have end of life conversations with relatives. Now it's a daily experience. One of my colleagues recently had to speak to three women in a row to break the bad news that their husbands were likely to die. Many intensive care workers have not yet recovered from the stresses of the first wave in the spring, and now they are under immense pressure again. I think many dedicated colleagues are suffering from emotional burnout. The biggest problem at the moment is the lack of intensive care nursing staff because they or a family member has coronavirus.

Are relatives allowed to say goodbye to the dying?

Because of the risk to relatives much of the communication is by telephone, however a close relative is allowed to see their loved one if they are dying.

People keep warning that the NHS might declare a disaster. What does that mean?

It means that our system might be overwhelmed, with too few hospitals or intensive care beds. We are already having to make difficult decisions about who gets to be admitted to the intensive care unit.  

Is there a danger that, in addition to the pandemic, more people will die because they don't dare go to hospital?

Yes, people are afraid to seek medical care at the moment. Patients are presenting with serious conditions such as heart problems or cancers too late. I have experienced patients delaying coming to hospital, which then makes their treatment much more complicated. There is a danger that at our hospital operations for cancer will be delayed, as has already happened elsewhere in the country.

I heard an English doctor saying he felt like he was at war.

Those would not be my words. All our staff are working flat out. Everyone has been surprised by the ferocity of the second wave, we had expected a gradual increase starting two weeks after Christmas. We are also surprised that it seems to be affecting a younger population.  

Did the government respond too slowly?

During the first wave they seemed slow to react. In this second wave I think they have been caught out by the recent mutation in the virus which seems to have increased the R number dramatically.  

Do you dread going to work?

I certainly do not look forward to it at the moment, but I have the training and experience for my role. I do worry about the system becoming completely overwhelmed.

Is there anything that gives you hope?

I was vaccinated last week, and so was my wife who is a nurse. The increased use of three vaccines that have been approved in the UK will hopefully begin to have an effect on the vulnerable groups and healthcare staff. 1.5 million people in the UK have been given a vaccine to date. And I hope for the spring.