Good afternoon, this is @bencsmoke, Huck's politics editor here with a special report from the frontlines of the covid crisis as hospitals threaten to be overwhelmed and the government plans to announce new extensions to tier 4 lockdown to help thwart the spread of the virus.

We've been chatting to NHS staff across the east and the south east of the country who've spoken of dire conditions, horrendous pain and suffering and a spiralling physical and mental cost of the pandemic.

One junior doctor at an East London Hospital referred to the Christmas weekend as "easily the worst and most traumatic weekend I’ve worked" adding "the past two weeks have been getting worse and worse in capacity of the staffing levels we have as well as ventilated beds..."

"me alone i’ve had 4 serious medically emergencies with two of them going to [intensive care] and one sadly passing away. I’ve got a ward full of young people on high flow oxygen on their fronts and older people who are sadly nearing the end of their lives"

This comes as reports of ambulances queuing outside hospitals across the city increase (here seen outside the Royal London in Whitechapel in a tweet posted yesterday) https://twitter.com/IbrahimChsTV/status/1343948536149372929?s=20

A front line staff member at a major south London hospital told us that "All non-emergency surgeries being cancelled where I work and theatre staff being redeployed to ICU and critical care units, for at least the next two months it seems"

They told us that though there has been talk of this happening for a while, the decision to redeploy and cancel surgeries seems to have been taken very suddenly (or at least we communicated very suddenly)

PPE is "guarded like gold" and morale in ICU staff is low, though, we were told, has lifted with the redeployment of staff to the unit. when asked what would help right now their answer was telling:

"more staff and a pay rise would be nice. can only dream."

Yesterday saw 53,000 new cases of covid in the UK as the new strain, which scientists have found to be up to 70% more transmissable continues to ravage the country. There were over 400 recorded deaths yesterday.

Current hotspots for the virus include northern Kent, east London and Essex with hospitals in the county today announcing a 'major incident' https://www.theguardian.com/uk-news/2020/dec/30/major-incident-declared-in-essex-as-covid-threatens-to-overwhelm-health-services

As of Tuesday, as reported by the Financial Times there were 21,787 hospital beds occupied with covid patients which is higher than the April peak of 18,970 https://www.ft.com/content/9e4ffdab-8245-44d6-a110-206c6cc94796

A paramedic in the east of the country tells us that they have been told to avoid covid hospital admissions wherever possible which they say is sensible but it means they've been put in "the position of telling families (mostly of care home patients) their relative will die..."

they continued "I can’t count the number of phone calls I’ve had to make this year explaining to a next of kin that their lived one is unlikely to recover and try and facilitate some kind of phone conversation between a distressed relative and a disorientated/elderly patient.."

cont. "This year there have been way less hugs goodbye, way less hand holding at the beside. It was never an easy part of the job to facilitate, but was important. In most cases the crew themselves or care home staff try to step in and hold hands or provide some kind of company"

Where someone is taken to a ward, it can be just a harrowing the paramedic tells us: "If you do take someone to a covid ward you do so knowing that they will not see their family again and you’ll be the last face they see as all staff in ward will now be wearing hood, goggles..."

cont. "hair net. They’ll never see a smiling face again. They’ll never hold a hand that’s not in a double layer of gloves again.

Those we spoke to inside hospitals reported good levels of PPE with Department for Health and Social care telling us over email that they had "around 30 billion items on order"= statistics released by the dpt stating they distributed 321 million PPE items in 7 days up to 20/12/20

In the community, however, the story is different according to those we spoke to. The same paramedic from earlier stated "They give us a paper mask+gloves to attend covid positive patients, then no time to decontaminate properly,+ then blame staff for going off sick with covid"

cont. "We’ve had several colleges critically unwell and one was on life support for 6 weeks. He’s still recovering at home now, and probably won’t ever be well enough to return to work, yet we're still being sent out with inadequate PPE"

cont. "It’s a paper mask, a dinner lady apron and some gloves. You’ll attend a covid patient and take them into the ‘red zone’ (covid area) and be greeted by doctors and nurses in full PPE: good, suit, goggles, hairnet etc...and we walk through in just our stupid paper mask.."

cont. "Then get emails suggesting it’s our fault that we are contracting covid and that we need to ‘up our game’"

Awaiting a quote from @DHSCgovuk on provision of protection for all NHS staff.

Those we have talked to so far have spoken of being tired, lonely, scared, exhausted. They're angry at what they refer to as the 'incompetence' of this government. Theyre scared they won't get to see shielding members of their family again. They feel like there's no end in sight.

Should say at this point if you are an NHS worker we want to hear from you. Our DMs here are open or you can email on [email protected].

In the House of Commons, health secretary Matt Hancock has just announced huge extensions to both tier 4 and tier 3 areas. There are no longer any areas in England in tier 1 or 2. Chair of health select committee Jeremy Hunt calls for schools to be closed to help protect NHS.

Theres increased pressure on govt to not reopen schools next week. Theyre already set to bend on this, with education secretary Gavin Williamson due to announce delay in return of millions at 4pm(just weeks after threatening Greenwich with legal action for shutting schools early)

We spoke to someone who works with Reception age children (age 4) (who are some of those students who will be returning next week as far as we know). they said " my school is bubbling in years, but bubbles often don't work bc SEN staff have to go from class to class to do work.."

cont. "...I've been off about 4 times because one of the children or a staff member has tested positive. since September ive racked up 5 covid tests. we haven't been social distancing with the children because you can't with 4 year olds..."

cont. "...but we have been getting them to wash their hands frequently and but been social distancing from other staff" When asked what they wanted from the announcement at 4 they stated the priority should be implementing testing in all schools.

At an east London hospital, we spoke to a healthcare assistant who urged the Govt to keep the schools shut "we need schools to remain shut as so many of our patients caught it from their kids or from their jobs in schools. More [staff] too but that ain't happening anytime soon."

They spoke of current carnage in the capital's hospitals, "Patients die, I prepare the body and within minutes, there is another patient dropped off by a&e to take the bed. It's relentless. PPE is mostly adequate but we regularly run out of other essentials like clean linen..."

"...disinfectant wipes and even nasal canullas for administering oxygen as we can't get them from central supply to the wards quick enough."

Staff numbers and capacity are a real concern for all we've spoken to..

The HCA in east London told us "Neither the nurses I work under or myself are trained in [Non invasive ventilation], it's something you wouldn't normally see on our ward but I now spend my shifts caring for these very sick patients as our ITU is full..."

"...In normal times, the Nurse+ Midwifery Council wouldnt let us near these patients as its not within our competency but we are doing it anyway. The patients on NIV require pretty much continuous monitoring which is something we have to do alongside admitting new Covid patients"

As we wait for the press conference, the latest figures have been released and they make grim reading: https://twitter.com/skynewsbreak/status/1344313667316305921

On the PPE issues mentioned earlier in the thread a @DHSCgovuk spokesperson told us "Our NHS is facing a huge challenge and the Government will continue to support it in every possible way. We are confident we can provide a continuous supply of PPE to the frontline over...

cont. "the coming months, with almost 32 billion items ordered, and staff vacancies are falling with over 13,000 more nurses compared to last year. We are also investing £52 billion this year and £20 billion next year..."

cont. " to help the health service fight coronavirus, including £3 billion to boost NHS capacity during this difficult winter.”

Speaking last night, one of those we spoke to in an East London trust told us "morale is absolutely awful, especially when we look at our neighbouring countries and see how different it could be. feels like this government is playing with our lives and we have no control..."

cont. "we’ve had two consultants pass away from covid in the last week, one of whom was on my ward when he suddenly died. we’ve known about covid for a year and we’re in a worse position that we were in march, it makes no sense to me"

There are lots of rumours flying around about London running out of oxygen and beds etc - something we put to NHSE London yesterday evening, and something which they categorically denied.

From the junior doctor in the east London trust "wards are overwhelmed every winter to be honest, but we’ve really been struggling the past 3-4 weeks. oxygen flow at the bigger hospital in my trust was at 105% capacity on sunday and..."

cont. "we’ve had to lower our targets for patients like we did in the first peak to cope"

As said earlier in the thread, if you're working in the NHS right now we want to share your stories and your experiences. Our DMs are open or you can drop us an email on [email protected].

We've been contacted by a junior doctor from the west midlands to offer some clarity on this point from the paramedic yesterday: https://twitter.com/HUCKmagazine/status/1344295374169759750?s=20

JD said "Just a brief point regarding your recent tweets about paramedics in the Covid crisis. Doctors/nurses wearing full PPE (suit/hairnet/etc) is NOT the norm and is only done in select few places like A&E/ITU..."

cont. "I work on a Covid ward and the standard equipment for entering a bay full of known positive patients is still a paper mask, gloves, and plastic apron"

When asked about prevalence of illness on the ward they said "At this point most of the staff in my ward have had Covid+ are back at work, so likely protected by natural immunity. Infection rates have been very high. I'd estimate 50% of patient facing staff on my ward at least"

On how the hospital is coping they said " My hospital is struggling for beds, but so far no shortages of oxygen or ventilators. Worse than it would normally be at this time of year though...most people are expecting things to get worse."

cont. "My ward is mainly elderly patients who will not be suitable for ITU, so the mortality rate is very high. Some staff like physios have been offered the choice to rotate to a different ward to try and prevent burnout from so many deaths"

They stated that whilst morale was holding up "A lot of little things that were appreciated like free food, free scrubs, etc. have dried up+ there's more of a sense of managing a pandemic on top of your normal job/life than during 1st lockdown where everything else was on pause"

cont. "Hospital administrators are definitely getting stressed out though, one of the biggest issues I've had is patients being shuffled around hospital so much that continuity of care is compromised+ sometimes even the separation of Covid/non Covid patients is mistakenly broken"

Currently awaiting a statement from Barts Health trust about an allegedly deteriorating situation at Royal London Hospital. Lots floating around on twitter about it, which we're not going to repost but as soon as we have something from the hospital we'll post it here.

As we await that statement on the Royal London, we’ve been sent this from a member of staff at Homerton which shows the true scale of the crisis. According to the trust website the hospital has almost 500 beds. as of 8am this morning 163 of them were occupied by covid patients.

Those who we spoke to there told us their annual leave has been cancelled and they're being asked to come back in to help deal with the crisis. They told us "For Adult beds they have around 400 but they’ve had to convert some of the children’s wards!..."

cont. "ITU (intensive treatment unit) are just putting them in escalation units and closing theatres"

They also told us, like some of the earlier staff we spoke to that "I’m going in to a CPAP (non invasive ventilation) ward never had training."

When we contacted NHS England about this earlier they told us "It is our understanding that all staff taking on new roles..."

cont. "or responsibilities as a result of the pandemic are trained in what they are expected to do.... No one would be providing care they are not qualified to give."

When we put this to the healthcare worker we spoke to at Homerton they told us "Well they are definitely lying! Or they count 5 minute learnings as training who knows." Another healthcare worker in the trust told us "Training for us literally consisted of the first NIV patient.."

cont. "arriving and an ITU specialist nurse showing us how she would set it up and some basic troubleshooting which took about 5 minutes."

We've reached out to Homerton hospitals trust for comment.