National coronavirus restrictions are needed to prevent a “catastrophe” amid rising infections, an expert has warned, as England’s hospitals deal with more Covid-19 patients than during the April peak of the first wave.

Tighter measures - widely dubbed Tier 5 - are required to tackle the new variant of the virus, which is the main reason for the increase in cases, said Professor Andrew Hayward, of the Government’s New and Emerging Respiratory Virus Threats Advisory Group (Nervtag).

The re-opening of schools would see the need for “increased, strict restrictions” in other areas of society “to pay for that”, he added.

NHS England chief executive Sir Simon Stevens has warned that doctors and nurses are “back in the eye of the storm”.

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Figures from NHS England show there were 20,426 patients in NHS hospitals in England as of 8am on Monday, compared with the 18,974 patients recorded on April 12.

Sir Simon said: “Many of us have lost family, friends, colleagues and – at a time of year when we would normally be celebrating – a lot of people are understandably feeling anxious, frustrated and tired.

“And now, again, we are back in the eye of the storm with a second wave of coronavirus sweeping Europe and, indeed, this country.”

Prof Hayward, professor of infectious diseases epidemiology at University College London, said widespread Tier 4 restrictions – or even higher – are likely to be needed as the country moves towards “near-lockdown”.

He said: “I think we are entering a very dangerous new phase of the pandemic and we’re going to need decisive, early, national action to prevent a catastrophe in January and February.

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“A 50 per cent increase in transmissibility means that the previous levels of restrictions that worked before won’t work now, and so Tier 4 restrictions are likely to be necessary or even higher than that.

“I think we’re really looking at a situation where we’re moving into near-lockdown, but we’ve got to learn the lessons from the first lockdown.”

Pressure is continuing to mount on the Government to delay further the re-opening of secondary schools in January amid concerns about their contribution to rising cases.

Two teaching unions have warned that allowing students to return will put them at risk of catching the new variants of Covid-19.

Prof Hayward said he thinks schools will have to return “maybe a little bit later” and that reopening would mean “we’re going to have to have increased, strict restrictions in other areas of society to pay for that”.

Geoff Barton, general secretary of the Association of School and College Leaders (ASCL), welcomed the Government’s plans for soldiers to offer remote support for testing in schools, but warned it is unlikely to be enough.

Sir Simon said there is a “chink of hope” in the various Covid-19 vaccines, with the Oxford/AstraZeneca jab expected to be approved imminently by the Medicines and Healthcare products Regulatory Agency, according to reports.

He said: “We think that, by late spring, with vaccine supplies continuing to come on stream, we will have been able to offer all vulnerable people across this country Covid vaccination.

“That perhaps provides the biggest chink of hope for the year ahead.”

But the current vaccination target will have to be doubled to two million jabs a week to avoid a third wave of the virus, according to a projection from a London School of Hygiene and Tropical Medicine paper reported by the Telegraph.

Calum Semple, professor of outbreak medicine at the University of Liverpool and a member of the Scientific Advisory Group for Emergencies (Sage), described the Oxford/AstraZeneca vaccine as a “game changer” but warned that “herd immunity” through vaccination will not be likely until the summer.

It came as hospitals struggled to cope with the surge in coronavirus patients, while trusts have been told to begin planning for the use of Nightingale hospitals.

Dr Yvonne Doyle, medical director at Public Health England, said: “This very high level of infection is of growing concern at a time when our hospitals are at their most vulnerable, with new admissions rising in many regions.”

Saffron Cordery, deputy chief executive of NHS Providers, said some trusts are reporting up to three times the number of Covid patients as at the peak of the first wave.

“This means hospitals and also ambulance services in Tier 4 areas and beyond are incredibly busy, compounded by increasing staff absences due to illness and the need to self-isolate,” she said.