A third of critical care beds in Liverpool hospitals are occupied with Covid patients, as clinicians grow increasingly uneasy about 'Freedom Day' on Monday.
Fuelled by relaxations of lockdown rules and the arrival of the highly contagious Delta variant, infections have been rocketing across the UK.
Yesterday there were in excess of 40,000 new coronavirus infections nationally, the highest number since January.
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Politicians and scientists are hoping that the millions of vaccines administered to Brits so far will protect the NHS from being overwhelmed, but hospitalisations are rising and there are also growing pressures not directly related to the virus.
The Royal Liverpool and Aintree hospitals are not yet as badly hit as other regions in the country, and this weekend provided mutual aid to hospitals in Manchester, but concerns are rising locally.
Today Dr Peter Hampshire, clinical director for critical care and pain at Liverpool University Hospitals NHS Foundation Trust, shared his concerns on Twitter after a shift in intensive care.
Responding to a story about Manchester hospitals needing to stand up extra critical care beds, he said: "I'm not sure that many people understand that hospitals are already under significant pressure, even before all restrictions are lifted on July 19.
"I'm on ICU this week and in Liverpool, 1/3rd of our critical care beds are occupied by people with Covid. It feels like last October with a slow but steady rise in cases.
"We have already offered mutual aid to Manchester. And our Emergency Department and ambulance colleagues are under massive pressure.
"NHS staff are still recovering from the winter/autumn/spring we had and it's not uncommon to talk to staff who have been off with stress."
Dr Hampshire also pointed to the enormous backlog in non-emergency surgical procedures as a source of pressure, and hinted they may need to be yet more damaging cancellations if Covid patients continue to come through the doors.
He said: "We can't really afford to stepdown surgery again as we have already done this for most of the last year, so we are really behind.
"However I'm not sure what the alternative plan is if we continue to see more admissions. If the end of restrictions is "irreversible" then that is quite scary as this is the only way we have gained control before.
"Vaccines have really helped but if we see thousands of new infections then we will continue to see young people who haven't had the vaccine and the vaccinated but vulnerable getting ill."
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