Liverpool hospitals are now treating more coronavirus patients than they were in the peak of the first wave of the pandemic, according to senior medics.
Dr Tristan Cope, medical director of Liverpool University Hospitals NHS Foundation Trust, which runs the Royal, Aintree and Broadgreen hospitals in the city, said numbers were continuing to rise.
Writing on Twitter, he said: "Sadly we are now treating more patients in hospital with Covid-19 in Liv Hospitals than we did in April at the peak of the first wave and numbers continue to rise.
"So important that people in Liverpool and LivCityRegion adhere to social distancing restrictions.
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"Treating so many Covid patients in addition to usual acute and emergency care of patients with non-Covid conditions puts a huge strain on Liv Hospitals staff.
"Thank you to all our staff for their incredible hard work and dedication in dealing with this very difficult situation.
"We can all help reduce that pressure by doing the right thing and taking some very simple measures: washing our hands frequently, keeping our distance from others from outside our household and wearing face coverings in indoor settings."
The city region became the first area of the country to become subject to Tier 3 restrictions, which include the closure of bars and pubs which are not serving food, last week.
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Liverpool has the third highest infection rate in the country according to the latest figures.
In the seven days up until October 17 there were 2,970 recorded new cases, meaning a rate of 596.3 cases per 100,000 people, down from 691.7.
Chief nurse of the hospitals trust Dianne Brown wrote on Twitter: "As Covid rates Liv Hospitals exceed the number back in April, need to recognise the impact this is having on our staff."
