Fears are growing that the Midlands and the North could be hit even worse than London and the South East by the mutant strain of coronavirus.
Tier 4 restrictions have placed most of the south into a lockdown-like situation as cases soared during December, but experts fear that parts of the country still in both Tiers 2 and 3 could see huge increases in the coming days.
And to make matters worse, the areas' hospitals have barely recovered from the second wave, so they are starting at a worst point compared to wear the capital and surrounding areas were.
Dr Nick Scriven, immediate past president of the Society for Acute Medicine, said: "Outside of London, the worry at the moment is that all of the same issues are occurring but from a worse 'starting point' as the Midlands/North never really exited the second wave.
"Staff illness is also a major concern now, with suggestions 10% are already affected but that is likely to worsen."
He added the rising number of coronavirus patients in hospital is "extremely worrying".
"With the numbers approaching the peaks from April, systems will again be stretched to the limit," Dr Scriven said.
"It is not 'just the case' of using the Nightingale hospital as there are simply no staff for them to run as they were originally intended (mini intensive care units).
"They could play a role perhaps if used as rehabilitation units for those recovering but, again, where do we find the specialist staff - the NHS simply does not have the capacity to spare anyone.
"Using 'surge' capacity as NHS England suggests will mean mobilising any usable bed area and stretching staff to look after patients there - often outside the normal 'comfort zone' of staff, e.g. unwell medical patients on surgical wards, or, even less safely, opening up 'mothballed' areas ('ghost wards' from previous years) and spreading staff more thinly than usually considered optimal or even safe.
"This will, of course, mean cancelling elective care again.
"With ICU capacity there will be a need to utilise every ICU bed in a region and the nursing operating theatre areas like in the spring, again hitting elective surgical lists."
The Government's tier system is to be reviewed again on December 30.
