London is suffering an unprecedented medical catastrophe. Last Saturday, Mayor of London Sadiq Khan declared a “major incident” in the capital.

Khan said in a statement, “The situation in London is now critical with the spread of the virus out of control… our hospitals are at risk of being overwhelmed. The stark reality is that we will run out of beds for patients in the next couple of weeks unless the spread of the virus slows down drastically.”

In an interview with Sky News, he described the situation as “like a theatre of war.”

Khan’s announcement is an admission that the Conservative government’s “herd immunity” policy, which he has helped enforce, has brought the health service to the point of collapse in a city of almost nine million people.

Fifteen of London’s 32 boroughs are recording infection rates of more than 1,000 cases per 100,000 people, up to 1,569 in Barking and Dagenham—according to the latest figures for the week to January 6. The average figure for London is 1,052. Twenty-four boroughs recorded week-on-week increases in the rate of infection.

Official testing figures only scratch the surface. The Office for National Statistics estimates that one in 30 people are infected with the virus in London, up to one in 20 in the worst-hit areas.

These numbers are putting unsustainable pressure on health services. The London Ambulance Service is dealing with 8,000 calls a day, compared with 5,000 on a normal busy day, meaning people in need of emergency help are sometimes having to wait hours before paramedics arrive. More than 100 firefighters have been drafted in to drive ambulances.

Roughly 800 patients a week have to wait in the ambulance for more than an hour when they get to hospital because staff are too busy to admit them.

Roughly 40 percent of patients in London are ill with Covid-19. As of last week, six of London’s 18 acute National Health Service (NHS) trusts had unoccupied beds in the single figures. Several had no intensive care beds spare at all. Sixteen out of 21 London trusts had breached their “safety threshold”, with bed occupancy levels over 92 percent. Two of these were 100 percent full.

More than 800 coronavirus cases a day are currently being admitted to the city’s hospitals. Close to 1,000 were admitted to intensive care in the last fortnight. These numbers will increase over the next weeks as the surging case numbers of the last few days produce more hospitalisations.

Last week, the Health Service Journal reported a dire warning given by NHS England London medical director Vin Diwakar in a briefing with the city’s hospital trusts. He warned that in the “best case” scenario, London’s hospitals would be short 1,500 beds by January 19. They would be 2,900 short in the average case and 4,400 in the “worse” case. Speaking at the Downing Street press conference Tuesday Dr Diwakar said that the NHS Nightingale Hospital is now open to treat non-Covid patients but warned more patients may need to be treated outside the capital if rates continue to rise.

Besides beds, there are also severe shortages of staff. ICU nurses in major hospitals are being required to look after three patients at a time, rather than the normal one-to-one care.

Dr Zudin Puthucheary, a council member of the Intensive Care Society who works at Royal London Hospital, told Sky News Saturday, “There are more patients than we have ever had, and we have less staff than we have ever had.

“We've cannibalised staff from all around the hospital—volunteers are pouring in to try and look after these patients and deliver the best care we can. Staff are breaking themselves to make this happen and keep our patients safe—and it's not going to be enough.”

He warned, “The NHS is breaking in front of us and there is no plan to stop it breaking.”

Nearly 1,000 people succumbed to the virus in London hospitals last week, taking the total for the city to 9,815 or one eighth of the UK’s officially registered Covid-19 death toll. More deaths and long-term health complications will be caused by the forced cancellations of other treatments, including urgent cancer surgeries at multiple hospitals.

Khan’s announcement of a major incident and calls for more government support cover up his own criminal role in allowing this situation to develop.

When Prime Minister Boris Johnson ended the one-month November lockdown to save the Christmas profits of the shops and corporations, Khan said in a December 3 statement, “The end of national lockdown will undoubtedly be a major boost for London’s struggling shops and hospitality venues which were forced to close just as preparations for the Christmas period began. At this crucial time of the year I’m urging all Londoners to safely show their support for London’s high streets as we all make our decisions about where to shop this Christmas.”

This was under conditions in which London’s case numbers had stopped falling during the latter part of the lockdown, holding at around 155 per 100,000, and then beginning to increase. Experts were warning that London should be placed under tougher restrictions.

On December 5, Khan went to Oxford Street to encourage people to go shopping in “this golden month and this golden quarter”. That week, the infection rate increased to 192. A week later it was 325 and a week later, in the seven days up to December 18, it was 602. London was only placed under enhanced but entirely inadequate “Tier 4” restrictions December 20. In the week to December 30, the rate was 814 per 100,000 and it now stands at over 1,000.

Khan also worked closely with Transport for London and the private London bus operators to conceal information about Covid-19 infections and keep workers on the job in unsafe conditions.

The declaration of a major incident has serious implications. The BBC’s home and legal correspondent Dominic Casciani explains, “In general terms,” declaring a major incident, “means public bodies can legally stop delivering some everyday services, so that their personnel, attention and resources can be diverted to the emergency confronting them.”

Dr Puthucheary warned in his interview with Sky News that this could mean hospitals having their decision-making power taken away from them. “I’m scared because we are reaching a point where someone might tell us we can't prioritise our patients above everything else—those decisions are going to be taken away from us and none of us have ever lived through that.”

Casciani noted, “At other times, the plans will lead to the military sending soldiers to aid the civilian effort…”

Essex, a county bordering London, specifically requested such a deployment two weeks ago, after declaring a major incident. Sir Bernard Jenkin, Conservative MP for Harwich and North Essex, said that local politicians were “submitting a request for military assistance to the civil authority, a MACA request to assist with the construction of community hospitals, additional hospital capacity and supported by the armed forces and party staffed by the armed forces.

“They would also like armed forces help with the roll-out of the vaccine to accelerate that in Essex and to assist with testing in schools.”

Throughout the pandemic, the military has increasingly been brought forward to plug the gaps in essential and local services left by years of austerity and privatisation. 20,000 soldiers were reportedly placed on standby in March, of which 5,000 are currently deployed in what the Ministry of Defence (MoD) calls “the biggest peacetime operation ever.” The MoD adds that “[t]housands more are supporting efforts through their day jobs in military planning, Defence Medical Services, Defence Science and Technology Laboratories and elsewhere.”

But while they are currently dealing with the medical elements of the crisis, the army’s fundamental role is to defend the capitalist state against popular opposition. In July, a sub-committee of the government’s Scientific Advisory Group for Emergencies (SAGE) warned of “grave challenges to public order” which were “likely to require military support.” It noted that “[t]ensions resulting from the pandemic and lockdown have become inextricably bound with structural inequalities and international events.”

As mass opposition develops, including strikes and protests, against the consequences of the government’s murderous policies, the current military deployments will assume an openly repressive character.

The declaration of a major incident in the capital is a warning to the working class across Britain that they must take the response to the pandemic out of the hands of Johnson and his collaborators. The ruling class has no answer to this crisis outside of mass death and violent repression.

Workers must fight for their own independent interests. The Socialist Equality Party calls for the establishment of rank-and-file committees of workers in every workplace and neighbourhood to fight for effective lockdowns with full income, educational and social support, genuinely safe conditions for genuinely critical key workers, and a functioning test-and trace system—to be funded by the unearned fortunes of the super-rich.