Intensive care medics in London have made a fresh appeal to the public to comply fully with England’s coronavirus restrictions, as they struggle to deal with more patients than at any time over the last four winters. Morale among ICU staff is tumbling and concerns have been expressed about a “mass exodus” as the second wave of Covid infections escalates rapidly in London and elsewhere in England. Some doctors and nurses have already quit. Dr Rebecca Lewis, a co-secretary of the Doctors’ Association UK, said the government had done little to look after doctors and nurses, and that many had in effect been forced to work for 10 months without a break as a result of cancelled leave and staff shortages. “NHS staff repeatedly warned the government against relaxing guidelines over Christmas but unfortunately these warnings were not heeded, and we are now seeing the grave consequences,” she said. “It is becoming more and more difficult to see how we will avoid a mass exodus of doctors and nurses after all this is over, due to the impossible mental strain working through this pandemic has put them under. Little has been done to look after and protect those who are tasked with looking after us, and we will continue to see the consequences of this even beyond the pandemic.” Morale has also been sapped by some people’s flagrant breaches of restrictions, protests by Covid deniers outside some London hospitals over the past week. “It makes me feel so angry,” said an intensive care nurse at University College London hospital (UCLH), who asked not to be named. “I just saw them on the ground floor, not wearing any masks, but we didn’t discuss among colleagues because we don’t have any time.” The stress reached a peak this week seeing women like her, in their 30s, severely ill with the virus and fearing she could suffer the same fate. “I’ve got palpitations going into work, it’s so horrific. We’re not immune to trauma either,” she said. As she spoke to the Guardian on Friday, the number of deaths recorded daily reached its highest since the start of the pandemic, and the mayor of London, Sadiq Khan, declared a major incident as the number of infections in the capital rose steeply. Some sections of the public have failed to perceive the damage the virus is causing, according to a critical care nurse at Barnet hospital. “Fake news is really damaging, because some people believe it. I don’t know what their motivation is but ultimately it has a malicious intent,” she said. The government’s initial failure to prioritise healthcare staff for vaccination had also dampened staff’s spirits, she said, coming on the back of longstanding concerns over NHS underfunding and a wider failure to address poor public health. “Morale is dreadful, I’m really sorry to say that,” she said. “People do this job because they believe in it. We are one of the few countries in the world with universal healthcare from cradle to grave, but there’s a limit. People are working long shifts, are off sick, and there’s just so much work to do.” The enforced absence of patients’ families has also deeply affected healthcare workers. “The emotional and physical toll does not necessarily arise from wearing PPE all day and night; its knowing families can’t be at the patients’ bedside,” said an intensive care doctor at UCLH. “It’s horrible having to update relatives over the phone to tell them that they’ve got worse or there’s no change.” With about four or five patients per nurse, as opposed to the ideal scenario of one-to-one care, there are concerns senior doctors could be forced to ration treatment if the rate of infection and hospital admissions does not subside quickly. A nurse treating Covid patients at the Royal London hospital said that in a recent fortnight, at least one person she had been caring for had died each shift. “Waking up in the morning to come in has just been getting harder and harder because every shift is complete shit,” she said. “But then you get on the tube after your shift and see people not wearing a mask, and there’s just still a lot of people out, considering how bad it is.” She hasn’t seen her siblings since March because she fears spreading Covid to her family, and believes the weekly clap for carers, which returned on Thursday, would remain a hollow gesture until more people begin obeying the lockdown. Back on the ward, capacity has long been exceeded and there have been chaotic scenes. “We had a Covid patient waiting in A&E for up to 49 hours for a bed the other day, and that wasn’t even the worst we’ve had, she said. “My colleagues and friends have been great cheering me up. Just knowing that at some point it will eventually be over is the only thing keeping me going, but we’ve still got the peak to come.”