A team of intensive care specialists in masks and visors huddle around a screened bay on the third floor of a large hospital trust to help a critically ill patient.
The elderly man is connected to a line to measure his blood pressure and he has a breathing apparatus that supports him. A stack of six monitors give an update on his condition when he is fed a gastric tube.
He is one of 14 patients on a critical care ward. He is receiving some of the best medical care in the world, but his concerned medical team know the long-term prognosis for this patient at the unit in King's College hospital in south London, and many like him, is uncertain.
Most of the patients recently admitted to critical beds were unvaccinated, according to the staff who spoke to the Observer.
The medical teams at King's are bracing for a new influx of patients with the Omicron variant. People are being urged to get their jabs.
A third of patients who are transferred to critical care beds with Covid will die, according to several studies. Most will improve over a week to 10 days, but a few will need long-term treatment in the unit.
Doctors and nurses are concerned about the number of patients being transferred to critical care beds who are still unvaccinated.
The critical care beds at King's were unvaccinated, according to Michael Bartley, a critical care matron.
He said that they are not here to judge patients but to look after them. If the patient is too sick, we will take over their breathing and cardiopulmonary functions.
The long-term effects of the disease can be devastating. Some patients have been with us for more than 100 days. The age of those who are unvaccinated is between 35 and 65. The message is to get your vaccines.
King's has a high proportion of unvaccinated patients in intensive care beds. The percentage of unvaccinated Covid patients who were admitted to critical care in England fell from 75% in May to 42% last month as more people were jabbed.
London has the lowest proportion of vaccinations. Many of the unvaccinated in London are seeking urgent medical help as a new wave of the Pandemic hits the country.
The staff at King's are prepared for the future. Andy Hall is the photographer for The Observer.
Dr Laura-Jane Smith, a respiratory consultant who works on a Covid ward at King's, said on Friday that she had seen four new patients admitted to the ward this morning. All of them are unvaccinated.
I have not sent anyone to intensive care who has had any vaccines recently. People who are vaccine-free are not getting sick as much. The ones that we are seeing are going home quicker. It is hard to hear people say that they wish they had the vaccine.
Smith and her colleagues are facing another winter crisis as Omicron spreads. She said that they were hoping that it wouldn't be as bad as last January.
5,538 people had a confirmed positive test result for Covid in the week of December 13 to 17. This is an increase of 188% compared to the previous week.
The UK reported a record number of new Covid cases for the third day in a row. In London, hospital admissions are climbing quickly where Omicron has taken hold.
The London School of Hygiene & Tropical Medicine has warned that Omicron is likely to be the dominant coronaviruses variant by the end of the month and that there could be 175,000 hospital admissions and 24,700 deaths in England between 1 December and 30 April next year.
The staff at King's hold a daily incident coordination briefing in a ground-floor conference room at .
The hospital has a 98%Occupancy rate and only five of the critical care beds are free. Staff are falling ill at an alarming rate.
Plans are being drawn up to double the number of intensive care beds in two units and convert other wards for Covid patients. The trust currently looks after 142 Covid patients, compared with 773 during the peak of the second wave in January. There are 17 critical care beds.
The head of emergency planning and clinical site operations at King's likened the preparation to a calm before a storm.
She said that it was her job to put the plans in place. There is a point where you think we are ready. Initial indications were that patients were not as sick as in previous waves.
She said that last year, when Christmas and New Year came around, they were seeing patients in the emergency department who were so sick they were going to critical care.
Patients who are going to general wards for a couple of days are able to go home. We are seeing some genotyping that is highly suggestive of Omicron.
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The impact of vaccines, better drug treatments and the possibility of a lesser severity of Omicron may be involved in the decreased severity. This is good news because it means Covid patients can be discharged at the same rate.
The initial indications were that the trust would be able to cope, and it wanted to make sure that other services were available for non- Covid patients. She said that there was a concern that services could be overwhelmed, but that she did not consider it to be a significant risk.
A report by Imperial College London found no evidence that Omicron had a lower severity than the Delta variant. booster vaccines would be important in helping to mitigate the impact of the virus.
Whatever the severity of the Omicron variant, doctors are grateful for the range of treatments now available to help patients. The anti-Inflammatory dexamethasone was the first drug to save lives.
The staff at the hospital say the speed at which the vaccines and new treatments have been made available isphenomenal.
Professor Clive Kay, chief executive of the King's College Hospital, said one of his main concerns was ensuring there were adequate staffing levels to cope with demand. The number of staff who are isolated or off sick because of Covid has risen from 160 to 517 in just over a week. There were more than 200 nurses who were off sick last Friday.
Prof Kay said that it meant that we were having to look at scaling back some of the non-urgent routine activity.
Initial data showed that the most recent Covid admissions were not as sick as previous waves. He said at the peak of the first wave in spring last year, about one in four or five patients needed critical care.
The hospital staff are unsure of what the next few weeks and months will bring, but they are prepared for whatever comes through the doors.
Prof Kay said that they can't say that they won't be able to cope. We will just have to deal with it.
The view is endorsed by hospital staff. The matron said that they haven't turned a patient away. We will look after patients to the best of our ability.
