The coming days will be “absolutely critical” for the NHS in the West Midlands with hospitals “struggling” under rising Covid variant case rates, health chiefs have said.

Doctors, nurses, GPs and health workers are on the front line in a race against time to see if lockdown measures and the ever-increasing tempo of the vaccine rollout can head off increasing infections.

Sally Roberts, chief nursing officer for the Black Country and West Birmingham clinical commissioning group (CCG), said the next two weeks would be crucial and it was “tough out there” on wards, and in primary care.

She said the region’s Nightingale hospital at the Birmingham NEC remained on a 72-hour standby, but urged the public not to “get fixated” on the facility and rather act now by following lockdown rules, in order to help medics.

Health chiefs have said “all indicators” were the new more highly contagious coronavirus variant had taken root in the region, and particularly Wolverhampton, Sandwell and Birmingham.

Mayor of London Sadiq Khan declared “major incident” on Friday as he said Covid was “out of control” in the capital, with Public Health England (PHE) figures showing the case rate was now above 1,000 infections per 100,000 people.

Speaking on a video briefing to regional reporters, West Midlands Mayor Andy Street said the seven council areas that make up the regional conurbation of three million people were “behind London” but rates had “moved up”.

He  said: “What we have got to do is every day that goes by over the next two critical weeks is look to see if the curve is beginning to change; for infections first and then, for hospitalisations.”

He added only by analysing that data would it be possible to see if lockdown measures were working.

“Every single citizen has a contribution to make to that outcome,” he said.

“(We have to) watch every piece of data coming through as to whether all of our caring services can move through the huge challenge we now have.”

He added: “The next seven days will be absolutely critical in this fight.

“The data only reflects people’s behaviour – that is mission critical to the outcome.”

Katie Spence, of PHE in the West Midlands, said the increase in infections was “very worrying” with “far more cases of the new highly-transmittable version of the virus among that”.

In PHE’s most recent weekly figures, 31,297 of England’s newest infections were in the West Midlands – just under 10% of the total number for the country in the same period.

Ms Spence said: “This rapid rise is highly concerning and it will sadly mean yet more pressure on our health services while we’re in the depths of winter.

“This dramatic increase in cases and deaths should be  bitter warning for us all that we must not forget the basics; the lives of our friends and families depend on it.”

The latest figures available through NHS Digital in the week to January 5 for the seven West Midlands areas make for sobering reading, with infections increasing across all boroughs.

Wolverhampton’s rate was 947 cases per 100,000 people, Sandwell 863, Walsall 744, Dudley 679, Birmingham 669, Coventry 503 and Solihull 499.

However, Ms Roberts, from the CCG, said the pace of the vaccine rollout was “accelerating” with “tens of thousands” of doses now being delivered to her area alone.

She added the mass vaccination centre at Millennium Point in Birmingham would begin administering vaccine to appointment-only patients, from Monday.

All four NHS trusts in the Black Country and West Birmingham sub-region and all primary care sites, including doctor’s surgeries, were now administering jabs including the Oxford vaccine, said Ms Roberts.

Deliveries for care home residents started after Christmas, while final preparations were now under way to open a second, previously announced, mass vaccination centre in the region at the Black Country Living Museum, in Dudley.

Asked if the region would need to ramp up vaccinations to 300,000 people per week to meet the mid-February target for the four most vulnerable groups, Ms Roberts said the figure was “about right”.

She added GPs would also move from a “push” to a “pull mechanism” of vaccine supply by about January 25, “which we’re really looking forward to getting”.

Under that new system, practices request supplies they need for coming days through a national system – rather than the current top-down arrangement of supplies being “pushed” to surgeries.

“That will help hugely for our modelling and in terms of our delivery,” she added.

Meanwhile, Cllr Ian Ward, Labour leader of Birmingham City Council, said he had been pleased by the Government response to a Midlands cross-party letter to the Health Secretary asking for “regular and timely” updates on the vaccine rollout.

He praised Matt Hancock’s “prompt reply” adding he was “delighted” that Mr Street had, following talks with the Vaccinations Minister Nadhim Zahawi, been able to “guarantee a smooth supply of vaccines” to the region.