Health chiefs in the UK have urged the government to legally enforce some of the COVID-19 prevention measures, such as mandatory face coverings in enclosed spaces, as coronavirus infections in Britain continue to spike over the 40,000 mark daily.
The NHS Confederation, a membership body of the country's National Health Service (NHS), said a back-up strategy, or "Plan B plus", is required as preemptive action over winter when the health service is already stretched due to seasonal flu and other diseases.
The warning comes as the UK hit another daily high of 43,738 COVID cases on Tuesday and 223 COVID deaths, which is the highest daily coronavirus death figure since March.
"It is time for the government to enact Plan B of its strategy without delay because without preemptive action, we risk stumbling into a winter crisis. Also, health leaders need to understand what a "Plan C" would entail if these measures are insufficient," said Matthew Taylor, chief executive of the NHS Confederation.
"There is a crucial opportunity for the public to pull together and show extra support for the NHS by behaving in ways that will keep themselves and others safe and also safeguard stretched frontline services for those most in need... The government should not wait for COVID infections to rocket and for NHS pressures to be sky high before the panic alarm is sounded," he said.
The UK government has set out a COVID-19 winter strategy, which focused on building the population's defences through vaccinations and other pharmaceutical interventions.
Within that, a "Plan B" would be enacted if pressures on the NHS were deemed to be at risk of becoming unsustainable. Additional measures could include clear communications to the public that the level of risk has increased, introducing certificates for people's COVID-19 vaccine status, and legally mandating people to wear face coverings in certain settings, in addition to considering asking people to work from home if they can.
The NHS Federation said on Tuesday that many of these measures, particularly around mask-wearing and COVID-19 certification, are already common in parts of Europe where the prevalence of the disease is lower.
"Alongside this, the NHS Confederation believes that this should go further with a "Plan B plus'', calling on the public to mobilise around the NHS and do whatever they can to support frontline services this winter," it noted.
However, the government maintains that it is not yet time to enact Plan B and has called on eligible over-50s to come forward for their booster vaccine shots, as they receive their notifications from the NHS.
"I don't want to inject any hint of complacency but I think so far our approach is working," UK Business Secretary Kwasi Kwarteng told the BBC on Wednesday, in reference to the health chiefs' intervention.
He pointed to lower rates of hospital admissions and deaths than in earlier waves of infection and also that deaths are well below the winter months' peak.
Under the government's ongoing Plan A for dealing with COVID in England this winter, COVID-19 top-up booster doses are to be offered to around 30 million people in the over-50s category, a single dose of a COVID-19 vaccine to be offered for healthy 12 to 15-year-olds and people are "advised" to wear face coverings in crowded places.
If these measures are perceived as not being enough to prevent excessive load on the NHS, then steps like making face coverings mandatory in some settings, asking people to work from home and introducing vaccine passports could be considered as a Plan B.