Hospitals across the UK are being told to prepare to face the same Covid pressures as the NHS in London and south-east England.
London's weekly rate is 858 per 100,000 people, double the rest of the UK.
Professor Andrew Goddard, president of the Royal College of Physicians, said the new more-infectious variant of the virus was spreading across the country.
Case numbers were "mild" compared to where they would be in a week, he said, and doctors were "really worried".
It comes as almost half of the major hospital trusts in England are said to be dealing with more Covid-19 patients than at the peak of the first wave in April, with the NHS having its "busiest winter ever".
On Friday, hospital bosses warned the next few weeks would be "nail-bitingly difficult" as cases of the new variant - which is up to 70% more infective - topped 50,000 for the fourth consecutive day.
Prof Goddard told BBC Breakfast: "There's no doubt that Christmas is going to have a big impact, the new variant is also going to have a big impact, we know that is more infectious, more transmissible, so I think the large numbers that we're seeing in the South East, in London, in south Wales, is now going to be reflected over the next month, two months even, over the rest of the country."
He said hospitals in London and the South East were "really feeling" the pressure, and healthcare professionals feared there was "still a long way to go".
"It seems very likely that we are going to see more and more cases, wherever people work in the UK, and we need to be prepared for that."
Pressure has been so great on hospitals in London and south-east England that some patients have been moved out of the area.
Dominic Harrison, director of public health for Blackburn and Darwen, said a decision on a new lockdown had to be decided "in the next week" - instead of waiting for the North to get to the same rates as London and the South East "and 'call it late' which has been our pattern of response too often".
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London's Nightingale emergency hospital is ready to admit patients, the NHS has said, while other sites currently not in use are being readied.
Prof Goddard said it was vital the public did not "let their guard down" and continued to follow government guidelines, including wearing a face mask, maintaining social distancing and washing hands.
"Until the vaccination hits and does its job - that's what our best defence is going to be," he said.
Dr Ami Jones, an intensive care consultant in Wales, told BBC Breakfast that "hospitals are absolutely bursting", adding that a quarter of her staff were currently off sick or self-isolating, making managing patients even more challenging.
"We don't have the support we had in the first wave," she added. "I've just got my bare bones staff now.
"When we see the daily figures - we know that will sting us in about 10-12 days' time in the hospital. We are not even at day 10 post-Christmas yet and it's already exceedingly busy.
"We are going to get to the point where we physically don't have the staff to look after people safely anymore."
Dr Jones also urged the public to "please just obey the rules", adding: "Stop mixing with other households because it is spreading like wildfire - and we haven't got much more space in the hospitals left."
'All in this together'
Meanwhile, the US government's top infectious diseases expert, Dr Anthony Fauci, has said he does not agree with UK plans to give as many people as possible a first dose of the Pfizer/BioNTech coronavirus vaccine, while delaying second doses.
Dr Fauci said the US would not be adopting a similar strategy.
But Prof Anthony Harnden, deputy chair of the Joint Committee on Vaccination and Immunisation, defended the move.
He told BBC Radio 4's Today programme the vaccine "offers 90% protection for one dose" and that patients he had seen had accepted the decision, as the priority was "to get as many people vaccinated in the elderly and vulnerable community as possible".
He said: "I think the country is all in this together. And, I think we really, really want to pull together to try and do the best strategy possible."
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2021-01-02 12:59:00Z
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