Plan B is a go. And just like that, more mask mandates, working from home guidance and, most controversially, vaccine passports have been rushed in. While we wait, of one thing we can be certain: Covid decisions this winter are once again being determined by one institution. While we wait to find out more about the omicron variant, there is one thing we can say with certainty: our future rests once again on the ability of the National Health Service to handle an uptick in cases.

When the pandemic struck and the airwaves were filled with images of overwhelmed Italian hospitals, the decision was taken that, whatever it took, the same thing could not be allowed to happen here. Lockdown was necessary, we were told, “to protect the NHS”. Ever since then, the levels of “non-pharmaceutical intervention” to which we have been subjected has been contingent on the capacity of the health service.

With that in mind, delivering on its promises to increase that capacity should have been the Government’s utmost priority throughout this year. Boris Johnson and Rishi Sunak were certainly not shy of pouring more money into the health service.

Yet the NHS has a guilty little secret, rarely talked about given its status as the national religion. On many metrics, capacity has not been rising – it’s actually been falling.

Take the number of hospital beds. This is estimated to have fallen since 2019, with the number of NHS England overnight beds currently down by roughly 5,000. More space has been needed on wards to allow for social distancing, but in a struggle to restructure or to get creative with the defunct Nightingale hospitals (which sat largely empty at the height of the crisis), capacity has been reduced instead. The number of adult critical care beds in England did manage to spike during the most difficult months of the pandemic. Predictably, though, that success has been squandered, and the increased capacity has not been sustained.

Any system would struggle to deal with Covid. Indeed, we have seen waves of the virus cause problems for different countries’ healthcare provisions at different times. But it is a particular disaster for a system that, like the NHS, is designed to operate at near peak capacity as a means of achieving “efficiency”.

Covid patients only occupy 5 per cent of NHS beds currently: far below the peak occupancy of over 30 per cent in January, and hardly the definition of threatening to overwhelm the service. But with only 5.2 per cent of beds currently available for new patients (again, a design feature of the NHS), the combination of even a small drop in bed capacity, plus a new variant or even a severe wave of another illness such as flu, risks putting the service – and our freedoms – in jeopardy.

And what of healthcare workers, who are also key to increasing capacity? Understaffing has been a persistent problem for the NHS, and it may soon worsen. A survey from the British Medical Association last year suggested that up to one in three doctors may retire early, due to stressful conditions – not made any easier by low compensation relative to counterparts in more market-based systems.

Then there is the problem of access. The over-75s may be first in line for their Covid boosters, but other serious ailments are more likely to be overlooked as GPs have been instructed to forgo their yearly health checks to speed up the jabs. Whatever capacity the NHS does or not have means little to patients who cannot even manage to see their GP, gatekeepers for the wider health service, thanks to the crackdown on access to primary care.

There are now nearly six million patients caught in the Covid backlog and forced to wait months on end to have serious conditions treated.

The first lockdown was justified on the grounds that we needed time to increase NHS capacity and stop the system from being overwhelmed. Then vaccines were – rightly – touted as the answer to our Covid woes. Now, however, we are told that a heavily vaccinated Britain no longer marks the end of the crisis but, as Professor Chris Whitty put it on Wednesday night, a “transition period”, with some way still to go. That means all of us still being asked to sacrifice our liberties for the sake of a health service that has not only failed to progress but in many ways moved backwards.

Even accounting for the blind love so often offered up to the NHS, there is surely only so long this can be tolerated.