“The lesson is to go earlier than you think you want to, a bit harder than you think you want to and broader – waiting and watching simply doesn’t work”.

The words of chief scientific adviser Sir Patrick Vallance, speaking to MPs in January, are front of mind for some today as NHS leaders call for the government to bring in new Covid restrictions.

The creeping rise in Covid cases to more than 40,000 a day for the past week, the highest rate in Europe, has promoted a new wave of warnings, although hospital admissions have not surged.

Downing Street insists it is not time for ‘Plan B’, which Boris Johnson set out in mid-September, for a return to mask-wearing indoors, guidance to work from home, and possibly the use of vaccine certificates in some venues.

The NHS Confederation, which represents health service organisations, have sounded the alarm saying the NHS may “stumble into another crisis” if restrictions are not brought in.

The group’s Chief executive Matthew Taylor suggested restrictions on indoor gatherings could be needed as every part of the service is “already stretched”.

I’m told there are no plans to introduce any of this, although ministers concede it will be a “tough winter” and the situation is being closely monitored.

COVID-19: Minister rules out another lockdown as PM is urged to enforce ‘Plan B’ to avert winter crisis

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COVID-19: How would Plan B tackle rising coronavirus cases – and when could it come into force?

And nor is another winter lockdown on the cards, says the business secretary, who told Sky News “I can rule that out”, adding that even talking about lockdowns and travel restrictions is “completely unhelpful”.

But at the top of government there is now concern that the vaccine shield may be cracking because of the slow roll-out of booster jabs for the vulnerable and over-50s – and surging cases in children.

I’m told by a government source the plan is to “collectively throw everything” at improving this, given millions of over-50s and those in vulnerable categories are yet to have them.

The message of a TV advertising campaign to be launched on Friday is that waning immunity is a real and present danger and boosters are essential.

Older people and their relatives report that access to booster jabs is a problem, with GPs having to offer a full range of normal care while also doing boosters.

Speeding up the vaccination of young teenagers is also a priority. The health secretary announced yesterday that 12 to 15-year-olds would be able to access jabs at walk-in centres during half term, rather than at school, which was welcomed by teaching unions.

Latest COVID news as UK cases and deaths rise

If this all feels like the slow-motion Covid disaster of the run-up to last Christmas, the dynamics are different.

There is interest in why Covid cases have been falling in Scotland – and whether it is to do with mask-wearing or the earlier start of the school term.

Labour would support additional measures and have called on the government to give stronger signals on the importance of mask-wearing. Shadow Chief Secretary to the Treasury Bridget Philipson said it was worth taking early steps “to stop things from escalating”.

That point – always obvious in hindsight – is the key decision of the coming weeks.

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