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In a packed intensive care unit, here’s a glimpse behind the lines of Britain’s Covid war.

Britain often tried to ignore the coronavirus as it advanced from Asia to northern Italy to the United States, leapfrogging political and geographic boundaries, carried by airline passengers and cruise ship vacationers just as the government entered the final phase of the departure from the European Union.

But today, the battle against the virus is still being waged on myriad fronts.

It is fought from emergency rooms to burial grounds, from the parlors of modest homes to the chanceries of state, from the soaring vault of a cathedral-cum-vaccination center to small-town mortuaries designed to cope with quotidian calculations of mortality, not the crushing onslaught of a pandemic.

The British government casts its fight in superlatives: the fastest authorization of vaccines, the speediest rollout of inoculations. But there is another, more macabre marker: a higher per capita death toll than any other large country in the world.

It took the emergence of a much more transmissible variant of the virus in the southeastern county of Kent in December to galvanize the country and its government. Last month, Sharon Peacock, the head of Britain’s genetic surveillance program, said the variant had “swept the country,” adding, “it’s going to sweep the world in all probability.”

For years, British physicians say, they have sought funds for the National Health Service to expand intensive care facilities, only to be “laughed out” of committee rooms, as one of them put it. And so, their charges cling to life in crammed theaters, many in induced comas.

Dr. Susan Jain, a specialist in anesthesia and intensive therapy, works in an intensive care unit in London that had to expand from 10 patients to 30, nearly all of them on ventilators. “We are very packed in our particular unit,” she said. “It isn’t quite as bad as MASH, but that’s what comes to mind.”

It is not a place Mohammed Malik, 53, a retired I.T. project manager who was discharged in February, recommends visiting. “The I.C.U. is the last place you want to end up,” he said. “There’s nothing after the I.C.U. other than death.”

While he was there, one of his five daughters, Miriam, who was pregnant, was found to be infected, too. Her baby was delivered by cesarean section; his daughter was in a coma for 10 days. “It was the darkest of all the darkest moments,” he said.

They survived. But even now, he said, he experiences strange anomalies, like the absence of a detectable pulse on his right side. He had nothing but praise for his doctors.

As elsewhere in Europe, the virus seemed to retreat in late summer. Travel restrictions were eased. In England, the government even offered cash incentives for people to eat out in crowded restaurants. Then the caseload curve veered sharply upward again.

“I never thought it would be so severe,” Dr. Jain said.

In this wave, she noted, the patients seemed to be younger, possibly because of the new variants, though the government’s data was inconclusive. But the “root is probably in the way it has been handled centrally,” she added, referring to officials’ having shied away from harsher measures earlier.


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