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An Imperial College London study warned this week the R rate of transmission for the virus in the capital is 2.86. This is the highest level in England and could result in each infected person passing the virus on to almost three others. The surge in transmission could put London at risk of being placed into Tier 3, which is the highest level of restrictions in the UK.

Gary Marlowe, chair of the British Medical Association’s London regional council, warned the crisis was “catastrophic” for London.

He said: “Having the estimated highest R rate in the country, meaning that each infected person in London is infecting up to three more, is potentially catastrophic for our capital city.

“Local health services are already buckling under the pressure and in some areas of London we are now seeing a steep rise in the number of patients needing intensive care.

“And while death rates are currently low, we know the number of people who will lose their lives is likely to rise.”

Guidance for office workers and tourists hit hospitality and retail businesses in the City greatly during the first national lockdown this year.

This has sparked fears people will not adhere to the rules of staying at home a second time.

Catherine McGuinness, policy chair at the City of London Corporation, the Square Mile’s governing body and landlord of Leadenhall market, said: “Hibernating through the winter is not an option for our economy.

“We are building up an economic crisis which has the potential to impact more people than the health one. It is vital that we protect livelihoods as well as lives.”

Mr Marlowe also warned placing London into the highest tier could lead to “grave consequences”.

He added: “People cannot live in a never-ending Tier 3. They need to know when an end is in sight and what to do to keep infection rates low.

“If such a strategy is not put in place by government, the cycle will keep repeating itself and the consequences will be grave.”

London Mayor Sadiq Khan said he believed people in the capital could face a tough winter.

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He said: “Nobody wants to see more restrictions – but this is deemed to be necessary in order to protect Londoners’ lives by myself, London council leaders and by ministers.”

Stricter measures may result in backlash in London, as businesses could suffer financially this winter.

Under Tier 3 restrictions, people must not socialise with anybody they do not live with indoors or most outdoor hospitality venues.

Pubs and bars must also close unless they operate as a restaurant.

Mr Khan also backed a national lockdown to help control the spread.

Home Secretary Priti Patel yesterday said the Government would not rule anything out.

She said: “Well I think at this stage of course we can rule nothing out.

“We are a Government that is focused on making sure that we stop the spread of this virus, and also we protect public health.

“So we have been using, and we are using and we will continue to use, every single means available to us to do exactly that.”

Communities Secretary Robert Jenrick added coronavirus rates are in a “bad place” all over the country.

But he said the Government is resisting another national lockdown.

He told Sky News: “We will continue with our localised but proportionate approach on taking action where the virus is strongest, but you can see from those figures that the virus is in a bad place in all parts of the country.

“The approach of trying to bear down on it where it is most concentrated, I think, continues to be the best way forward because despite the fact the virus is rising across the country it is very concentrated in some places nonetheless.”

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