The emergence of the omicron SARS-CoV-2 variant raises the possibility of rapid increases in COVID-19 admissions and intensified pressure on elective care. We used NHS England activity data from the period following the end of the first COVID-19 wave (ie, from September, 2020, onwards) to estimate how increases in the number of hospital beds occupied by COVID-19 inpatients at any one time might affect elective surgery activity in England over the coming winter months. We calculated the potential shortfall in projected elective surgery activity from December, 2021, to February, 2022, compared to the same period in 2019 before the COVID-19 pandemic. Full methodology is described in the appendix.

If the number of COVID-19 inpatients in England were to remain at the level seen in the first 2 weeks of October, 2021, when, on average, 5003 patients were receiving treatment for COVID-19, we project that 51 204 (95% CI 44 219–58 343) elective surgical procedures would take place per week (figure). If the average number of COVID-19 inpatients were to increase to 10 000, 47 348 (39 206–56 641) elective surgical procedures would take place per week. If the number of COVID-19 inpatients were to increase to the levels seen in the first COVID-19 wave (in April, 2020, there was an average of 16 090 COVID-19 inpatients in England at any one time), elective surgical procedures would decrease to 43 225 (33 859–54 633) per week.