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Health workers are "back in the eye of the storm" as coronavirus cases rise at the end of the "toughest year", NHS England's chief executive has said.
Sir Simon Stephens paid tribute to NHS staff in a new year message, saying they had "brilliantly" cared for 200,000 severely ill Covid-19 patients.
He said that by late spring he expected the NHS to have offered vaccinations to all vulnerable people.
That offered "the biggest chink of hope" for 2021, Sir Simon said.
With coronavirus infections at what public health officials called an "unprecedented level" and a new variant spreading, hospitals are close to the April peak of Covid-19 patients.
In a message to staff recorded at a vaccination centre, Sir Simon said Covid-19 meant 2020 had probably been "the toughest year most of us can remember".
"That is certainly true across the health service where we have been responding to the worst pandemic in a century," he said.
Sir Simon said: "Many of us have lost family, friends, colleagues and - at a time of year when we would normally be celebrating - a lot of people are understandably feeling anxious, frustrated and tired.
"And now again we are back in the eye of the storm with a second wave of coronavirus sweeping Europe and, indeed, this country."
The NHS England chief executive said the pandemic had shown "sometimes the worst of circumstances bring out the best in people".
He said that was demonstrated in the work of intensive care nurses and doctors, paramedics, therapists, porters, cleaners and other staff as the health service treated 200,000 severely ill Covid-19 patients as well as those with other conditions.
They were supported by "the superb work of neighbours and volunteers and carers and care home staff" as well as by the advances in medical science, he said.
'Enormous debt of gratitude'
Sir Simon suggested that the scientific breakthroughs that led to effective and safe vaccines offered hope for 2021.
"We think that by late spring with vaccine supplies continuing to come on stream we will have been able to offer all vulnerable people across this country Covid vaccination," he said.
"That perhaps provides the biggest chink of hope for the year ahead."
The vaccine roll-out depends on the "dedication and commitment" of more NHS staff, such as GPs, pharmacists, nurses and others, Sir Simon said.
He said: "Therefore now is the right time, I believe, on behalf of the whole country, to record our enormous debt of gratitude and our huge thanks."
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