The ambulance service in northwest England, one of the areas worst-hit by COVID-19, declared a major incident on Monday over an exceptionally high volume of calls, especially in the Greater Manchester area. The service said it had received 2,266 emergency calls in eight hours, an increase of 36% compared with the same time on the previous Monday. It said COVID-19 accounted for approximately 15% of the activity. Declaring a major incident is a formal step allowing managers to take measures such as calling in extra staff. The North West Ambulance Service declared the incident over after about 2-1/2 hours. “The major incident was managed in accordance with our usual protocols but we continue to urge the public to only call us if their condition is life-threatening or potentially life-threatening,” the service said. Greater Manchester is currently at the “Very High” alert level, the highest of three bands in England’s new tiered response to the coronavirus outbreak. A sharp rise in infections has led the government to impose a second national lockdown in England, which is due to come into force on Thursday. The United Kingdom has the highest COVID-19 death toll in Europe.