Northwick Park hospital in Harrow is battling to cope with the outbreak.
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Twenty-one patients died between Friday and Monday at Northwick Park Hospital and Ealing Hospital, which are both managed by London North West University Healthcare NHS Trust in Harrow, north-west London.
A senior nurse at Northwick Park Hospital said a shortage of equipment and trained clinicians meant doctors had already had to make tough decisions about rationing care to those most likely to survive.
Medical staff have already built an extra six-bed intensive care ward after the hospital ran out of space.
The senior nurse, who did not want to be named, told The Telegraph: "This Covid is really, really bad. We need help.
"We're already in an Italy situation, where the doctors are deciding who should be put on the ventilators and who should not.
"Most of the people who passed away have been elderly with various comorbidities [the presence of additional conditions], but we also have younger people struggling to breathe and they will sometimes get the ventilators first.
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"We also don't have enough people who can operate the machines, and that is a real problem.
“Many of our colleagues are falling ill with flu-like symptoms, but they still come into work because otherwise who will look after the patients?
"The very old ones die even with the ventilator. Some of them are conscious, but others are so confused because of the lack of oxygen. All we can do is try and make them comfortable."
Previously the hospital had declared a “critical incident”, saying it was overwhelmed with COVID-19 patients as London is the worst-hit area in the UK.
A senior director at another London acute trust told HSJ: “Given we’re in the low foothills of this virus, this is f***ing petrifying.”
A message sent to staff at Northwick earlier this week said: “I am writing to let you know that we have this evening declared a ‘critical incident’ in relation to our critical care capacity at Northwick Park Hospital.
“This is due to an increasing number of patients with Covid-19.
“This means that we currently do not have enough space for patients requiring critical care.
“As part of our system resilience plans, we have contacted our partners in the North West London sector this evening to assist with the safe transfer of patients off of the Northwick Park site.”
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