On the sunny afternoon of Wednesday last week, roughly 50 health personnel on duty at Millennium Hall, once a venue for festivity, were rushing to the patient wards through the donning area. Every inch of their bodies was covered by stuffy personal protective equipment (PPE). Some were sweating profusely even before entering to see the sick and, yes, the dying, too. It showed how much strain they were under.

Stretching across the facility lie 38 wards segregated by gender, classified alphabetically. Each has a capacity of around 14 beds, and a third of the wards were occupied by patients, some on the verge of death, others fighting to recover. Almost all were on oxygen support.

The centre's four ICUs were even more chilling. Each contains a dozen or so beds, all equipped with ventilators and a team of seven or eight medical staff trying to keep patients breathing with help from the machines. Strikingly, the centre's ICU units outnumber the combined capacity of the city's four major hospitals, including Black Lion and St. Paul.

All told, 181 patients were hospitalised at the Millennium Hall on September 15, 2021. The ICUs are accommodating 47 patients, most of them unconscious. Young and old, they were lying on their beds, unaware of what was going on around them but separated from their loved ones. Eight were on tracheal intubation (TI) - a stage doctors say very few ever make it through.

Only three or four people have survived this stage since this makeshift started operation, according to Dejene Damtew (MD), a ward supervisor at the centre. He gazed at a 58-year old woman lying intubated on an ICU bed.

"She could be a mother," he said, sounding resigned to the possibility that she may not make it out of the centre alive.

Designed to accommodate around 1,000 patients, the Millennium COVID-19 Care Centre (MCCC) hosted just 12 patients two months ago. All were stable, leading to speculation that authorities were considering shutting the centre down as case numbers dropped to their lowest levels in over a year. No deaths were recorded on June 30, marking the first time since mid last year.

The scenes are worlds apart now. Cases and deaths have been climbing since mid-August, flagging the pandemic's third wave, a year and a half since it first took hold. The filling wards and intensive care units coincide with the emergence of the COVID-19 delta variant, which the US Centre for Disease Control (CDC) describes as more than twice as contagious as previous variants.

This month alone, over 22,000 cases have officially been registered, marking a 18pc positive rate, a state of affairs that coincided with the confirmation of the presence of the delta variant in Ethiopia. Some 415 people have lost their lives, while thousands of severe cases were recorded over the same period. By mid-September, over 5,000 people had lost their lives to the pandemic in Ethiopia.

To the medical staff like Dejene working at the Millennium Hall and 31 other health centres providing COVID-19 treatment in Addis Abeba, this development means a return to the heavy workload, relentless pressure, long and sleepless hours and the personal risk they were facing when the pandemic hit its peak between March and May this year. Dejene has been working in COVID-19 treatment since the very beginning of the pandemic. He started as a quarantine service provider at the Tulip Inn on Gabon Street in the Mesqel Flower area, one of the hotels chosen as a quarantine centre last year. He then moved on to Mekedonia Homes for the Elderly & Mentally Disabled before being transferred to the Millennium Hall just as the second wave took hold earlier this year.

Things were bad then; the highest-ever deaths in a single day clocked in at an unnerving 47 people on April 20, 2021.

It appears Dejene and doctors like him are back to square one lately. On September 13, just two days following the new year's celebrations, 38 deaths were recorded.

Even though the medical staff at the Millennium Hall were preparing for a third wave, what they are experiencing is more daunting than they had expected. Among the over 800 critical COVID-19 patients in the country, over 700 of them are in the capital.

Dejene observes young patients coming more often. One such patient was a stable 28-year man who collapsed and died just a half-hour after ending a video call with his mother.

A glance around confirms his observation.

Among those intubated was a 31-year man who had no trace of underlying health conditions but tested positive for COVID-19 when he went to a hospital looking for treatment for haemorrhoids. He was lying there as a doctor adjusted his ventilator and made his observations, unable even to see the person trying to save his life. The young man was one of many, but, sadly, it was no longer a surprise for the doctors and nurses working there, who report people in their mid-20s often succumb to the virus.

Dejene gave both the 58-year old woman the young man a day before they “X," a term the medical staff in the centre use to refer to ventilated patients who do not make it through. Sadly, he was right, both passed away hours apart the very next day. They were two of half a dozen people who die at the centre every day.

On the hopeful side, some recover as well.

One of them is Tesfaye Beyene, 48, a human resources professional who moved to the capital from Dessie six months ago.

He came to Addis Abeba with his wife and four kids. As the sole breadwinner, his hospitalisation has been hard on his family. Though his wife, sister-in-law, and their housemaid had all been infected, Tesfaye's condition deteriorated. Healthy before COVID-19 hit him, he had been at the centre for two weeks. He is well on the way to recovery and no longer requires respiratory support.

Tesfaye did not know how the virus made it into his household. But he admitted to not taking recommended precautions. Health professionals and officials alike see the surge in cases and death rates as directly tied to a drop in vigilance.

The public's response has not been adequate, says Mebratu Massebo (MD), national COVID-19 response task-force coordinator at the Ministry of Health. He asserts a lack of exemplary behaviour from political leaders, and the instability in the country has drawn attention away from the pandemic.

Mebratu's observations are obvious to anybody who has walked the streets of Addis Abeba over the past couple of months. Not many people wear face masks, large social gatherings are nothing out of the ordinary, and sanitiser has been all but forgotten. Transport service providers are also back to their usual practice of filling their vehicles up to the brim with passengers.

Biruk Wolde, a taxi driver working the route between Stadium and Shiro Meda, does not demand his passengers to wear masks.

"I got tired of it," was his response.

Of the 12 passengers on his minibus, only four were wearing their masks. Biruk himself wears a relatively clean surgical mask and keeps a bottle of sanitiser handy, while his conductor makes do with a torn-up cloth mask that he uses to cover only his chin.