Dr Helen Carter said infection rates across the region were rocketing towards levels last seen at the height of the crisis, with cases now rising rapidly amongst the elderly.
And she said the situation was likely to deteriorate further if people did not follow the rules, with harsher lockdown restrictions put in place and an increase in the number of Covid deaths.
Dr Carter also said that hospital admissions were rising steeply, people requiring treatment for serious health conditions should not let a fear of coronavirus put them off from attending hospital.
As of October 21 there were 1,105.4 cases per 100,000 people in the West Midlands, while the number of deaths has risen steadily in recent weeks.
Dr Carter, the deputy regional director with Public Health England (PHE) in the West Midlands, said: "We’ve been in the grip of this pandemic for the last six months and we know people are getting tired of all the changes they’re having to make in their daily lives, but we’re now at a tipping point similar to March and we have to act to prevent history repeating itself.
"We’re in this for the long haul, and the more people that ignore the guidance and don’t observe the local restrictions in place – the worse things will become, the more restrictions will be put in place in the West Midlands, and more people will die across the region."
Dr Carter said there had been large increases in young people getting the virus, particularly in student populations, and that cases involving people aged over 60 were now "rising rapidly".
"For the most part, young people have mild symptoms, but it’s their parents, aunties, uncles and grandparents who are in danger of becoming seriously ill with this virus," she added.
"So, even if you’re not worried for yourself – think of those other people, who are older, have long-term health conditions, and who might not survive Covid-19.
"We can only fight this virus together."
She urged people to do their bit to support the NHS as it faces winter pressures, and added: "We need people to come forward for that care when they need it – don’t let the fear of coronavirus put you off getting essential tests and treatments."