The four Black Country boroughs are among the 20 worst places for cases in the country, with the new faster-spreading coronavirus strain believed to be responsible for four in every five infections in some areas.
Although cases are dropping, this is happening at a slower rate than in the rest of the country, which NHS chiefs believe is down to the late arrival of the new variant in the region.
Dr Lisa McNally, Sandwell’s director of public health, said the new strain, which emerged in the South East in September, is thought to spread “70 per cent quicker” than the previous one and urged people to be “more stringent.”
“The latest data I have had shows this new variant is actually responsible for about 80 per cent of infections in Sandwell,” she said.
“When you consider, before Christmas, it was very much in the minority of infections. It has gone from 10, 20 per cent, up to over 80 per cent in about a month really.”
In Staffordshire the new strain is responsible for about three quarters of new cases, says director for health, Dr Richard Harling.
He said it was now “more important than ever” to follow the rules and get tested regularly. “We are at a crucial stage in this pandemic and cannot afford to be complacent,” he added.
Wolverhampton recorded its highest weekly number of Covid deaths last week, at 97 – higher than at any point in the pandemic's first wave last spring.
Councillor Ian Brookfield, leader of Wolverhampton Council, said the number of cases in the city was still "staggeringly high".
He warned that "massive pressure" on local health services would "continue for a long time", and added: "We're not out of the woods yet."
Sandwell has the second highest rate in the country at 833.3 cases per 100,000 people, with 2,737 new cases in the seven days to January 21.
Wolverhampton is fourth on 752.2 after 1,981 cases were recorded, and Walsall is ninth on 700.9 (2,001 new cases). Dudley’s rate of 631.8 cases per 100,000 people (2,032 cases) puts it 19th in the country.
South Staffordshire now has the highest rate in Staffordshire at 541.6 cases per 100,000 people, after 609 new cases were recorded.
According to official figures there have now been nearly 104,000 deaths since the pandemic began.