Another 13m could fall to Tier 4 despite the vaccine breakthrough

Virtually all of England faces a brutal lockdown by spring after Matt Hancock stepped up pressure and warns that vaccines are the only hope to end the devastation.

The Minister of Health announced that three-quarters of the country will be in Tier 4 by midnight, with the rest of the Southeast, Midlands, Northeast, parts of the Northwest and parts of the Southwest joining the top tier.

All remaining areas – with the exception of just 2,000 people in the Isles of Scilly – will be expanded to Tier 3, including Liverpool, which was previously seen as an example of how to deal with the disease.

Wales, Scotland and Northern Ireland are already in the midst of their own gloom amid fears over the contagious "mutant" tribe that is in turmoil.

The gravity of the situation was underscored tonight when the UK recorded a further 50,023 cases – a quarter jump from the same day last week – and 981 deaths, the highest since April.

Mr Hancock made it clear that hopes for a return to normal now depend on a massive ramp up in vaccine adoption, and requested regulatory approval for Oxford / University's AstraZeneca push, which can beat the crisis by spring.

Even if the government succeeds in boosting vaccinations to two million doses a week, it will still take months to supply enough populations to safely relax restrictions.

In another dire signal, Boris Johnson warned in a roundtable interview this afternoon that given the positive news about vaccines, the public should in no way believe this is over as the virus is really rising.

"I know it's difficult for people, but it really has to be done," he told ITV.

He told the BBC: "There are many reasons for people to be optimistic about spring, but we need to focus on fighting the disease for now."

Pointing to rapidly increasing infections believed to be caused by the mutant Covid, Mr Hancock told Commons, "Sharply increasing cases and subsequent hospitalizations show that action must be taken where the virus is spreading. "

He said the majority of cases added yesterday "are likely the new variant."

Mr. Hancock added: “Unfortunately this new variant is now spreading in most of England and the cases are quickly doubling.

"It is therefore necessary to apply Tier 4 measures to a larger area, including the remaining parts of the Southeast as well as large parts of the Midlands, the Northwest, the Northeast and the Southwest."

Mr Hancock relayed more bad news, saying that most of the country will be under the first two brackets.

"Even in most of the non-Tier 4 areas, cases are rising, so there is a need to apply Tier 3 measures more broadly – including Liverpool and North Yorkshire," he said.

& # 39; The rest of Yorkshire will remain in Tier 3. These changes will take effect at 12:01 am tomorrow morning.

& # 39; The new variant means three quarters of the population will now be in Tier 4 and almost all of the country will be in Tier 3 and 4.

"And I know that Tier 3 and Tier 4 measures are placing a significant burden on the people and especially the businesses affected, but I fear that given the number of cases we've seen, it is absolutely necessary."

Education Secretary Gavin Williamson is expected to announce changes to plans for the schools' return later in January. Secondary education is expected to keep classrooms closed longer while testing systems are set up.

About three quarters of England – more than 44 million people – will be under Tier 4 restrictions, according to the latest system review announced in the House of Commons this afternoon.

Another 14 million will be in Tier 3 and only the Isles of Scilly will be in Tier 1.

Speculation of a "Tier 5" raid, which could include tougher measures like a curfew, is also mounting, although Mr Hancock made it clear it would not be the case today.

Around 24 million people, including London, much of the south and east, are already subject to the strictest stay-at-home instructions.

The government has been pressured to act as hospitals across England and has warned of increasing strains on services due to the Covid-19 patient numbers, which had peaked during the pandemic. A record high of 51,135 additional cases was reported on Tuesday. along with 414 deaths.

In the final twists of the pandemic:

• Secondary schools are expected to close on January 11th at the earliest when there are peak cases among teenagers – but scientists want them to close by February. Boris Johnson will make the final decision today;
• The WHO has warned that the coronavirus is not necessarily "the big one" and that a deadlier pandemic could hit the globe.
• Chief Medical Officer Chris Whitty received praise after being seen on the respiratory station of a London hospital over Christmas weekend.
• The 74-year-old author Michael Rosen says his Covid battle in the intensive care unit "Near Death" made him almost blind in one eye, sometimes deaf and dizzy.
• An A&E nurse tested positive for Covid-19 eight days after receiving the Pfizer vaccine.
• The intensive care units in London have asked major Yorkshire hospitals if they would agree to accept some patients as hospital admissions to the wards are past the peak of the first wave.
• 51,135 more cases and 414 deaths were reported on Tuesday.

The approval of the AstraZeneca vaccine was a much-needed boost after the country posted a record 50,000 daily cases yesterday.

Mr. Hancock insisted that a swift introduction of the prick now offers "high confidence" that the pandemic will be over within months.

Britain has ordered 100 million doses of the vaccine with supplies due today or tomorrow and the first bursts will begin on Monday.

Two doses are required to get long-term protection, but Mr Hancock said the stocks could be spread further than expected as the MHRA recommended increasing the gap between the first and second bursts from four weeks to 12 weeks extend .

The same rule will be applied to the Pfizer push approved back in early December, increasing the prospect that soon more Britons could get a single dose to ease the pressure on the NHS from rampant infections. Tony Blair has called for all available single-dose supplies to be used, with the booster lagging behind.

Mr. Hancock dodged, however, saying if he believed the number of animals vaccinated could be increased to the two million a week that scientists believe is necessary.

And in addition to the positive news, he warned urgently that the country is still facing an intensification of the brutal lockdown.

Mr Hancock said today's decision means the UK can "speed up the adoption of vaccines" and "bring forward the day we can get our lives back to normal," adding "we will be able to do so by spring." to get out of it. "

He told Sky News: & # 39; It's going to be some difficult weeks.

“We can see the pressure on the NHS right now and it is absolutely essential that people follow the rules and do everything possible to stop the spread, especially the new variant of this virus which is transmitted so much faster.

“But we also know that there is a way. The vaccine offers that route. We all have to keep our cool in the coming weeks. & # 39;

When asked if he could provide a schedule for vaccinating under-50s with no pre-existing conditions, Hancock told Times Radio, “It depends on the speed of manufacture. I wish I could give you an appointment now, your invitation. but we can't because it depends on the speed of manufacture.

& # 39; This product is not a chemical compound, it is a biological product so it is difficult to make and that is the rate limiting factor for its introduction.

“Now that we've delivered two vaccines, we can speed up. How fast we can accelerate depends on how fast the manufacturers can produce.

“But I can tell you that I now have a very high level of confidence that by spring enough of those who are vulnerable will be protected so that we can get out of this pandemic situation.

"We can see the way out and the way out is guided by this vaccine. So this is so good news for everyone."

Former Prime Minister Blair welcomed that the government appeared to be following its plan to use the available supplies to give a single dose to as many people as possible.

"The trial results suggest that all available vaccines are used to vaccinate people with the first dose without holding back a second dose for each person, which is overwhelming," he said.

“The first dose provides a high level of immunity – enough to stop hospital admissions – and the second dose is definitely most effective two to three months after the first. Until then, we will have additional vaccine supplies to cover second doses.

In addition, the government should urgently consider: Accelerating the vaccination program. Of course, 1 million vaccinations a week is remarkable by normal standards.

However, given the transfer rates and the cost of locking, we have a lot more to do. Given the advantages of the AstraZeneca vaccine in terms of ease of administration – like the flu shot – we should certainly use all potential resources available, including all pharmacies, occupational health capacities, and those necessary for quick training on how to administer vaccines and increase vaccine rates vaccination is suitable.

"And we should think about making the plan more flexible, with vaccination of groups most likely to transmit the virus and hotspot areas, and age and vulnerability."

The Lockdown Tiers bombshell news was received with grim acceptance tonight.

Liverpool Metropolitan Area Mayor Steve Rotheram said: “Although our area is leading the way in many medical developments in the fight against Covid, we have seen recent increases in transmission rates in all parts of our metropolitan area, which has resulted in a worrying positive increase Cases.

At the same time, cases in the rest of the country have risen at alarming rates and threaten to push our NHS to its limits.

"Getting included in Tier 3 today is something none of us wanted, but I hope these new measures will help slow and quickly contain the spread of the virus."

He promised to support local companies and called for more government support.

He added, “We have seen over the past 10 months that restrictions can only hold the virus in for a limited period of time.

"That is why I have asked ministers to come up with plans to speed up the introduction of the vaccine quickly so that we can finally return to some kind of normalcy at the earliest possible opportunity."

Yesterday's infection count of 51,135 is the highest number officially registered by the Ministry of Health within a single 24-hour period and represents a sharp increase of 44 percent compared to 36,804 last Tuesday.

The Oxford / AstraZeneca push, dubbed the 'Game Changer', has been given the go-ahead by the Medicines and Health Products Regulatory Authority (MHRA).

A spokesman for the Department of Health and Social Affairs said: “The government today accepted the recommendation from the Medicines and Health Products Regulatory Authority (MHRA) to approve Oxford University / AstraZeneca University of Covid-19 vaccine for use.

"This follows rigorous clinical trials and a thorough analysis of the data by experts at MHRA who have concluded that the vaccine meets its strict safety, quality and efficacy standards."

AstraZeneca said it intends to ship millions of cans in the first quarter of next year as part of an agreement with the government to ship up to 100 million cans.

Its managing director Pascal Soriot said: “Today is an important day for millions of people in the UK who will have access to this new vaccine. It has been shown to be effective, well tolerated, easy to manage and is supplied by AstraZeneca at no profit. & # 39;

In a statement, Health Secretary Matt Hancock said: “This is a moment to celebrate British innovation. Not only are we responsible for discovering the first treatment to reduce mortality from Covid-19, but this vaccine is being made available at low cost to some of the poorest regions in the world to protect countless people from this terrible disease.

& # 39; It's a tribute to the incredible British scientists at Oxford University and AstraZeneca whose breakthrough will help save lives around the world. I would like to thank every single person who has been part of this UK success story. While it is a time of hope, it is so important that everyone continue to do their part to fight infection. & # 39;

And Professor Andrew Pollard, Director of the Oxford Vaccine Group and Principal Investigator for the Oxford Study, said: “The regulator’s assessment that this is a safe and effective vaccine is a milestone and a confirmation of the tremendous efforts of a dedicated international team of researchers and our dedicated study participants.

"While this is only the beginning, we will begin to stay one step ahead of the pandemic, protect health and the economy as the vulnerable everywhere are vaccinated, as many as possible as soon as possible."

Data published in The Lancet Medical Journal in early December showed that the vaccine was 62 percent effective against Covid-19 in a group of 4,440 people who were given two standard doses of the vaccine, compared with 4,455 people who received one Placebo drug was administered.

1,367 people who were given half a first dose of the vaccine followed by a full second dose had 90 percent protection against Covid-19 compared to a control group of 1,374 people.

However, it turned out today that the idea of ​​giving half doses has been postponed, which raises some questions about the level of effectiveness.

The overall peer-reviewed data from the Lancet included complete results from clinical trials involving more than 20,000 people.

Among those given the placebo drug, 10 were hospitalized with coronavirus, including two with severe Covid, which resulted in one death. However, there were no hospital admissions or severe cases among those who received the vaccine.

Half the dose followed by a full dose came about as a result of an accidental dosing error.

However, the MHRA was made aware of what had happened and clinical trials for the vaccine were allowed to continue.

In an interview with the Sunday Times, Pascal Soriot, CEO of AstraZeneca, suggested that additional data submitted to the regulator showed that the vaccine might match the 95% effectiveness of Pfizer / BioNTech and Moderna vaccines.

"We think we figured out the formula for success and figured out how to get effectiveness that is everyone else's after two doses," he said.

On Monday, Calum Semple, professor of outbreak medicine at the University of Liverpool and a member of the Emergency Scientific Advisory Group (Sage), described the vaccine as a "game changer" but said it would be until the summer of enough people to get herd immunity – when the virus is circulating.

"To maintain herd immunity in the wider community through vaccination rather than natural infection, probably 70% to 80% of the population will need to be vaccinated, and unfortunately that will take us well into the summer," he said.

Prime Minister Boris Johnson chaired a meeting of the government's Covid-19 Operations Committee last night when the need for changes to the tiered system was agreed. Health Secretary Matt Hancock is expected to share the details with MPs later today.

Areas that may be moved from Tier 3 to Tier 4 due to rising fall rates include parts of the East Midlands such as Northamptonshire and Leicestershire and all areas of West Midlands Metropolitan County.

Hartlepool in northeast England, as well as a handful of areas in Lancashire – Blackburn with Darwen, Burnley, Pendle and Ribble Valley – could also be upgraded from Tier 3 to 4.

The Times also reported that ministers are also considering burdening parts of Southwest and Cumbria with the toughest measures in the country.

Saffron Cordery, deputy general manager of NHS Providers, warned that options were tightening and that moving areas to the highest level was necessary.

“In some parts of the country, the pressure on the NHS is not increasing sustainably. Fortunately, trust in other areas has helped. As the virus spreads rapidly alongside increasing winter pressures, the options are narrowing.

“We urgently need to be one step ahead of the outbreak. The Covid 19 Tier Review offers the opportunity to do so. It will take difficult decisions that will take millions of people to the highest level.

"The government must act boldly, quickly and clearly to contain the threat from Covid-19."

Figures from NHS England showed there were 21,787 patients in NHS hospitals in England at 8 a.m. on Tuesday, compared with 20,426 on Monday and 18,974 at the first wave peak on April 12th.

Five of the seven NHS regions in England are currently reporting record numbers of Covid-19 hospital patients: East England, London, Midlands, South East England and South West England.

The other two regions, North East and North West England, remain below the highs set in mid-November.

Meanwhile, the number of additional laboratory-confirmed cases registered in the UK in a single day hit a new record Tuesday, surpassing 50,000 for the first time to 53,135.

However, authorities cannot be sure if this will be the UK's worst pandemic day yet, as mass testing was not introduced in the UK until May. However, it has been estimated that in the late period there were potentially 100,000 cases per day at the peak of March and early April.

Public Health England chiefs admitted that "some" cases announced yesterday will be the result of a delay in reporting over Christmas, but warned that the number was mainly "a reflection of a real surge". Data shows that around 40,000 cases on Tuesday came from samples taken on or after Boxing Day in England.

The government said an additional 414 people died within 28 days of testing positive for Covid-19 on Tuesday, bringing the UK total to 71,567.

Yesterday's 414 deaths are 40 percent lower than the 691 recorded the same day last week. However, it can take several weeks for infected patients to get sick, meaning the daily death toll will inevitably rise over the next 14 days.

A senior doctor said some trusts in London and the Southeast are considering the option of pitching tents outside of hospitals – something usually reserved for sudden events like terrorist attacks or industrial disasters – to screen patients.

The number of Covid-19 patients in London hospitals is now higher than at the height of the first virus wave, at 5,371 as of 8 a.m. on Tuesday, according to NHS England.

During the first wave, the number of patients in London peaked at 5,201 on April 9.

Ambulances lined up outside hospitals on Tuesday, including the Royal London Hospital in Whitechapel and the Queen & # 39; s Hospital in Romford, both in east London, as well as the Queen Elizabeth Hospital in Birmingham. A junior doctor in the capital said his hospital was "aggressively overburdened". of Covid-19 patients.

Dr. Susan Hopkins, Senior Medical Advisor for Public Health England, said the "unprecedented levels" of Covid-19 infection across the UK were "extremely worrying".

More than six million people in east and south-east England face the highest restrictions on Saturday, which means 24 million – 43% of the population – are now affected.

Ministers are also reportedly considering plans to force areas into "Tier 5" measures, with the closure of secondary schools. However, it is expected that they will expand Tier 4 in the "immediate future".

The effects of Tier 4 measures will be announced within days as it can take up to two weeks for someone infected with the virus to show symptoms and receive a test. However, it is feared that the holiday season could cloud the water due to delays in reporting positive results during the holiday season.

It is believed that scientists leading the government through the pandemic have advised Mr Johnson to take stricter measures than those introduced in November.

Whitehall sources have told The Telegraph that Tier 4 could expand across the country after today's review.

Around 24 million people in London, the South East and East of England are already among the toughest Tier 4 curbs.

"I would expect more than half of England to get into Tier 4, but I wouldn't be surprised if two-thirds end up in the top tier," a health official told the publication.

& # 39; There is also real concern about the South African variant which seems to be spreading quickly. Unfortunately, more action is needed to address rising cases across the board. & # 39;

Lockdown measures are also in place in the other three home countries after mainland Scotland introduced level 4 restrictions for three weeks from Saturday and a similar home stay order in Wales.

Northern Ireland has also launched a new six-week lockdown and the first week measures are the toughest yet. A curfew is in operation from 8 p.m., from this point on the shops are closed and all indoor and outdoor gatherings are prohibited until 6 a.m.

Dr. Susan Hopkins, Senior Medical Advisor at Public Health England, commented on the cases on Tuesday: “We continue to see unprecedented levels of Covid-19 infection across the UK, which is of particular concern, especially as our hospitals are hardest hit susceptible. While the number of cases reported today (Tuesday) includes some from the festival season, those numbers largely reflect a real increase.

“Today more than ever, it is more important than ever that we continue to work together to stop the spread of the virus, reduce the rate of infection and protect the most vulnerable and the NHS.

“A critical part of this is that we each obey the restrictions in force, however difficult it may be at this time of year. It is important that we reduce our contacts, especially the mixing between households. We need to follow the basic measures – wash hands, wear a mask and keep your distance from others. & # 39;

One of Number 10's scientific advisors warned yesterday that England must be thrown into a third national shutdown to prevent a "disaster" in the New Year.

Professor Andrew Hayward, an epidemiologist at University College London and a member of SAGE, warned the country of a "very dangerous new phase of the pandemic".

He urged ministers to "learn the lessons from previous waves" when the government was criticized for being too slow to block and to act early this time.

Urging the government to take swift action to curb the spread of the virus, Professor Hayward said this morning, “I think we are entering a very dangerous new phase of the pandemic and we will need determined, early national action to prevent it a disaster in January and February.

“A 50 percent increase in portability means that previous restrictions that were previously applied no longer work. Hence, Level 4 restrictions are likely to be required or even higher.

"I think we're really looking at a situation where we're approaching lockdown, but we need to learn the lessons from the first lockdown."

Professor Hayward said the surge in cases was "largely due to the new, more contagious variant of the coronavirus" and suggested that returning students to school would mean tighter restrictions in other areas of society.

He said: & # 39; We had control measures that previously controlled the old variant are not sufficient for this variant.

"So if we want to control the new variant, we need much stricter restrictions."

Professor Hayward said he thought schools would have to return "maybe a little later" but that would mean, "we have to increase strict restrictions in other areas of society to pay for that".

“We have to stay in more or less similar kinds of messages from home unless you really have to, so there is that combined with incentives for testing, incentives for isolation – those kinds of things that get us through Next wear will be a few months while we vaccinate as many people as possible. & # 39;

In response to Professor Hayward's comments, the Prime Minister's official spokesman replied, “I would like to reiterate what we did during the pandemic when we took action based on the latest scientific and medical evidence.

“You saw that we did this all of December when we moved areas to Tier 4 precisely to reduce virus transmission and to try to keep the virus R-rates in high areas Decrease prevalence.

"As I said, we will obviously be constantly reviewing the measures and of course constantly reviewing the latest scientific and medical data."

The government hasn't ruled out stricter new Tier 5 restrictions that could shut schools and universities down. or the prospect of a new national lockdown in January.

Fears that a third national lockdown may be on the way increased yesterday when Cabinet Minister Michael Gove didn't reject the idea of ​​moving the entire country to Tier 4.

He said, “We are reviewing what levels parts of the country should be based on scientific evidence.

“The Joint Biosecurity Center will make a recommendation to the ministers, but I cannot anticipate that as it obviously has to be a judgment based on the medical situation. The NHS is under pressure and difficult months are ahead. & # 39;

According to an analysis of the official MailOnline numbers, more than 90 percent of councils in England saw their coronavirus outbreaks increase before Christmas.

The data suggests that Cumbria could be the next area to be later classified in Tier 4 today.

In drei der sechs Bezirke des Tier 2-Bezirks hat sich die Covid-Infektionsrate – die Anzahl der Neuerkrankungen pro 100.000 Menschen – in der Woche bis zum 22. Dezember verdoppelt.

Statistiken des Gesundheitsministeriums zeigen, dass Eden, in dem rund 50.000 Menschen leben, in der letzten Woche eine Rate von 422,5 hatte – von 200,9 in den letzten sieben Tagen. Anfang des Monats lag sie bei 41,3.

Dies bedeutet, dass der Bezirk, zu dem auch Penrith gehört, mehr bestätigte Covid-Fälle für die Bevölkerungszahl verzeichnete als mehrere Räte, die bereits unter Tier 4 gestellt wurden, einschließlich Teilen von Surrey, Berkshire und Oxfordshire.

Allerdale (163,7) und Copeland (64,5) sahen im gleichen Zeitraum ebenfalls Ausbrüche mit doppelter Größe. Der letztere Stadtteil Cumbrian weist jedoch immer noch die niedrigste Infektionsrate für Coronaviren in England auf.

Und Barrow-in-Furness – ein weiterer Teil des Landkreises – war eines von nur 27 Gebieten, in denen Woche für Woche weniger Fälle verzeichnet wurden. In den 288 anderen Bezirken Englands blieben die Ausbrüche stabil oder wuchsen. Bei 35 Behörden verdoppelten sich die Infektionen im gleichen Zeitraum.

Lokale Gesundheitsbosse befürchten, dass das schnelle Wachstum in Fällen in Teilen des an Schottland angrenzenden Landkreises durch dieselbe Coronavirus-Mutation verursacht wird, die sich schnell in den Heimatbezirken ausbreitet.

Boris Johnson versprach, dass die Zuweisung der Stufen auf dem „gesunden Menschenverstand“ basieren würde, wobei die JBC – eine Whitehall-Organisation, die über die Whack-a-Mole-Strategie entscheidet – anhand von fünf Kriterien entscheidet, welche Bereiche die strengsten Einschränkungen benötigen.

Dies umfasst die Gesamtinfektionsrate für jedes Gebiet, die Anzahl der Fälle in den über 60-Jährigen und die Geschwindigkeit, mit der der Ausbruch wächst oder schrumpft.

Die Beamten untersuchen auch die Positivitätsrate der Tests – die Anzahl der bestätigten Infektionen pro 100 durchgeführten Tests – und den Druck auf die örtlichen Krankenhäuser.