More people are in hospital now (3,451) than on the first day of the National lockdown on 23rd March 2020. (3,097).
NHS Nightingale Hospitals are being put on standby in Manchester, Sunderland, and Harrogate.
Monday 12th October 2020 is the day much of the country had been waiting for. Prime Minister Johnson was due to outline the three-tier system with increasingly more severe restrictions which will be deployed for the next weeks and months in the UK notably with lockdown areas.
Will it be decisive? Will it be clear? Will it be effective?
Three C’s + D + V.
Professor Jonathan Van-Tam, Deputy Chief Medical Officer, did a warm-up routine in the morning and gave his thoughts. He spoke about pubs, saying that we should think about the Japanese approach, which is the three C’s:
He then added a couple of letters of his own:
D for Duration
And V for volume of noise which encourages people to shout and sing and dance etcetera particularly if fuelled by alcohol.
Pubs and restaurants have all these issues, which can create an environment for spreading a virus.
A level playing field.
Education Secretary Gavin Williamson took the opportunity to sneak out an announcement that A levels and O levels will be going ahead in 2021, but they will be delayed by three weeks.
Prime Minister Boris Johnson spoke in the afternoon to the house of commons and already set the context. He closed his speech in the House as follows:
‘This is not how we want to live our lives, but the narrow path we have to tread between social and economic costs of a full lockdown and the massive human and indeed economic cost of an uncontained epidemic. I must warn the House the weeks and months ahead will continue to be difficult and will test the mettle of this country. I have no doubt at all that together we will succeed.’
7 pm Press Briefing – PM Boris Johnson.
Prime Minister Johnson gave a press briefing alongside the Chancellor Rishi Sunak and the Chief Medical Officer Professor Chris Whitty.
We learn that the three tiers are to be as follows:
Tier 1 Medium
Follow the rule of six if meeting indoors or outdoors.
Pubs and restaurants to shut at 10 pm.
Tier 2 High
No household mixing indoors.
Rule of six will apply outdoors.
Tier 3 Very High
No household mixing indoors or outdoors.
Pubs and bars not serving meals will be closed.
Guidance against travelling in and out of the area.
It was expressed that for the ‘very high’ category, the restrictions are not limited to those stated. Other measures dictated by local authorities can and will be added to meet local issues and compliance.
A more detailed table on quite what this means is below:
Tier 1 Medium
For areas where national restrictions continue to be in place:
All businesses and venues can continue to operate in a COVID secure manner, other than those that remain closed in law such as nightclubs.
Certain businesses selling food or drink on their premises are required to close between 10 pm and 5 am. Businesses and venues selling food for consumption off the premises can continue to do so after 10 pm as long as this is through delivery service, click-and-collect or drive thru.
Schools, universities, and places of worship remain open.
Weddings and funerals can go ahead with restrictions on the number of attendees.
Organised indoor sport and exercise classes can continue to take place provided the rule of six is followed.
People must not meet in groups larger than 6, indoors or outdoors.
Tier 2 High
For areas with higher level of infections.
People must not meet with anybody outside their household or support bubble in any indoor setting, whether at home or in a public place.
People must not meet in a group of more than 6 outside, including in a garden or other space.
People should aim to reduce the number of journeys they make where possible. If they need to travel, they should walk or cycle where possible, or to plan ahead and avoid busy times and routes on public transport.
Tier 3 Very High
For areas with a ‘Very High’ level of infections.
The Government will set a baseline of measures for any area in this local alert level. Consultation with local authorities will determine additional measures.
The baseline means the below additional measures are in place:
Pubs and bars must close and can only remain open where they operate as if they were a restaurant – which means serving substantial meals, like a main lunchtime or evening meal. They may only serve alcohol as part of such a meal.
Wedding receptions are not allowed.
People must not meet with anybody outside their household or support bubble in any indoor or outdoor setting, whether at home or in a public space. The Rule of Six applies in open public spaces like parks and beaches.
People should try to avoid travelling outside the ‘Very High’ area they are in, or entering a ‘Very High’ area, other than for things like work, education, accessing youth services, to meet caring responsibilities or if they are in transit.
People should avoid staying overnight in another part of the UK if they are resident in a ‘very high’ area or avoid staying overnight in a ‘very high’ area if they are resident elsewhere.
Locations and categories:
For completeness I have outlined those areas which are subject at this juncture to the 3 different tiers:
Tier 1 - Medium
Everywhere in England apart from those places listed below.
Tier 2 - High
Cheshire: Cheshire West and Chester, Cheshire East
Lancashire: Lancashire, Blackpool, Preston, Blackburn with Darwen, Burnley.
West Yorkshire: Leeds, Bradford, Kirklees, Calderdale, Wakefield.
South Yorkshire: Barnsley, Rotherham, Doncaster, Sheffield.
North East: Newcastle, South Tyneside, North Tyneside, Gateshead, Sunderland, Durham, Northumberland.
Tees Valley: Middlesbrough, redcar and Cleveland, Stockton-on-Tees, Darlington, Hartlepool.
West Midlands: Birmingham, Sandwell, Solihull, Wolverhampton, Walsall.
Leicester: Leicester, Oadby and Wigston.
Nottingham: Nottinghamshire, Nottingham City.
Tier 3 – Very High
Liverpool City Region: Liverpool, Knowsley, Wirral, St Helens, Sefton, Halton.
The Prime Minister began the briefing by saying that the infection rate had gone up 4 times in 4 weeks.
The measures would be reviewed every four weeks.
The Chancellor spoke about the Job Support Scheme and other initiatives including a cash grant of £3,000 per month for businesses who have to close.
The Treasury has given £3.7 billion to local authorities since March and announce an extra £1 billion to support them.
Professor Chris Whitty Showed some slides to try to give context to the three-tier system, the highlights of which are below:
An estimated 224,000 people within the community (excluding care homes, hospitals, and other institutional settings) have had COVID-19 from 25th September 2020 to 1st October 2020.
The geographical spread of infections is as outlined in the Tiering lists above, but it is noticeable that cases are increasing down the spine of England, with those over 40-year-olds increasing from an initial younger base.
Author’s retrospective note. It looks as though this whirlwind spread of cases in recent weeks was the start of the UK ‘Kent’ mutation (later called delta) that we were unaware of at the time.
Professor Whitty re-iterated that flexibility exists in tier 3 for them to be tailor-made for local authorities to add to the baseline restrictions.
‘Because of progress made in developing therapies, vaccines, diagnostics and other measures we will go into next winter in a much better place than we are this winter.’
He was asked by a journalist if he felt that the measures were strict enough. He clearly does not, and that is where the flexibility in tier 3 comes into play. He said,
‘I am not confident, and nobody is, that the base measures are sufficient. A full lockdown works. Letting it go increases the numbers.’
He went on to say that the challenge was finding the answer in between a full lockdown and local measures.
My city of Nottingham has been placed into tier 2. Despite having the highest infection rate in the UK, we avoid Tier 3, for now at least. Why not Tier 3? The hospitals are not full, and the cases have not yet spread to older people; most of the cases are in young people, notably students returning to Nottingham University. There is a huge 1,510 people who have tested positive for COVID-19 at the University, up from 425 students last week.
Will this spread to the rest of us? Probably. 523 of these students with the virus are resident in student halls, but 677 live in private properties. Another 310 live in ‘purpose-built student accommodation.’
Twenty staff also have the virus.
Quote of the day.
‘Fools ignore complexity. Pragmatists suffer it. Some can avoid it. Geniuses remove it.’ – Alan Perlis.