Boris Johnson Announces Three-tier Coronavirus Strategy for England

Tighter restrictions have been confirmed by the Government as the Prime Minister confirmed a ‘three-tier’ system for England to classify the severity of rates of COVID-19.

From Wednesday, regions will be classed as either ‘medium’, ‘high’, or ‘very high’ risk.

The details, announced in the Commons by Boris Johnson, came as the NHS said that Nightingale hospitals in Manchester, Sunderland, and Harrogate were being asked to mobilise in the next few weeks in response to growing rates of SARS-CoV-2 infections in the North West and North East.

Speaking at a Downing Street news briefing earlier, Prof Jonathan Van-Tam, England’s deputy chief medical officer, warned that additional hospital admissions and deaths were now ‘baked in’ as the virus spread from younger to older age groups.

What the Three Tiers Mean

Speaking ahead of his evening televised address to the nation, Mr Johnson said he did not believe another national lockdown was appropriate but that he was not prepared to “let the virus rip”.

The three-tier system would mean:

  • Medium: Covering most of England, national restrictions such as the ‘rule of six’ and the 10pm curfew for pubs, bars, and restaurants would apply

  • High: People in areas including Greater Manchester and Birmingham would be prevented from socialising with other households indoors

  • Very High: People would be banned from socialising with other households both indoors and in private gardens, while bars and pubs would be closed unless they were able to operate as restaurants

The Prime Minister said that agreement had been reached with leaders in Merseyside for the Liverpool city region to move into the ‘very high’ alert level. There, gyms, leisure centres, betting shops and casinos would also be told to close.

Mr Johnson said that discussions were ongoing with other leaders in the North West, North East, and Yorkshire and Humber over lockdown restrictions.

Mr Johnson told the Commons: “They, like us, like everyone in this House, are grappling with very real dilemmas, but we cannot let the NHS fall over.”

He warned MPs that “the weeks and months ahead will continue to be difficult and will test the mettle of this country”.

A debate and a vote on the new restrictions will take place at Westminster. The Government has promised to keep the measures under continual review.

In reply, Labour leader Keir Starmer said it was clear that the country faced a “critical moment” in efforts to contain the SARS-CoV-2 virus.

However, he added: “I’m now deeply sceptical that the Government has actually got a plan to get control of this virus, to protect jobs, or regain public trust.”

Cases of Coronavirus ‘Heating Up’

Illustrating the latest situation this morning with a series of maps and graphs, Prof Van-Tam said latest data showed COVID-19 cases were “heating up” south of the West Midlands and East Midlands.

“It has changed in a matter of just a few days, and that is clearly of concern to me,” he said.

Prof Van-Tam said that while the resurgence of cases in Northern England earlier in the autumn had mainly been driven by people aged 20 to 29, there was now a spread into older age groups, including people aged 60 and over.

This was of significant concern, he said, because “the elderly suffer a much worse course with COVID-19. They are admitted to hospital for longer periods, and they are more difficult to save”.

‘A Very Hard Winter’ 

Speaking at the same Downing Street briefing, Prof Steve Powis, NHS England’s medical director, said “we now have more patients in hospital with COVID-19 than we did before the Government announced [its] restrictions of 23 March”.

He described as “wishful thinking” suggestions that elderly people could be “fenced off” from the risk of the virus, saying there were already “steep rises” in the number of over-65s, and particularly over-85s, being admitted to hospital.

Announcing plans to reactivate the three Nightingale hospitals in the North of England, Prof Powis said: “The support they provide and how they will be used will be up to local clinicians; whether it’s for COVID-19 patients requiring ventilation, for patients recovering from COVID-19, or in order to maintain essentially elective and diagnostic services for patients with conditions other than COVID-19.”

He also announced an enhanced testing regime for NHS staff in areas hardest hit by a rise in infection rates. “We will be introducing, with tests provided by the Test and Trace service, regular testing for staff in these high risk areas, even when they don’t have symptoms,” he said.

Speaking at the same briefing, Dr Jane Eddleston, a consultant in intensive care medicine at Manchester University NHS Foundation Trust, urged people to take the virus “extremely seriously”. She said that the North West of England currently had around 40% of all COVID cases.

Dr Shaun Fitzgerald from the Royal Academy of Engineering, and visiting professor at the University of Cambridge, said Prof Powis’s assessment of the number of people currently in hospital with COVID-19 was “concerning”. He said: “A scenario of the NHS being completely overwhelmed is something we can’t allow, and unfortunately it seems inevitable that more stringent restrictions on our movements will be needed.”

The Royal College of Physicians (RCP) welcomed the rollout of more testing for NHS staff in high risk areas. Prof Andrew Goddard, president of the RCP, said that “from what our members have been telling us, we know for certain that we are now in the second wave of COVID-19”.

He warned it was going to be “a very hard winter”.

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