Coronavirus: Regional tier system must be strengthened after England leaves lockdown, says medic

England’s system of regional coronavirus restrictions may have to be tightened when lockdown ends next month, after evidence that the basic tier 1 restrictions have “very little effect” on the course of the disease, one of the government’s top medical advisers has said.

Prime minister Boris Johnson has repeatedly said that he wants to return to the tier system after 2 December, when England’s four-week lockdown is due to expire.

But health secretary Matt Hancock today warned that it was “too early” to know whether the state of the pandemic will allow significant relaxation of the restrictions, which currently require pubs, restaurants and non-essential shops to close and ban most social contacts, or whether large swathes of the country will be left in lockdown by a different name.

Epidemiologist Susan Hopkins, a director of Public Health England, indicated that it may not be possible to go back to the previous three-tier system introduced in October, under which the bulk of England was place in the “medium” tier 1.

Tier 1, which required the public to observe the “rule of six” limit on social gatherings and imposed a 10pm curfew on hospitality venues, had little impact on the spread of coronavirus, she said.

Speaking at a 10 Downing Street press conference, she hinted strongly that the exit from lockdown will have to take England into the tighter restrictions of tier 2, where indoor gatherings are banned, or tier 3, where pubs, bars and other facilities are closed and social mixing can take place only in parks and other public open spaces.

“I think we have recognised that the tiering of the country has had a different effect in each area,” said Dr Hopkins.  

“Tier 3, and especially tier 3-plus in the north has had an effect on reducing the numbers of cases in the northwest. And we can see in the northwest a declining number of cases now.

“Tier 2 seems to hold in some areas and not so well in others. It depends on how fast transmission’s occurring and how well the individuals in the population are taking that advice in.

“We see very little effect from tier 1. And I think when we look at what tiers may be there in the future, we will have to think about strengthening them in order to get us through the winter months until the vaccine’s available for everyone.”

Dr Hopkins was speaking as the latest figures showed 168 deaths reported in the most recent 24-hour period as cases of coronavirus continue to rise 11 days into England’s national lockdown.
Mr Hancock said daily deaths averaged 413 over the last seven days, up from 332 in the previous week, while the average number of new cases rose from 22,443 to 25,329 over the same period.

The health secretary said that the time-lag between infections, positive tests, hospitalisations and deaths meant that the cases currently coming to light reflected the state of the virus at the time lockdown was imposed on 5 November.

And Dr Hopkins said it would be another week before a judgment could be made on how much impact the stringent measures are having on damping down the outbreak.

“It is too early for us to know what the number of cases will be as we come to the end of the current lockdown,”said Mr Hancock.

“At the moment, most of the tests we’re getting back, and most of the positive cases, are from around the time the lockdown came in, so we are yet to see in the data – and it’s too early to expect to see in the data – the impact of the second lockdown.

“But we absolutely hope to be able to replace the national lockdown with a tiered system similar to what we had before.”

Dr Hopkins said: “We expect if the lockdown is working … that we will start to see cases decline over the next week.

“We expect it will be longer to see hospital admissions, another week or so, but I think as long as we start seeing cases decline then we can start making a judgment about what are the right decisions that we make and what the opening-up decisions that happen on 2 December.”

Earlier, Mr Hancock refused to rule out the possibility that large parts of England will remain under tight restriction when lockdown expires two weeks on Wednesday.

His comments were far gloomier than projections made by Boris Johnson, who has previously told MPs that he has “no doubt” that the restrictions will be eased and has promised them a vote on new arrangements in the week before current rules lapse.

Asked on BBC Radio 4’s Today  whether lockdown would in fact end on the planned date or whether large parts of the country would have to continue with the same restrictions under a “rebadged” scheme, Mr Hancock replied: “It is it is too early to say, I'm afraid.

“We've seen in the last week that there is still a very high number of cases. But we do absolutely want to come out of this national lockdown. That is our goal.

“Everybody has a part to play in making that happen, of course, following the social distancing rules and – the critical thing – isolating if you need to."