Review of local restriction tiers: 17 December 2020

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The Rt Hon Matt Hancock MP

Local action is vital to our strategy of suppressing the virus, while protecting the economy, education and the NHS, until a vaccine can make us safe. Help is on its way thanks to the rollout of a safe and effective vaccine, but we are not there yet.

While we have moved to a localised approach through the tiers system, we have been clear that these must be tough, recognising that case rates are rising in many areas of the country, and our knowledge that the winter months are the most challenging for our NHS.

We have assessed each area individually, and as Monday’s decisions on Essex and today’s decisions on Waverley and parts of Hampshire show, we are prepared to move at a more localised level where the data and human geographies permit.

As set out in the COVID-19 winter plan, there are 5 indicators which guide our decisions for any given area, alongside consideration of ‘human geographies’ like travel patterns.

These are:

  • case detection rates in all age groups
  • case detection rates in the over 60s
  • the rate at which cases are rising or falling
  • positivity rate (the number of positive cases detected as a percentage of tests taken)
  • pressure on the NHS

While each metric is important in its own right, the interplay between each indicator for a given area is equally important, so a hard and fast numerical threshold on each metric is not appropriate.
These are not easy decisions, but they have been made according to the best clinical advice, and the best possible data from the JBC.

The regulations will require the government to review the allocations at least every 14 days. We will also take urgent action when the data suggests it is required, as we did on Monday.

The first formal review took place yesterday, and the allocations and a detailed rationale is published below.
I will also deposit the data packs used to inform these decisions in the libraries of both Houses.

These changes will be implemented from 00:01 on 19 December. This list will also be published on GOV.UK and a postcode checker will be available for the public to check what rules apply in their local area.

Area allocation tables

At the end of national restrictions case rates across England were falling. However, the most recent data now indicates that case rates are now stabilising or increasing across a large number of areas. Case rates in areas of northern England, which have previously been declining from very high levels are now flattening. There is a worsening and concerning epidemiological picture in London and parts of the South East and East of England.

We should not underestimate the challenge of the weeks ahead. Winter also brings additional challenges – rates are higher than they were in the summer, the colder season increases the transmission risk (people are more likely to be inside), the risk from other respiratory diseases is higher and pressures on the NHS are therefore inherently greater.

De-escalating areas now will likely lead to rising case numbers, and risks areas being rapidly re-escalated in December or in the new year. As a result a cautious public health approach has been adopted.

North West

Area Reason
Cheshire and Warrington

Tier 2 (High)


Since the end of national restrictions cases of the virus in Cheshire and Warrington have remained stable. Current case rates are broadly stable across Cheshire and Warrington though case rates in over 60s are increasing. Case rates remain greater than 100 per 100,000 in Warrington and Chester West and Chester. The epidemiology indicators remain too high for allocation to Tier 1, but do not justify inclusion at Tier 3.

COVID admissions in the Cheshire and Warrington area have reduced since the last review. The daily COVID bed occupancy is below the national acute hospital average and stable.

Cumbria

Tier 2 (High)


Since the end of national restrictions the situation in Cumbria has deteriorated from a relatively low numbers of cases. Case rates are broadly increasing across the region and have increased by more than 20% over the last 7 days in Barrow-in-Furness, South Lakeland, Carlisle and Eden. The epidemiology indicators remain too high for the area to be allocated to Tier 1, and while there is an upwards trajectory on some indicators in Barrow-in-Furness, South Lakeland, Carlisle and Eden, it does not currently justify inclusion in Tier 3.

COVID admissions, bed occupancy and critical care bed occupancy in the Cumbria and North East area are stable. In the Healthier Lancashire and South Cumbria STP there has been a slow increase in COVID admissions over the last 14 days. The daily COVID bed occupancy is above the national acute hospital average and continues to rise.

Greater Manchester

Tier 3 (Very High)


Since the end of national restrictions the situation in Greater Manchester has remained stable. Case rates remain greater than 150 per 100,000 in Bury, Manchester, Oldham, Rochdale and Wigan. Case rates in over 60s are decreasing across the majority of the area but are above 150 per 100,000 in Bolton, Bury, Manchester, Oldham and Rochdale. Case rates are lowest in Tameside, Trafford and Stockport but the most recent data indicates that case rates are now plateauing or increasing, therefore any de-escalation of these areas would likely lead to cases increasing, particularly given the interconnectedness of these areas with the rest of Greater Manchester. Positivity remains high across the area but is falling. The epidemiology indicators remain too high for de-escalation to Tier 2.

COVID admissions in the Greater Manchester declining. Bed occupancy in line with the national average and critical care bed occupancy is not rising but remains high.

Lancashire

Tier 3 (Very High)


Since the end of national restrictions there is a mixed, concerning picture across Lancashire. While case rates have now stabilised they are increasing in some areas in the most recent data that is subject to upward revision. The local authorities with the highest case rates are those located in the east of Lancashire that neighbour the north of Greater Manchester and West Yorkshire (Burnley, Blackburn with Darwen, Pendle, Rossendale, Chorley). Case rates in over 60s are increasing in several areas and remain above 150 per 100,000 in Blackburn with Darwen, Blackpool, Burnley, Chorley, Preston, Ribble Valley, South Ribble, Hyndburn and Wyre. Lancaster and Fylde have the lowest case rates in the area at 98 and 93 per 100,000, respectively. Case rates for these two local authorities have decreased but the trajectory based on the latest data indicates that case rates are now starting to stabilise or increase, therefore any de-escalation of these areas would likely lead to cases increasing. The epidemiology indicators remain too high for de-escalation to Tier 2, as it could lead to rising case numbers.

The local NHS has seen a slow increase in COVID admissions over the last 14 days. The daily COVID hospital bed occupancy is above the national average and continues to rise.

Liverpool City Region

Tier 2 (High)


Since the end of national restrictions the situation in Liverpool City Region has broadly improved. Case rates have decreased and are stable, including in the most recent data in all local authorities apart from the Wirral where a small increase is seen. Case rates remain greater than 100 per 100,000 in Halton, Knowsley and St Helens. Case rates in over 60s are increasing in Halton and Knowsley. The epidemiology indicators are too high for the area to move down to Tier 1 but the trajectory does currently not warrant inclusion in Tier 3.

COVID admissions in the Cheshire and Merseyside STP are reducing. The daily COVID bed occupancy is below the national acute hospital average and stable.

North East

Area Reason
North East 7 (LA7)

Tier 3 (Very High)


Since the end of national restrictions, the overall picture in the North East 7 has remained stable and case rates are broadly decreasing in Gateshead, Newcastle, North Tyneside and Northumberland. However, case rates are high and continuing to rise in South Tyneside which has the highest case rate in the area (272 per 100,000) and is seeing a deterioration across all epidemiology indicators. Case rates is lowest in Gateshead (94 per 100,000) however the trajectory of some neighbouring local authorities is concerning, with increasing case rates, therefore de-escalation of this area would likely lead to cases further increasing, particularly given human travel patterns across the region. De-escalating areas now could lead to further rises in case numbers, and overall, the epidemiology indicators are still too high for the area to move down to Tier 2.

COVID admissions, bed occupancy and critical care bed occupancy in the Cumbria and North East STP are stable.

Tees Valley 5 Local Authorities

Tier 3 (Very High)


Since the end of national restrictions, the situation in the majority of local authorities in the area have remained stable however the overall picture remains concerning. Case rates are broadly stable across the area though increases of over 10% have been seen in Redcar and Cleveland and Middlesbrough. Case rates in over 60s are now increasing across Hartlepool, Middlesbrough and Redcar and Cleveland and remain high. De-escalation too early poses a risk that transmission of the virus will increase rapidly and that this area is only in Tier 2 for a very short period of time before potential re-escalation is needed. The epidemiology indicators remain too high for allocation to Tier 2 and their trajectory is not consistently decreasing.

COVID admissions, bed occupancy and critical care bed occupancy in the Cumbria and North East STP are stable.

London

Area Reason
London

Tier 3 (Very High)


Since the end of national restrictions, the situation in London has deteriorated. Case rates in all ages are greater than 200 per 100,000 in 18 of the 33 local authorities. Case rates in all ages are also continuing to increase across 32 of the 33 London local authorities; the case rate is increasing by 30% or more over the last 7 days in 24 London boroughs. Case rates in those aged 60 and over are above 100 per 100,000 in 27 of the 33 local authorities and are increasing in the majority of boroughs. Positivity has increased across the majority of boroughs. The epidemiological picture continues to deteriorate especially in the most recent incomplete data (that is subject to upwards revision). The overall case rate is increasing exponentially in London.

The rate of increase of the epidemiology indicators is concerning and under emergency measures taken this week warranted immediate allocation to Tier 3 of the 32 London Boroughs and the City of London. The epidemiological indicators in London continue to deteriorate and the whole of London should remain at Tier 3.

The number of daily COVID hospital admissions continues to rise in London.

 

Yorkshire and Humber

Area Reason
South Yorkshire

Tier 3 (Very High)


Since the end of national restrictions South Yorkshire has improved marginally but is still of concern. Case rates are decreasing in Barnsley, Doncaster and Sheffield but remain over 150 per 100,000 in those aged over 60 in Barnsley and Doncaster. Rotherham remains of concern with case rates in all ages and in over 60s remaining over 200 per 100,000. The epidemiology indicators remain too high for de-escalation to Tier 2.

While COVID admissions, bed occupancy and critical care bed occupancy in the area are not rising, they are above the national averages.

The Humber

Tier 3 (Very High)


There is an improving picture across the majority of The Humber. Case rates are decreasing in all four local authorities and by 10% or more over the last 7 days in three of them. The case rate in Kingston upon Hull remains very high though falling. Case rates in over 60s are decreasing across the majority of the area though are increasing and remain high in Kingston upon Hull. Case rates are lowest in North East Lincolnshire and East Riding of Yorkshire, however in the most recent data, cases in the local authorities are stabilising or increasing, which is also seen in neighbouring areas, therefore any de-escalation of these local authorities would likely lead to cases increasing. Overall, the epidemiology indicators are still too high for de-escalation to Tier 2. De-escalation too early poses a risk that transmission of the virus will increase rapidly and that this area is only in Tier 2 for a very short period of time before potential re-escalation is needed.

Covid admissions in the Humber area are decreasing and bed occupancy is now below the national average.

West Yorkshire

Tier 3 (Very High)


Since the end of national restrictions the situation in West Yorkshire has improved though is still of concern. Case rates are decreasing by more than 10% in all five local authorities. Case rates in over 60s are stable or decreasing across the West Yorkshire but remain above 150 per 100,000 in Bradford and Wakefield. Positivity rates are falling across the area. The epidemiology indicators remain too high for de-escalation to Tier 2. De-escalating too early where there is still high prevalence in the community poses a risk that this area is only in Tier 2 for a very short period of time before re-escalation is needed

COVID admissions, bed occupancy and critical care occupancy in the area are falling steadily.

York and North Yorkshire

Tier 2 (High)


Since the end of national restrictions, the picture in York and North Yorkshire has improved. Case rates are broadly stable or decreasing. The overall case rate has decreased by over 10% in the last 7 days in Craven, Richmondshire, Hambleton and York. Case rates in over 60s are stable or decreasing across the majority of the area although rising from a low base in Hambleton and Ryedale. The most concerning area is Scarborough with the case rate for all ages now above 150 per 100,000 and rising. The epidemiology indicators are too high for allocation to Tier 1 but the trajectory does currently not warrant inclusion in Tier 3.

Covid admissions in the Humber, Coast and Vale area are decreasing and bed occupancy is now below the national average. Critical care occupancy is also reducing now.

COVID admissions, bed occupancy and critical care occupancy in the West Yorkshire and Harrogate area are falling steadily.

East Midlands

Area Reason
Derby and Derbyshire

Tier 3 (Very High)


Since the end of national restrictions, the situation in the majority of Derby and Derbyshire has deteriorated and the overall picture remains concerning. Case rates are increasing overall with rates in Derby, South Derbyshire, Bolsover and High Peak increasing by more than 25% in the last 7 days. Case rates are high and continuing to rise with large increases in South Derbyshire, Bolsover and Derby. Case rates in over 60s remain over 100 per 100,000 in five local authorities in the area and are rising in six. Positivity rates are stable or increasing in many places. Case rates are lowest in Derbyshire Dales (71 per 100,000), however the trajectory of neighbouring areas is concerning, with case rates now plateauing or increasing, therefore any de-escalation of this area would likely lead to cases increasing with the local authority. Overall, for Derby and Derbyshire the epidemiology indicators are still too high for de-escalation to Tier 2.

In the local NHS there has been an increase in Covid admissions, with bed occupancy at the national average. The proportion of critical care beds or beds with mechanical ventilation occupied by COVID patients remains high.

Leicester City

Tier 3 (Very High)


Since the end of national restrictions rates in Leicester City has remained stable though remain high. The case rate in all ages has been stable over the last 7 days but is still very high at 256 per 100,000. Case rate in over 60s is 227 per 100,000. Overall, the epidemiology indicators remain too high for allocation to Tier 2.

The number of daily COVID hospital admissions in the area continues to rise. The daily COVID hospital bed occupancy rate is above the national and rising. The proportion of critical care beds or beds with mechanical ventilation occupied by COVID patients also remains high.

Leicestershire

Tier 3 (Very High)


Since the end of national restrictions, case rates in all ages have increased across Leicestershire, with rates in Oadby and Wigston, Melton, Blaby, Harborough, Northwest Leicestershire and Hinckley and Bosworth increasing by more than 10%. Case rates in over 60s are also increasing in all local authorities and are over 150 per 100,000 in Oadby and Wigston, Melton, Harborough and Charnwood. Positivity is increasing across Leicestershire. The epidemiology indicators remain too high for the area to move into Tier 2.

The number of daily Covid hospital admissions in the area continues to rise. The daily Covid hospital bed occupancy rate is above the national average and rising. The proportion of critical care beds or beds with mechanical ventilation occupied by Covid patients remains high.

The hospital pressures have not been as strong a concern previously. However, this is now a material concern, suggesting we must act cautiously.

Lincolnshire

Tier 3 (Very High)


The overall picture is mixed but concerning in Lincolnshire. Case rates remain over 200 per 100,000 in Lincoln, Boston, West Lindsey and North Kesteven. The case rate in all ages has increased by 20% or more over the last 7 days in Lincoln and West Lindsey and decreased by 10% or more in Boston, East Lindsey, South Kesteven and South Holland. In the most recent few days the case rate is increasing, including South Holland. Case rates in over 60s remain greater than 150 per 100,000 in four local authorities in the area and are increasing in three. The epidemiology indicators remain too high for allocation to Tier 2.

The increasing rates of Peterborough to the south are also important to note for southern parts of Lincolnshire like South Holland and South Kesteven

In the Lincolnshire STP there have been high levels of activity but slowly diminishing admissions, bed occupancy and critical care occupancy.

Northamptonshire

Tier 2 (High)


The overall picture remains mixed in Northamptonshire. Case rates are broadly increasing across the area, but case rates in over 60s are decreasing across the majority of the area. Case rates in all ages have increased by 25% or more over the last 7 days in Northampton and both East and South Northamptonshire, with Northampton also showing a rise in all indicators. The epidemiology indicators do not currently warrant inclusion in Tier 3.

The number of daily COVID hospital admissions in the Northamptonshire STP continues to rise and has doubled in the last 14 days. The daily COVID bed occupancy is above the national acute hospital average and continues to rise.

Nottingham and Nottinghamshire

Tier 3 (Very High)


There is a mixed picture across Nottingham and Nottinghamshire. Case rates are broadly decreasing across the area though the case rate in all ages has increased by 10% or more over the last 7 days in Gedling, Ashfield and Mansfield. In the most recent few days, the case rate is now increasing. Case rates in over 60s remain greater than 150 per 100,000 in Bassetlaw and Mansfield but are broadly decreasing across the area. The most concerning local authority is Bassetlaw with the case rates in all ages at 223 per 100,000 and the case rate in people aged over 60 at 223 per 100,000. Rushcliffe has the lowest case rate (80 per 100,000), but the most recent data indicates this is increasing, therefore any de-escalation of the area would likely lead to cases increasing further. The epidemiology indicators are still too high for Tier 2. De-escalation too early now poses a risk that transmission of the virus will increase rapidly, and that this area is only in Tier 2 for a very short period of time before potential re-escalation is needed.

COVID admissions, bed occupancy, and critical care occupancy in the Nottingham and Nottinghamshire Health and Care STP remained stable over the last 14 days.

Rutland

Tier 2 (High)


Since the end of national restrictions, the situation has deteriorated with all epidemiology indicators showing an increase. Case rate has increased by more than 40% over the last 7 days and is now at 113 per 100,000. The case rate in over 60s is increasing but from a low base. Test positivity is also increasing. The epidemiology indicators and trajectory remain too high for allocation to Tier 1.

The number of daily Covid hospital admissions in the Leicester, Leicestershire and Rutland STP continues to rise. The daily COVID bed occupancy is above the national acute hospital average and continues to rise. The proportion of critical care beds or beds with mechanical ventilation occupied by Covid patients remains high.

West Midlands

Area Reason
Birmingham and Black Country

Tier 3 (Very High)


Since the end of national restrictions, the overall picture remains concerning in Birmingham and Black Country. Whilst case rates in all ages have decreased by over 10% in Dudley, Sandwell and Walsall, in the most recent few days case rates have plateaued or are increasing. Case rates in over 60s have decreased across the majority of the area but remain above 150 per 100,000 in Birmingham, Dudley, Sandwell and Wolverhampton. Test positivity remains high. The most concerning local authority is Wolverhampton, with very high and increasing case rates in all ages and in those over 60. Overall, the epidemiology indicators remain too high and their trajectory does not support allocation to Tier 2. De-escalating the area now will likely lead to rising case numbers.

There are high levels of activity but slowly diminishing admissions, occupancy and critical care occupancy in the Black Country and West Birmingham STP. COVID admissions, bed occupancy, and critical care occupancy in the Birmingham and Solihull STP remain stable over the last 14 days.

Worcestershire

Tier 2 (High)


Since the end of national restrictions, the situation in Worcestershire has remained stable. Case rates are broadly decreasing or remaining the same across Worcestershire and the overall case rate has decreased by 10% or more over the last 7 days in Redditch, Worcester and Malvern Hills. In the most recent few days the case rate is marginally increasing. The epidemiology indicators remain too high for de-escalation to Tier 1. De-escalating areas now will likely lead to rising case numbers, and risks areas being rapidly re-escalated at, or in advance of, the next review point.

The number of daily COVID hospital admissions in the Herefordshire and Worcestershire STP continues to rise. The daily COVID bed occupancy is below the national acute hospital average but continues to rise.

Shropshire and Telford and Wrekin

Tier 2 (High)


Since the end of national restrictions case rates have started to increase, which continues in the most recent few days. Case rates for all ages in in Shropshire are below 100 per 100,000 but they have increased by over 25% in the last 7 days. Case rates in over 60s are broadly stable. Overall, the epidemiology indicators remain too high and their trajectory does not yet support allocation to Tier 1. De-escalating areas now will likely lead to rising case numbers.

The number of daily COVID hospital admissions in the area continues to rise. The daily COVID bed occupancy is above the national acute hospital average and continues to rise. The proportion of critical care beds or beds with mechanical ventilation occupied by COVID patients remains high.

Herefordshire

Tier 1 (Medium)


Since the end of national restrictions, the picture in Herefordshire has improved. Overall case rates have decreased by more than 20% and the case rate in over 60ss is stable at 41 per 100,000. Epidemiology indicators have decreased sufficiently for the area to be de-escalated to Tier 1. It will be important to keep the epidemiology under review to ensure transmission of the virus does not require re-introduction of tier 2 measures.

The number of daily COVID hospital admissions in the area continues to rise, and while the daily COVID bed occupancy is below the national acute hospital average it also continues to rise.

Coventry

Tier 3 (Very High)


Since the end of national restrictions case rates in Coventry have remained relatively stable. Case rates in over 60s are 131 per 100,000 and have increased over the previous 7 days. The most recent data shows that the case rate for all ages has now started to increase. The trajectory of the epidemiology indicators does not support de-escalation to Tier 2. De-escalating now will likely lead to rising case numbers, and risks rapid re-escalation at, or in advance of, the next review point.

The number of daily COVID hospital admissions in the area continues to rise. The daily COVID bed occupancy is below the national acute hospital average but is rising. The proportion of critical care beds or beds with mechanical ventilation occupied by COVID patients remains high.

Solihull

Tier 3 (Very High)


Since the end of national restrictions case rates have remained relatively stable in Solihull. The case rate in all ages is 150 per 100,000 though case rates for the over 60s has increased and has nearly reached the same level. The most recent data shows that the case rate remains stable. The trajectory of the epidemiology indicators does not support de-escalation to Tier 2. De-escalating now will likely lead to rising case numbers, and risks rapid re-escalation at, or in advance of, the next review point.

COVID admissions, bed occupancy, and critical care occupancy in the area have been stable over the last 14 days.

Warwickshire

Tier 3 (Very High)


The overall picture remains concerning in Warwickshire. Case rates for all ages have increased in Warwick, Rugby and Stratford-on-Avon, and the most recent data also shows that this trend is continuing across the area. Warwick is of particular concern with a rapidly increasing case rate that now stands at 176 per 100,000 (increase of 76% over the last 7 days) and a case rate in the over 60s at 159 per 100,000 (also increasing at a concerning rate). The epidemiology indicators are still too high for Tier 2. In Stratford-on-Avon the case rate is lower but is on the increase (over 50% increase in case rate for all ages in the last 7 days). The changing trajectory of the epidemiology indicators does not support de-escalation to Tier 2. De-escalation now will likely lead to rising case numbers, and risks rapid re-escalation at, or in advance of, the next review point.

The number of daily COVID hospital admissions in the area continues to rise. The daily COVID hospital bed occupancy rate is below the national average but continues to rise. The proportion of critical care beds or beds with mechanical ventilation occupied by COVID patients remains high.

Staffordshire and Stoke-on-Trent

Tier 3 (Very High)


The overall picture in Staffordshire remains mixed and concerning, with very high case rates across the area, particularly in people aged over 60. Case rates have decreased across a number of local authorities in the area, but the most recent data shows they are now plateauing at a high level and increasing in East Staffordshire and Stafford. Case rates in people aged over 60 are greater than 150 per 100,000 in East Staffordshire, Stafford, Staffordshire Moorlands, Newcastle-under-Lyme, Cannock Chase and Stoke-on-Trent. The most concerning local authorities are Stoke-on-Trent, East Staffordshire and Stafford, with case rates over 200 per 100,000 in all ages and in those aged over 60. The epidemiology indicators remain too high for allocation to Tier 2 and their trajectory is not consistently decreasing.

The number of daily COVID hospital admissions in the Staffordshire and Stoke on Trent STP continues to rise. The daily COVID bed occupancy is above the national acute hospital average and continues to rise. The proportion of critical care beds or beds with mechanical ventilation occupied by COVID patients remains high.

East of England

Area Reason
Bedford, Central Bedfordshire, Luton, and Milton Keynes

Tier 3 (Very High)


Since the end of national restrictions, the situation in Bedford, Central Bedfordshire, Luton and Milton Keynes has deteriorated and overall case rates are increasing. Case rates remain greater than 150 per 100,000 population in all four local authorities in the area and are over 200 per 100,000 in Luton and Milton Keynes. The case rates in the most recent few days shows rapid increases in Bedford, Central Bedfordshire and Milton Keynes, and a very high rate in Luton. Case rates in people aged over 60 remain above 100 per 100,000 and are increasing in Central Bedfordshire, Luton and Milton Keynes. Positivity is increasing across all four local authorities. The rate of increase of the epidemiology indicators is concerning and warrants escalation to Tier 3.

The number of daily COVID hospital admissions in the Bedfordshire, Luton and Milton Keynes STP continues to rise. The daily COVID bed occupancy is above the national acute hospital average and continues to rise. The proportion of critical care beds or beds with mechanical ventilation occupied by COVID patients remains high.

Cambridgeshire and Peterborough

Tier 3 (Very High)

Peterborough

Tier 2 (High)

Cambridgeshire


Since the end of national restrictions, the situation in Cambridgeshire and Peterborough has deteriorated. Case rates have increased by 10% or more over the last 7 days in East Cambridgeshire, South Cambridgeshire, Cambridge, Huntingdonshire and Peterborough. In the most recent few days case rates are increasing. Test positivity is slightly increasing across the area from a low base. The most concerning local authority is Peterborough with an overall case rate over 200 per 100,000 and increasing, and a case rate in over 60s greater than 150 per 100,000 and increasing. Overall, the epidemiology indicators in Cambridgeshire do not justify inclusion at Tier 3 and as such Cambridgeshire will remain at Tier 2. However, the situation is much more concerning for Peterborough which warrants escalation to Tier 3.

The number of daily COVID hospital admissions in the Cambridgeshire and Peterborough STP continues to rise. The daily COVID bed occupancy is below the national acute hospital average but continues to rise.

Essex, Thurrock, and Southend-on-Sea

Tier 3 (Very High)

Basildon

Braintree

Brentwood

Castle Point

Chelmsford

Epping Forest

Harlow

Maldon

Rochford

Southend-on-Sea

Thurrock

Tier 2 (High)

Colchester

Tendring

Uttlesford


Since the end of national restrictions, the situation in Essex, Thurrock, and Southend-on-Sea has deteriorated. Case rates are greater than 200 per 100,000 population in ten out of the fourteen local authorities and are increasing across the area. The overall case rate has increased by 50% or more over the last 7 days in Basildon, Brentwood, Epping Forest, Castle Point, Chelmsford, Braintree, Rochford, Maldon, Tendring, Southend-on-Sea and Thurrock. Case rates in those aged 60 and over are greater than 150 per 100,000 in Basildon, Brentwood, Epping Forest, Castle Point, Harlow, Rochford, Southend-on-Sea and Thurrock local authorities and are increasing in all local authorities apart from Colchester. In the most recent few days the case rate is increasing exponentially across the area.

The rate of increase of the epidemiology indicators is concerning and under emergency measures taken this week warranted immediate allocation to Tier 3 of those local authorities in South Essex with the highest case rates and those local authorities bordering London (Basildon, Brentwood, Harlow, Epping Forest, Castle Point, Rochford, Maldon, Braintree, Chelmsford, and Thurrock and Southend-on-Sea Borough Councils). The epidemiological indicators in these areas continue to deteriorate and they should remain at Tier 3.

The epidemiological indicators are lower in Uttlesford, Tendring and Colchester and did not justify inclusion at Tier 3 under the emergency measures. However, whilst the indicators have continued to deteriorate, they do not currently justify elevating these areas to Tier 3.

The number of daily COVID hospital admissions continues to rise in the Mid and South Essex STP. The daily COVID bed occupancy is above the national acute hospital average and continues to rise. The proportion of critical care beds or beds with mechanical ventilation occupied by COVID patients remains high.

The number of daily COVID hospital admissions continues to rise in the Hertfordshire and West Essex STP. The daily COVID bed occupancy is below the national acute hospital average but continues to rise.

COVID admissions remain stable in the Suffolk and North East Essex STP. The daily COVID bed occupancy is at national average and remains stable. The proportion of critical care beds or beds with mechanical ventilation occupied by COVID patients remains high.

Hertfordshire

Tier 3 (Very High)


Since the end of national restrictions, the situation in Hertfordshire has deteriorated. Case rates have increased by over 30% in the last 7 days. This is particularly noticeable in South Hertfordshire (where it borders London) with case rates very high in Broxbourne (391 per 100,000) Watford (272 per 100,000) and Hertsmere (237 per 100,000). Case rates in those aged 60 and over are also increasing across the area. The rate of increase is concerning and warranted the immediate escalation of Broxbourne, Hertsmere, Watford and Three Rivers to Tier 3 under emergency measures this week. These areas should remain in Tier 3. In Dacorum, East Hertfordshire, St Albans, Welwyn Hatfield, North Hertfordshire and Stevenage the situation has continued to deteriorate. This, in addition to the close proximity and links to the surrounding areas of Buckinghamshire, Bedford, Central Bedfordshire, Luton, Milton Keynes, London, and parts of Essex and Hertfordshire already escalated to Tier 3 warrants escalation of these areas to Tier 3.

The number of daily COVID hospital admissions continues to rise in the Hertfordshire and West Essex STP. The daily COVID bed occupancy is below the national acute hospital average but continues to rise.

Norfolk

Tier 2 (High)


There is a mixed picture across Norfolk. The overall case rate has increased by 10% or more over the last 7 days in Great Yarmouth, King’s Lynn and West Norfolk and Breckland and is stable in Norwich, Broadland, South Norfolk and North Norfolk. Positivity is decreasing across the majority of Norfolk. In the most recent few days the case rates have started to increase. Overall, the epidemiology indicators in Norfolk remain too high for allocation to Tier 1 but do not currently justify inclusion at Tier 3

The number of daily COVID hospital admissions continues to rise in the Norfolk and Waveney Health and Care Partnership STP. The daily COVID bed occupancy is below the national acute hospital average but continues to rise.

Suffolk

Tier 2 (High)


Since the end of national restrictions, the situation in Suffolk has deteriorated. Case rates and positivity are broadly increasing across the area. The overall case rate has increased by 20% or more over the last 7 days in Ipswich, East Suffolk, Mid Suffolk and West Suffolk. The most concerning local authority is Ipswich where case rates in all age groups, case rates in people aged over 60 and test positivity are all very high and rapidly increasing. Whilst the rate of increase of the epidemiology indicators is concerning, the indicators do not at present justify escalation of all of Suffolk to Tier 3.

COVID admissions remain stable in the Suffolk and North East Essex STP. The daily COVID bed occupancy is at national average and remains stable. The proportion of critical care beds or beds with mechanical ventilation occupied by COVID patients remains high.

South East

Area Reason
Berkshire (Reading, Wokingham, Bracknell Forest, Windsor and Maidenhead and West Berkshire)

Tier 3 (Very High)


Since the end of national restrictions, the outbreak across Berkshire has deteriorated. Case rates, over 60s and positivity are increasing in the majority of areas. Case rates are high and continuing to rise with large increases in Reading (198 per 100,000), Bracknell Forest (202 per 100,000) and Wokingham (158 per 100,000). The case rate in all ages has increased by 10% or more over the last 7 days in all areas – Bracknell Forest, Reading, West Berkshire, Windsor and Maidenhead and Wokingham. The rate of increase of the epidemiology indicators is concerning and warrants escalation to Tier 3.

In the Buckinghamshire, Oxfordshire and Berkshire West STP the number of daily COVID hospital admissions continues to rise. The daily COVID bed occupancy is below the national acute hospital average but continues to rise. In the Frimley Health and Care ICS the daily COVID bed occupancy is below the national acute hospital average but continues to rise and has doubled in last 14 days. The proportion of critical care beds or beds with mechanical ventilation occupied by COVID patients remains high.

Slough

Tier 3 (Very High)


The overall picture continues to deteriorate and is very concerning. Case rate in all ages and test positivity remain very high and are increasing. The case rate in all ages is 296 per 100,000 population and the case rate in the over 60s is 209 per 100,000 population. There has been a particularly sharp rise in the most recent few days. The epidemiology indicators in the area do not justify allocation at Tier 2.

In the Frimley Health and Care ICS the daily COVID bed occupancy is below the national acute hospital average but continues to rise and has doubled in last 14 days. The proportion of critical care beds or beds with mechanical ventilation occupied by COVID patients remains high.

Buckinghamshire

Tier 3 (Very High)


Since the end of national restrictions, the situation across Buckinghamshire has deteriorated. The overall case rate has increased by 20% or more over the last 7 days in all areas: Aylesbury Vale, Wycombe, South Bucks and Chiltern. Test positivity is also increasing. The most recent data indicates that the case rate is continuing to increase. Case rates in the over 60s are increasing significantly in Wycombe, South Bucks and Chiltern. The rate of increase of the epidemiology indicators is concerning and warrants allocation to Tier 3.

In the Buckinghamshire, Oxfordshire and Berkshire West STP the number of daily COVID hospital admissions continues to rise. The daily COVID bed occupancy is below the national acute hospital average but continues to rise.

East and West Sussex, and Brighton and Hove

Tier 3 (Very High)

Hastings

Rother

Tier 2 (High)

Brighton and Hove

Eastbourne

Lewes

Wealden

Adur

Arun

Chichester

Crawley

Horsham

Mid Sussex

Worthing


There is deteriorating picture across East and West Sussex, and Brighton and Hove. The case rates in all ages, case rates in people aged over 60s, and positivity are broadly increasing across the majority of the area, however in general this increase is from a relatively low level. The most concerning local authorities are Hastings and Rother, where case rates are rising rapidly and are 372 per 100,000 and 228 per 100,000, respectively. The case rate in the over 60s is 301 per 100,000 in Hastings and 179 per 100,000 in Rother. The rate of increase of the epidemiology indicators in Hastings and Rother is very concerning and warrants allocation to Tier 3. The remaining areas are not currently at the level for escalation to Tier 3.

In the Sussex and East Surrey Health and Care Partnership the number of daily COVID hospital admissions continues to rise. The daily COVID bed occupancy also continues to rise.

Hampshire, Portsmouth, and Southampton

Tier 3 (Very High)

Gosport

Havant

Portsmouth

Tier 2 (High)

Basingstoke and Deane

East Hampshire

Eastleigh

Fareham

Hart

New Forest

Rushmoor

Test Valley

Winchester

Southampton


Since the end of national restrictions the situation across the majority of Hampshire, Portsmouth and Southampton has deteriorated. The case rates in all ages, case rates in over 60s, and positivity are broadly increasing across the majority of the area, however in general this is from a relatively low level. The overall case rate has increased by 50% or more over the last 7 days in Havant, Rushmoor, Hart, New Forest, and by 10% or more in East Hampshire, Portsmouth, Fareham, East Hampshire and Southampton. The case rate in over 60s is over 150 per 100,000 in Rushmoor and Gosport. The rate of increase of the epidemiology indicators for Portsmouth, Gosport and Havant is increasing and warrant escalation to Tier 3 for those areas.

The NHS position for Hampshire remains stable with no major change.

Isle of Wight

Tier 2 (High)


Since the end of national restrictions, the picture on the Isle of Wight has continued to improve. Case rate in all ages is at 11 per 100,000 and has decreased over the last 7 days, however in the most recent data the case rate is increasing. The epidemiology indicators in the area do not justify allocation at Tier 2.

The NHS position for Hampshire and the Isle of Wight remain stable with no major change.

Kent and Medway

Tier 3 (Very High)


The overall picture in Kent and Medway remains very concerning with a continued deterioration in epidemiology indicators. Case rates in all ages and in people aged over 60, and test positivity continue to increase in the majority of the area. Case rates are above 200 per 100,000 and case rates in the over 60s are greater than 190 per 100,000 in all local authorities apart from Sevenoaks. The current epidemiology indicators and trend do not justify allocation to Tier 2. Swale has the highest case rate in all ages and in the over 60s at 644 per 100,000 and 359 per 100,000, respectively. The epidemiology indicators in the area remain concerning and do not justify allocation at Tier 2.

The number of daily COVID hospital admissions continues to rise in Kent and Medway. The daily COVID bed occupancy is above the national acute hospital average and continues to rise. The proportion of critical care beds or beds with mechanical ventilation occupied by COVID patients remains high.

Oxfordshire

Tier 2 (High)


There is a deteriorating epidemiological picture across Oxfordshire, albeit starting from a relatively low level. Case rates in all local authorities (Oxford, South Oxfordshire, Cherwell, Vale of White Horse and West Oxfordshire) have seen large increases over the last 7 days. Test positivity is increasing across the area. Case rates in over 60s are above 100 per 100,000 and increasing in South Oxfordshire. The epidemiology indicators and trend are too high for allocation to Tier 1 but do currently not warrant inclusion in Tier 3.

In the Buckinghamshire, Oxfordshire and Berkshire West STP the number of daily COVID hospital admissions continues to rise. The daily COVID bed occupancy is below the national acute hospital average but continues to rise.

Surrey

Tier 3 (Very High)

Elmbridge

Epsom and Ewell

Guildford

Mole Valley

Reigate and Banstead

Runnymede

Spelthorne

Surrey Heath

Tandridge

Woking

Tier 2 (High)

Waverley


Since the end of national restrictions the situation in Surrey has deteriorated. Case rates are broadly increasing across the area and are increasing by 10% or more over the last 7 days in Woking, Tandridge, Spelthorne, Epsom and Ewell, Surrey Heath, Elmbridge, Guildford, Reigate and Banstead . Case rates in the over 60s and positivity are increasing across the majority of the area. The most concerning local authorities are Woking, Runnymede, Tandridge and Spelthorne, which border or are in close proximity to London; case rates in these areas are above 200 per 100,000. The rate of increase of the epidemiology indicators is concerning and warrants allocation to Tier 3, apart from Waverley where case rates and case rates in over 60s are lowest. Case rates in Waverley are 89 per 100,000, and are lower than other areas of Surrey, including neighbouring Guildford borough and therefore does not justify escalation to Tier 3 at this point. There is a risk of future escalation as case rates have risen over 25% in recent days

Surrey Heartlands Health and Care Partnership the daily COVID bed occupancy is below the national acute hospital average but continues to rise. The proportion of critical care beds or beds with mechanical ventilation occupied by COVID patients remains high.

South West

Area Reason
Bristol

Tier 2 (High)


Since the end of national restrictions, the situation in Bristol has broadly improved. The case rate remains high at 120 per 100,000 (though decreasing), and the case rate in over 60s is also high. In the most recent data however, the trajectory of case rates has levelled off. Epidemiology indicators have decreased sufficiently for the area to be de-escalated to Tier 2.

In the Bristol, North Somerset and South Gloucestershire STP, COVID admissions, bed occupancy and critical care bed occupancy remain stable below the national average.

North Somerset

Tier 2 (High)


Since the end of national restrictions, North Somerset has remained stable. The case rate (123 per 100,000) and rate in over 60s (82 per 100,000) remain relatively high. In the most recent data, the case rate is stable. Epidemiology indicators have decreased sufficiently for the area to be de-escalated to Tier 2.

In the Bristol, North Somerset and South Gloucestershire STP COVID admissions, bed occupancy and critical care bed occupancy remain stable below the national average.

South Gloucestershire

Tier 3 (Very High)


Since the end of national restrictions, the situation in South Gloucestershire has started to deteriorate. The case rate remains high, though the case rate in over 60s are decreasing. In the most recent few days the case rate is increasing. Improvements in the epidemiology indicators in this area have slowed and remain high. This does not support de-escalation to Tier 2.

In the Bristol, North Somerset and South Gloucestershire STP COVID admissions, bed occupancy and critical care bed occupancy remain stable below the national average.

Gloucestershire

Tier 2 (High)


Since the end of national restrictions, the situation in the majority of the area has deteriorated. Case rates are increasing in Gloucester, Stroud, Forest of Dean and Cheltenham and rates in over 60s are increasing across the area. In the most recent data, the area is on a rapidly increasing trajectory. The most concerning local authority is Forest of Dean where overall case rate (164 per 100,00), case rate in the over 60s, and positivity are high and have seen large increases in the past seven days. There have been a number of contained care home outbreaks in Forest of Dean and Stroud which account for some of this rise. The rate of increase of the epidemiology indicators is concerning but does not yet warrant escalation to Tier 3. It will be important to keep the epidemiology under review as the increased transmission of the virus may require the introduction of tighter measures.

In the Gloucestershire STP the number of daily COVID hospital admissions continues to rise. The daily COVID bed occupancy is above the national acute hospital average and continues to rise. The proportion of critical care beds or beds with mechanical ventilation occupied by COVID patients remains high.

Cornwall and Isles of Scilly

Tier 1 (Medium)


Since the end of national restrictions, the situation in Cornwall and the Isles of Scilly have continued to improve. Case rates are currently low (18 per 100,000), though the most recent data indicates that the case rates are starting to increase. The epidemiology indicators in the area do not however justify escalation to Tier 2.

In the Cornwall and the Isles of Scilly Health and Social Care Partnership the number of daily COVID hospital admissions continues to rise. COVID occupancy remains very low.

Devon, Plymouth, and Torbay

Tier 2 (High)


There is a mixed picture across Devon, Plymouth and Torbay. The overall case rate has increased by 20% or more over the last 7 days in Teignbridge (51 cases per 100,000), Mid Devon (81 cases per 100,000) and North Devon (109 cases per 100,000). In the most recent data, the case rate is increasing in the majority of areas. The epidemiology indicators, and their trend, remain too high for allocation to Tier 1.

In the Devon STP admission numbers are stable and occupancy is below the national average.

Dorset, Bournemouth, Christchurch and Poole

Tier 2 (High)


There is a stable picture across Dorset, Bournemouth, Christchurch and Poole. The overall case rate (56 per 100,000) is broadly stable. Case rates in the over 60s are relatively low (44 cases per 100,000) but increasing across the area. The recent increases in epidemiology indicators and their current level do not justify allocation to Tier 1.

In the Dorset STP admissions are stable and occupancy is below the national average.

Wiltshire and Swindon

High (Tier 2)


Since the end of national restrictions, the situation in Wiltshire and Swindon has improved. Case rates and positivity are broadly decreasing across the area (average of 80 per 100,000), although test positivity remains high in Swindon. The epidemiology indicators are currently too high for allocation to Tier 1, but the trajectory does currently not warrant inclusion in Tier 3.

In the Bath and North East Somerset, Swindon and Wiltshire STP COVID admissions, occupancy and critical care bed occupancy remain stable below the national average.

Somerset, Bath, and North East Somerset

Tier 2 (High)


There is a deteriorating epidemiological picture across the majority of Somerset, Bath and North East Somerset. Case rates have broadly increased across the area and by 15% or more in Mendip, Sedgemoor and South Somerset over the last seven days. However, this is from a relatively low level. Case rates in the over 60s are decreasing across the majority of the area though there is a marked increase in Sedgemoor and Somerset West and Taunton. The epidemiology indicators remain too high for allocation to Tier 1 but are not currently at the level to justify Tier 3.

In the Bath and North East Somerset, Swindon and Wiltshire STP COVID admissions, occupancy and critical care bed occupancy remain stable below the national average. In the Bristol, North Somerset and South Gloucestershire STP COVID admissions, bed occupancy and critical care bed occupancy remain stable below the national average.

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