Where's next for Tier Four?

Where’s next for Tier Four? Covid cases have risen five-fold in just a fortnight in parts of Sussex and Hampshire that escaped harsh measures (so use our tool to find out how quickly the outbreak is growing in YOUR area)

  • Boris Johnson cancelled Christmas for 16million people living in London and across the South East 
  • But parts of the region which escaped the harshest measures have seen a dramatic rise in positive tests 
  • Crawley in Sussex saw cases rise almost five-fold since the beginning of the month, from 40.9 to 200.2
  • Only Hastings in Kent, and Essex boroughs of Rochford and Braintree saw their Covid outbreaks grow quicker

Swathes of Sussex, Hampshire and Oxfordshire could be next to be hit with Tier Four restrictions because Covid cases are spiralling across the counties, official figures suggest amid fears a mutated form of the coronavirus is ripping across England. 

Boris Johnson sparked fury on Saturday night after he cancelled Christmas for 16million people living in London and across the South East. Shops, gyms, hairdressers and beauty salons have been ordered to shut again, with residents told not to leave Tier Four.  

But parts of the region which escaped the harshest measures have seen a dramatic rise in positive tests since the start of December, bolstering fears Number 10 will need to take tougher action after Christmas to tackle Covid. 

Crawley in Sussex saw cases rise almost five-fold since the beginning of the month, with the borough’s infection rate soaring from 40.9 positive tests per 100,000 people in the week ending December 1 to 200.2 over the seven-day spell that finished December 15. 

Only Hastings in Kent, and the Essex boroughs of Rochford and Braintree – all of which were plunged into Tier Four after the Prime Minister hit the panic button on Saturday night – saw their Covid outbreaks grow quicker over the same time frame. 

Eden in Cumbria also had a rapid increase in cases (from 41.3 to 200.9), as well as Rushmoor, which is a borough of Hampshire on the border with locked-down Surrey that saw its infection rate grow from 70.8 to 305.5.

MailOnline’s analysis of Department of Health statistics show 12 of the 50 regions where cases rose the quickest over the most recent two weeks are currently in Tier Two, including Adur, Eastbourne and Worthing in Sussex. Parts of Oxfordshire, Cambridgeshire, Suffolk, Essex and the only part of Surrey that escaped the toughest action – Waverley – also made the top 50.

Outbreaks are also rife in parts of Lincolnshire, with both Lincoln and Boston recording more cases than boroughs of London and Surrey. Government figures also reveal that outbreaks have doubled in a fortnight in more than a third of England’s local authorities, including in Tier One’s Cornwall and the Isles of Scilly where the rate has jumped from 25.2 to 53.3. 

The analysis comes amid growing fears that millions of families face living under draconian Tier Four restrictions until Easter. 

Matt Hancock yesterday hinted tougher measures will be needed after the Christmas amnesty, saying the virus was now ‘out of control’. And ‘Professor Lockdown’ Neil Ferguson today claimed the harshest curbs may ‘possibly’ have to stay until the spring. 

Crawley in Sussex saw cases rise almost five-fold since the beginning of the month, with the borough’s infection rate soaring from 40.9 positive tests per 100,000 people in the week ending December 1 to 200.2 over the seven-day spell that finished December 15

Department of Health data, which is updated every day, show the 20 areas of England with the highest infection rates are all currently under Tier Four. 

Thurrock in Essex is currently the nation’s Covid hotspot, recording 968.2 cases for every 100,000 people in the week ending December 15 – the most up-to-date set of figures.

Revealed: The areas that saw the biggest DROP in coronavirus cases

LOCAL AREA

Copeland

NE Lincolnshire

Calderdale

North Tyneside

Tameside

Darlington

East Lindsey

Kirklees

Derbyshire Dales

Tamworth

Wakefield

Bradford

Bolton

Wigan

Blackburn w Darwen

N. Warwickshire

Fylde

Torbay

Craven

Torridge

INFECTION RATE

22

119.1

158.9

132.7

105.5

173.2

173.6

166.7

71.9

136.9

153.9

172.1

153

168

251.2                           

136.4

105.2

42.6

126

92.3

% GROWTH

-51.65%

-39.67%

-32.81%

-26.60%

-26.48%

-26.30%

-25.20%

-24.57%

-21.25%

-21.05%

-20.34%

-20.14%

-20.02%

-19.39%

-17.18%                       

-16.01%

-15.84%

-15.81%

-15.32%

-12.51%

Department of Health data on infection rates in the week ending December 1, compared to the week ending December 15. 

The borough, home to 175,000 people, overtook Medway in Kent (931.9) to clinch the grim accolade. Basildon in Essex (931.1), Havering in London (925.4) and Swale in Kent (879.5) round up the top five.

But there is a huge disparity in Covid case rates between Tier Four boroughs, with Gosport in Hampshire getting lumped into the harshest bracket despite recording just 159.1 positive tests per 100,000 people last week. 

Lincoln’s rate (429) is almost three times’ higher than Gosport’s, despite only currently being in Tier Three. Boston (419), Burnley (372.2), Stoke-on-Trent (351.4) and East Staffordshire (340.7) are all also in the same boat. 

However, the Joint Biosecurity Centre – the secretive Whitehall body which decides the local lockdowns – doesn’t just look at infection rates in deploying its whack-a-mole approach. 

The body, which is run out of the Cabinet Office, also looks at how quickly cases are rising among over-60s, test positivity rates, and pressure on local NHS hospitals, before changing up the tier system. 

The JBC’s next review of the four-tier lockdown system is due on December 30 but any decision could be rushed through in an emergency, as was the case for upgrading London into Tier Three.

As well as the other criteria, officials also look at the speed at which Covid cases are rising or falling to decide on which tier each local authority in England needs to be in. 

MailOnline’s analysis shows only 46 areas saw outbreaks shrink over the last fortnight, with Copeland in Cumbria having the lowest Covid infection rate and the biggest drop in confirmed cases. But the borough, home to around 70,000 people, still finds itself in Tier Two.

Gosport also saw a 5.6 per cent drop in coronavirus cases between the weeks ending December 1 and 15, despite being lumped into Tier Four. 

Nine of the ten areas that saw the biggest drops in infection rates over the same two-week period are in Tier Three, including North East Lincolnshire, Calderdale, North Tyneside, Darlington and East Lindsey.    

It comes as it was suggested today that millions of families face living under draconian Tier Four restrictions until Easter.

‘Professor Lockdown’ Neil Ferguson, an Imperial College London epidemiologist who quit his role as a Government adviser after breaking rules to see his married lover, today claimed the harshest curbs could ‘possibly’ have to stay until the spring and admitted Britain was now in a race to vaccinate people.

 

Health officials across the UK recorded 35,928 positive cases – a new record figure – and another 326 deaths yesterday

Italy has detected a patient infected with the mutated strain of coronavirus that emerged in Britain, becoming the fifth country outside the UK to report a case after the variant first emerged in Kent in September

Italy becomes fifth nation to detect mutated Covid from Britain 

Italy has detected a patient infected with the mutated strain of coronavirus that emerged in Britain, becoming the fifth country outside the UK to report a case.

The Italian patient flew from the UK to Rome in the last few days with his partner, who did not test positive, Italy’s health ministry said. The pair are now isolating.

So far, cases of the new variant, said to be up to 70 per cent more infectious than regular Covid, have been spotted in Denmark, the Netherlands, Australia and Belgium.

In November there were nine instances of the strain in Denmark and one in Australia, while the Netherlands announced it had detected a case this month. There have also been unconfirmed reports of at least one case in Belgium.

Scotland and Wales have both picked up cases of the strain in recent weeks, although it is spreading predominantly in London and the South East of England, where it’s thought to account for 60 per cent of all new infections.

France’s health minister said this morning it was ‘entirely possible’ the version of the virus was already circulating in France despite tests not picking it up yet, while Northern Ireland’s First Minister said it was ‘probable’ the strain was there, too.

More than a dozen countries – including France, Germany, Italy, Ireland and Canada – have banned travel to and from the UK as part of an international crackdown to contain the mutant strain.

He warned Britain’s situation was ‘not looking optimistic right now’. 

It comes after Matt Hancock yesterday warned the Tier Four restrictions could be extended nationwide, after the Health Secretary said the virus was now ‘out of control’ following the emergence of a fast-spreading new variant. 

In his embarrassing U-turn on the festive period, the Prime Minister – who last week claimed it would be ‘inhuman’ to cancel Christmas – also slashed a festive amnesty from five days to just one for the rest of the UK.

It comes after it was revealed yesterday that Professor Ferguson played a major role in researching the variant that triggered the dramatic cancellation of Christmas. He was among those attending a meeting of Nervtag – the New and Emerging Respiratory Virus Threats Advisory Group – to discuss the new mutant strain on Friday.

The Imperial expert said it was now a simple race to ‘get vaccines in people’s arms’ because the virus couldn’t be stopped any other way. 

And a colleague of his, infectious diseases expert Professor Wendy Barclay, said it was possible that if the virus mutates enough the immunity produced by vaccines might not work, although there is no proof that this is true of the new strain.

Pfizer and BioNTech’s vaccine is being rolled out rapidly but it is complicated because it must be kept in specialist freezers. 

Regulators now face pressure to approve England’s own vaccine made by Oxford University and AstraZeneca – a decision is expected within the next week. 

Another completed vaccine by US company Moderna, which trials showed was 94.5 per cent effective, has been pre-ordered by the UK but won’t be available until the spring.

Dozens of countries have all already banned travel from Britain over fears the mutated strain of coronavirus could spread, with France last night causing chaos over the last minute decision to shut the border. 

Mr Johnson will hold crisis talks with Ministers today as he chairs the Government’s Cobra committee amid warnings of ‘significant disruption’ around the Channel ports in Kent.

QUESTIONS ANSWERED ON NEW COVID MUTATION: HOW DID IT HAPPEN, IS IT MORE DANGEROUS AND HOW LONG HAS IT BEEN IN THE UK?

By David Churchill

What has happened to the coronavirus to trigger such concern?

A new strain of Covid has developed which is said to spread far faster. A ‘strain’ is a new version of a virus which has genetic mutations. The new strain is a version of Sars-Cov-2, the coronavirus which causes the disease Covid-19.

It has been named VUI-202012/01. These letters and numbers stand for ‘variant under investigation’ and the month, December 2020.

What makes it so worrying?

This particular variant is defined by up to 17 changes or mutations in the coronavirus spike protein. It is the combination of some of these changes which scientists believe could make it more infectious.

It is thought they could help the virus’ spike protein latch on to human cells and gain entry more easily.

Is it certain the new variation is accelerating the spread of the virus?

No, but scientists say preliminary evidence suggests it does.

Boris Johnson said it may spread up to 70 per cent more easily than other strains of the virus, potentially driving up the ‘R rate’ – which measures how quickly the virus spreads – significantly.

On Saturday night, Mr Johnson said it could drive up the ‘R rate’ by as much as 0.4.

This would be particularly significant in areas such as Eastern England, where it is 1.4, and both London and the South East, where it is 1.3. The ‘R rate’ must remain below 1 for infections to decrease.

Is the new variant more dangerous?

Scientists don’t think so for now. When asked on Saturday night if it was more lethal than the previous strain, Chief Medical Officer Professor Chris Whitty said ‘the answer seems to be ‘No’, as far as we can tell at the moment’.

Yesterday Dr Susan Hopkins, of Public Health England, said there was evidence of people with the new variant having higher viral loads inside them.

But she said this did not mean people would get more ill.

Ravi Gupta, professor of clinical microbiology at the University of Cambridge, said: ‘It’s unlikely it’ll make people sicker, but it could make it harder to control.’

If it does make the virus harder to control and hospitals become overrun, it could pose new challenges.

Are mutations unusual?

No. Seasonal influenza mutates every year. Variants of Sars-Cov-2 have also been observed in other countries, such as Spain.

However, one scientific paper suggests the number and combination of changes which have occurred in this new variant is potentially ‘unprecedented’.

Most mutations observed to date are thought to have happened more slowly. Also, most changes have no effect on how easily the virus spreads.

There are already about 4,000 mutations in the spike protein gene.

What has caused the mutation?

This is still being investigated. One theory is that growing natural immunity in the UK population, which makes it harder for the virus to spread, might have forced it to adapt.

Another theory is that it has developed in chronically ill patients who have fought the virus off over a long period of time, with it then being passed onto others.

Prof Paul Hunter, Professor in Medicine at the University of East Anglia, yesterday said it was ‘plausible’ and ‘highly likely’ this has happened.

However, he stressed it is impossible to prove at the moment.

What evidence is there to support the latter theory?

Some evidence supporting it was spotted when samples of virus were collected from a Cambridge patient. They had been treated with convalescent plasma – blood plasma containing antibodies from a recovered patient.

It is possible the virus mutated during that treatment, developing more resistance to the antibodies. This patient died of the infection, but it’s also possible the mutation has occurred elsewhere.

A paper co-authored by Andrew Rambaut, Professor of Molecular Evolution at the University of Edinburgh, states: ‘If antibody therapy is administered after many weeks of chronic infection, the virus population may be unusually large and genetically diverse…creating suitable circumstances for the rapid fixation of multiple virus genetic changes.’

Professor Hunter added: ‘Mutation in viruses are a random event and the longer someone is infected the more likely a random event is to occur.’

What do these mutations do?

Many occur in what’s called the ‘receptor binding domain’ of the virus’ spike protein. This helps the virus latch on to human cells and gain entry. The mutations make it easier for the virus to bind to human cells’ ACE2 receptors.

It is also possible the changes help the virus avoid human antibodies which would otherwise help fight off infection.

Who detected it?

It was discovered by the Covid-19 Genomics UK (COG-UK) consortium, which carries out random genetic sequencing of positive covid-19 samples.

It is a consortium of the UK’s four public health agencies, Wellcome Sanger Institute and 12 academic institutions.

How long has it been in the UK and where did it start?

As of mid-December, there were more than 1,000 cases in nearly 60 different local authorities, although the true number will be higher.

They have predominantly been found in the south east of England, in Kent and London. It may now account for 60 per cent of the capital’s cases.

But it has been detected elsewhere, including in Wales and Scotland.

The two earliest samples were collected on September 20 in Kent and another the next day in London.

Why was action to tackle it not taken sooner?

Because the potentially greater transmissibility was only discovered late last week by academics.

Has it been detected anywhere else in the world?

One aspect of the new variant, known as a N501Y mutation, was circulating in Australia between June and July, in America in July and in Brazil as far back as April, according to scientists.

It is therefore unclear what role, if any, travellers carrying the virus may have had.

Dr Julian Tang, a Virologist and expert in Respiratory science at the University of Leicester, said: ‘Whether or not these viruses were brought to the UK and Europe later by travellers or arose spontaneously in multiple locations around the world – in response to human host immune selection pressures – requires further investigation.’

Another change, known as the D614G variant, has previously been detected in western Europe and North America. But it is possible that the new variant evolved in the UK.

What can I do to avoid getting the new variant?

The same as always – keeping your distance from people, washing your hands regularly, wearing a mask and abiding by the tier restrictions in your area.

Yesterday Dr Chaand Nagpaul, chair of the British Medical Association, said: ‘The way in which you control the spread of the virus, including this new variant, is exactly the same. It is about continuing stringent measures. The same rules apply.’

Will the new variant reduce the effectiveness of vaccines?

More studies are needed.

Dr Susan Hopkins, of Public Health England, said that until these are carried out scientists cannot be certain whether – and by how much – the new variant reduces the effectiveness of developed vaccines.

She said: ‘The vaccine induces a strong, multiple response, immune response and therefore it is unlikely that this vaccine response is going to be completely gone.’ When mutations happen it is, in theory, possible the antibodies generated by vaccines can be evaded.

But vaccines produce a wide range of antibodies that simultaneously attack the virus from different angles, making it hard for it to evade all of them at once.

Vaccines could also be tweaked to make them more effective if the new mutation does prove to be more resistant to them.

So what are the scientists doing now?

Scientists will be growing the new strain in the lab to see how it responds. This includes looking at whether it produces the same antibody response, how it reacts to the vaccine, and modelling the new strain.

It could take up to two weeks for this process to be complete.

 

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