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Two of Britain’s busiest hospitals were in crisis on Thursday – with one warning it is on the brink of being able to treat Covid patients only and the other saying it was in ‘disaster medicine mode’.
As the UK declared a record-high 55,892 coronavirus cases and almost 1,000 more deaths, the chief executive of University College London hospitals trust (UCLH) said admissions were ‘much more’ than during the first wave in the spring.
Professor Marcel Levi revealed the 550-bed hospital now has 220 Covid patients, with numbers increasing by 5 per cent a day. He added the ‘real pressure’ is on intensive care, where there are now ’70 very sick patients’.
According to The Guardian, whole floors at the hospital are being dismantled and rebuilt to allow them to be used as intensive care wards. They are being equipped with oxygen and continuous positive airway pressure (CPAP) machines which help people to breathe.
Meanwhile, the Royal London Hospital declared it is in ‘disaster mode’. In an email to staff, bosses at the hospital in Whitechapel, east London – Britain’s busiest – warned there is only one nurse for every three Covid patients.
‘We are now in disaster medicine mode,’ the message said. ‘We are no longer providing high standard critical care, because we cannot … Things are going to get harder before they get better.’
Patients are waiting 24 hours for beds inside with some taking taxis to A&E to jump the queue of ambulances waiting outside.
The Nightingale Hospital at the London ExCel Centre – hailed as a solution to the Covid crisis – remains on ‘standby’ as cases continue to rocket in the capital. The NHS says it will be reopened but there was no sign of movement there today.
Two of Britain’s busiest hospitals were in crisis on Thursday – with one – University College London hospitals trust (UCLH), pictured above – warning it is on the brink of being able to treat Covid patients only and the other saying it was in ‘disaster medicine mode’
Meanwhile, the Royal London Hospital declared it is in ‘disaster mode’. In an email to staff, bosses at the hospital in Whitechapel, east London – Britain’s busiest – warned there is only one nurse for every three Covid patients. Pictured: Ambulances were seen queuing outside the hospital on Thursday
UCLH’s Professor Levi told The Guardian: ‘The 500-bed hospital has 220 Covid patients, with the numbers increasing by 5 per cent a day, but the real pressure is on intensive care where there are now 70 very sick patients, as there were in the spring, and rising fast.
‘Usually in our ITU we have about 35 patients so we are already doubled in size at UCLH. We are further surging upon the request of London to 92 patients in the next week, and thereafter probably we will have to grow even further.’
As of 8am yesterday morning, 701 patients at Barts hospitals – which includes the Royal London and Whipps Cross in Walthamstow – had Covid, including 146 in intensive care, the London Evening Standard reported.
In response to the leaked email, Professor Alistair Chesser, group chief medical officer, told the paper: ‘The rapid expansion of intensive care beds in our hospitals has led to necessary changes in the clinical staffing model, in line with national guidance.
‘Despite this, our dedicated staff are providing high-quality care for all who need it thanks to their dedication and skill.’
Prof Chesser told staff on Thursday the situation at the hospital was ‘rapidly escalating’, adding: ‘Unfortunately we now find ourselves really short of nursing support all weekend starting from tonight. We really need anyone who can do health care support duties to come forward please.’
Earlier this week, ambulances were seen queueing outside hospitals including the Royal London Hospital in Whitechapel and Queen’s Hospital in Romford.
The grim warnings came as a record 55,892 Covid cases and 964 deaths were recorded, only 24 hours after 981 deaths were logged on the deadliest day since April.
It brings the UK total to 73,512 deaths within 28 days of testing positive for Covid-19.
The average case rate now stands at 377 positive tests per 100,000 people.Yesterday’s alarming figures signal a marked increase from numbers released a week ago.
Patients are waiting 24 hours for beds inside with some taking taxis to A&E to jump the queue of ambulances waiting outside
Some 39,877 new cases and 585 deaths were announced on Christmas Eve, meaning cases have risen 40 per cent and deaths by 65 per cent in a week.
Dr Yvonne Doyle, medical director at Public Health England said: ‘We know the overwhelming majority of deaths reported today are people who sadly passed away in just the last few days. Every life lost to this disease is a sadness.
‘It is imperative we all take action now to protect our family and friends.
Professor Marcel Levi, the chief executive of University College London hospitals trust (UCLH) said admissions were ‘much more’ than during the first wave in the spring
‘We have all had to make huge sacrifices this year, but please ensure that you keep your distance from others, wash your hands, and wear a mask.’
Dr Doyle added that people staying in to ring in the New Year would help stop the spread of the virus.
The latest data on the number of coronavirus tests carried out reveals around 420,000 are being carried out per day – still far off the Government’s Operation Moonshot target of 10million tests a day.
Thursday’s figure was the highest death toll since April 24, when 1,010 deaths were reported.
The UK’s worst day for Covid deaths was April 21, when 1,224 deaths were recorded. Recent figures may appear high due to a lag in reporting fatalities over Christmas.
The latest Covid-19 case rates for every local authority area in England reveal of the 315 areas in England, 80 per cent have seen a rise in cases.
Epping Forest in Essex continues to have the highest rate in England, with the equivalent of 1,328.9 cases per 100,000 people.
Thurrock, also in Essex, has the second highest rate at 1,268 per 100,000 people. Torbay in Devon has the lowest case rate with 74.1 cases per 100,000.
Dr Julia Grace Patterson, founder of Every Doctor UK, tweeted this afternoon: ‘From the Royal London Hospital, this email from management: ‘We are now in disaster medicine mode. We are no longer providing high standard critical care, because we cannot’. The content of this email is SHOCKING’.
MailOnline asked Royal London Hospital to comment on the claims, which came after one of the capital’s most senior doctors said the public are to blame for the record number of Covid cases in Britain.
Professor Hugh Montgomery, a consultant at University College Hospital in London, believes people have ‘blood on their hands’ if they don’t wear masks as daily infections hit 50,000-plus again and deaths approached 1,000 yesterday.
‘We can’t blame the Government, we can’t blame the Tier system. This is people behaving badly. I’m just very angry about this. If we were wearing masks, washing hands, this virus would not be as it is’, he told Times Radio. He added: ‘Anyone who doesn’t wear their mask – they have blood on their hands.
They are spreading this virus, then other people will spread it and people will die. They won’t know they’ve killed people, but they have’.
A patient is wheeled into the Royal London Hospital in Whitechapel today as bosses reportedly said they were in ‘disaster medicine mode’ because of the number of Covid patients
Ambulances queues outside the Royal London Hospital today where staff say wards are full and waits for beds have now hit 24 hours. The Independent claims that people were taking taxis to A&E to jump the queues
Dr Julia Grace Patterson, founder of Every Doctor UK, says she was leaked the email from management at the hospital warning that care standards were falling
Professor Montgomery’s incendiary claims have angered other medics, with Dr Ellie Cannon tweeting: ‘Wow. I couldn’t disagree more! Since when has a public health campaign ever been based on blaming the public?’ while another critic saying: ‘Throwing blame around just makes people feel angry and disheartened, and inevitably distracts everyone from more important issues’.
Essex has already declared a ‘major incident’ as the number of coronavirus cases threatens to overwhelm its six hospitals and ambulances queued outside A&Es all over the country due to a lack of beds and staff.
Gareth Grier, an A&E consultant at Barts Health NHS Trust in east London, said today: ‘If Covid patients are left in corridors then covid will spread like wildfire within the hospital. This cannot be allowed to happen. The corridor medicine that was previously endemic in emergency departments would kill people and staff if allowed to reoccur. Hence the awful, terrible option of treating patients outside hospitals’.
UK hospitals are running low on workers, ward space, oxygen and even pillows with patients being treated by medics inside emergency vehicles as they waited up to six hours to be admitted. In some cases people were later diverted more than 100 miles away while some packed London ICUs have started asking major hospitals in Tyneside and Yorkshire if they will take some of their Covid patients.
On the day Britain’s Oxford/AstraZeneca vaccine was approved for use yesterday, Essex declared a ‘major incident’ at its six hospitals, allowing then to move patients elsewhere, speed up discharging, call in extra staff as well as cancel non-emergency care and operations. The Department for Health and Social Care is also expected to set out later today what help the Government will give Essex.
Doctors in areas worst affected by the surging number of coronavirus cases have said they are ‘extremely fearful’ and are just days away from having to make ‘horrendous choices’ over who they can treat and who is left to die.
The chaos has been blamed on dwindling oxygen supplies and NHS chiefs say staff absence is twice its normal level because of illness and self-isolation with some hospitals begging nurses to return early from Christmas holidays and time off in January is now banned by some trusts.
Footage on social media revealed that queues of ambulances were lined up outside the Royal London Hospital in Whitechapel and Queen’s Hospital in Romford, both in east London, and in Kent last night when NHS Providers’ deputy chief executive Saffron Cordery warned pressure on the NHS was ‘rising at an unsustainable rate’.
There were also reports of delays at hospitals in East Anglia, south Wales and Birmingham, where doctor Punith Kempegowda tweeted: ‘Just getting out of a&e after another loooooooong day. Almost all these ambulances are waiting with patients inside them for more than 3 hours because there’s no place in hospital to bring them in’.
There are also growing concerns about the number of people in their 40s and 50s with no underlying health problems being admitted to wards or even appearing on intensive care wards, one London doctor has said.
While doctors have said they are frightened for the next few weeks as inpatient numbers exceeded the first wave peak and cases now bursting through the 50.000-per day mark.
With beds, staff and equipment all running low, consultant anaesthetist Dr Claudia Paoloni warned the situation was just days away from reaching the point where care would be rationed.
Dr Paoloni, president of the Hospital Consultants and Specialists Association, told The Guardian: ‘Our NHS just doesn’t have the beds to cope. Some areas will be overwhelmed in days. If ventilation capacity is exceeded, horrendous choices will have to be made over those who live and die.’
Professor Hugh Montgomery, pictured, an A&E consultant at University College Hospital in London, said he is ‘angry’ with the public for failing to follow the rules and have ‘blood on their hands’ for not wearing masks
A patient being transferred at Romford Queen’s hospital, Essex by paramedics in full PPE as Covid sweeps through hospitals
LONDON: The 4,000-bed Nightingale hospital stands empty, amid surging coronavirus cases and hospital admissions across the country. NHS England figures reveal England has more Covid-19 patients in hospital now than during the first wave of the pandemic in March and April. The hospital is pictured on December 22
She added that other life determining choices will also have to be made, including which patients to admit to intensive care and how long to continue treatments on patients who appear to be making no progress, if for example a patient with better chances of survival needs the haemodialysis machine they are using.
Tributes paid to popular 55-year-old design technology teacher who died from Covid-19
Paul Hilditch, 55, died just two days after Christmas following a two-week battle with Covid-19
Tributes have poured in for a secondary school teacher who died from Covid-19 just two days after Christmas.
Parents, pupils and teachers have described Teesside teacher Paul Hilditch, 55, as ‘dedicated and inspirational’ following his death on Sunday.
Headteacher of Conyers School, Louise Spellman, said they were ‘deeply saddened’ at the sudden loss of their colleague and friend.
Mr Hilditch taught engineering and technology at Conyers for four years and Ms Spellman said he was ‘a truly dedicated, caring and well-loved member of staff.’
Teaching unions have criticised the Government’s handling of the pandemic as they called for greater risk assessments to protect staff from the virus.
Ms Spellman said: ‘Paul was a fantastic teacher who thought so much of his students and really gave his all to ensure they achieved their best,’ she said.
‘Paul loved our school and our students: he will be remembered as a kind, devoted and truly brilliant teacher.
‘All of our thoughts and prayers are with Paul’s friends and family at this time.’
GPs are being offered £10 for every care home resident they vaccinate in a drive by NHS England to reach the majority of those deemed top priority by the end of January.
Latest figures show 786,000 people have received a Pfizer/BioNTech Covid-19 jab between December 8 and Sunday December 27, NHS England said. Around two-thirds, some 524,439, were delivered to people aged 80 and above, equalling around one in five people in that age group.
NHS staff will now also be prioritised following the approval of the Oxford vaccine, the health service said.
Dr Nikki Kanani, GP and NHS medical director for primary care, said: ‘Three-quarters of a million people have now received the Pfizer vaccine thanks to the tireless efforts of NHS staff who have given up time with their families over Christmas to deliver vaccines at the same times as treating record numbers of seriously-ill patients with Covid-19.
‘As we head into the New Year with a second vaccine that is also more versatile, we will be able to expand the programme and ensure that the majority of care home residents are protected within the next four weeks or so.
‘It is also great news that we will be able to begin vaccinating NHS staff serving on the frontline to protect them against coronavirus.’
Defence Secretary Ben Wallace has said the Army currently has 5,000 personnel deployed in the Covid-19 response.
Speaking to Times Radio, he said: ‘I just authorised last night 133 military planners and personnel to go to the NHS vaccine taskforce to make sure we ramp up delivery of that vaccine in parallel with the stocks as they come online.’
Mr Wallace said the Army could be used to deploy the vaccine in hard-to-reach areas, saying: ‘The strength and versatility of the Army is being able to get all over the UK and we will be able to do that as well.’
The Defence Secretary has said most military doctors are already working in the NHS, but hundreds of combat medics are available to help with the Covid-19 response.
‘What people need to understand is that a lot of our clinicians in the armed forces are also clinicians in the NHS, so they are often military reservists,’ Ben Wallace told Times Radio.
He continued: ‘It’s not quite as easy as just taking a whole load of people, who, let’s say, might be anaesthetists in the armed forces, and just putting them in the NHS.
‘You’ll probably find they are already working in the NHS as a reserve.’
Mr Wallace said: ‘On combat medics, we train quite a lot of people to be combat medics supporting frontline units etc.
‘They can deliver injections and those are the people we would make available to increase delivery of this vaccine as the vaccine stocks come online.’
Queens Hospital, Romford: Medics in PPE were caring for patients in ambulance parking bays as sources report a lack of A&E beds and oxygen
Southend: Essex’s hospitals are struggling under the weight of covid cases (Southend University Hospital pictured today) leading to a major incident being declared in the county allowing them to divert patients and get Government support
Birmingham: One doctor said ambulances were waiting for hours to admit patients at the Queen Elizabeth Hospital in England’s second city
East Anglia: One doctor tweeted this image and a sarcastic message rebutting claims that hospitals are not full
Bridgend: Nine ambulances were queuing outside the Princess of Wales Hospital in South Wales yesterday afternoon
Leaked figures revealed that England’s critical care capacity is now running at over 100 per cent at a number of hospitals across London, the south east, and east, the Health Service Journal reports.
Jenny Vaughan, vice-chairwoman of the Doctors’ Association UK, said: ‘DAUK has heard that due to some hospitals being short of intensive care unit beds, patients are having to be transferred out; distances in some cases are over 100 miles from hospitals in southeast London’.
Dr Vaughan said: ‘One of our members in north London has reported that because of the surge in patients with Covid-19, oxygen supplies have had to be conserved. DAUK is concerned for both the safety of patients and the impact of the pressure that staff are under.
‘Lessons have not been learnt, and the mistakes of the first wave are being repeated while frontline staff are treating sick patients in more and more extreme conditions.’
This morning Essex council and health chiefs warned of ‘significant growing demand’ on hospitals across the county and will enable local leaders to seek further support from the Government, the Essex Resilience Forum (ERF) said.
Southend, Basildon and Chelmsford’s Broomfield hospitals have warned that the number of Covid patients has ‘increased markedly, putting severe pressure on emergency departments’, cancelling non-urgent operations. Queen’s Hospital is a hospital in Romford also forms part of the ERF.
Leaked figures revealed that England’s critical care capacity is now running at over 100 per cent at a number of hospitals across London, the south east, and east, the Health Service Journal reports.
The Queen Elizabeth Hospital, in Woolwich, south-east London, declared a major incident on Sunday over fears they could run out of oxygen because of the number of coronavirus patients on its wards.
Today it emerged that its sister hospital in Lewisham had run out of pillows on one of its covid wards, leading to locals offering to donate some via social media.
Lewisham and Greenwich NHS Trust tweeted: ‘Thank you all for your concern, and very kind offers to buy us some but we are covered and have taken extra pillows to the ward in question’.
Another image taken from the NHS critical care dashboard and leaked to HSJ revealed that the number of covid-19 patients in London’s intensive care units has doubled in the last two weeks from 300 to 636
Data from the internal NHS critical care capacity dashboard – leaked to HSJ – showed that London had far surpassed its maximum capacity with intensive care units 114 per cent full on Monday night
The Essex Resilience Forum – which is made up of members of the NHS, emergency services and local authorities – said the number of patients in Essex receiving treatment for coronavirus had now increased to levels exceeding those seen at the peak of the first wave.
It added that such numbers were expected to increase further in the coming days and that cases were particularly high in Mid and South Essex, with Southend University Hospital begging staff to cancel leave and return to work to help cope with rising demand.
Areas of concern included critical care and bed capacity, staff sickness and the ability to discharge patients quickly into safe environments.
Anthony McKeever, executive lead for Mid and South Essex Health and Care Partnership, said: ‘We are taking every action possible within the NHS and across the wider health and social care partnerships in Essex to limit the impact on the NHS and the wider health system.
‘This involves using critical care capacity elsewhere in Essex and the Eastern region and identifying additional locations and capacity to assist with the discharging of patients to reduce pressure on hospitals’.
Coronavirus-stricken pregnant Virgin Atlantic stewardess, 34, is left homeless after fire destroys her house on Christmas Day – three months after she lost job and virus killed her father
A pregnant Virgin Atlantic stewardess who tested positive for Covid-19 has been left homeless after a fire destroyed her house on Christmas Day.
Keira Sanded, 34, faces months in temporary accommodation after her and her partner, who were unwell at the time, took food out of the oven and fell asleep before waking up to a blaze in their kitchen.
The mother-of-two from Newhaven, East Sussex, is 21 weeks pregnant with her third child and was made redundant in September after 13 years in her job.
The following week her father died from coronavirus.
Keira Sanded (pictured above), 34, faces months in temporary accommodation after a fire destroyed her house in Newhaven, East Sussex, on Christmas Day
The mother-of-two and her partner, who were unwell at the time, took food out of the oven and fell asleep before waking up to a blaze in their kitchen (pictured: the scene afterwards)
The scene in Ms Sanded’s kitchen after the fire. She said that fire crews told her it might be weeks before anyone could enter her home and months before it could be lived in again
‘It’s just been a year of devastation,’ said Ms Sanded, who has endured a difficult few months. ‘It’s just been one thing after another.’
She contracted the disease herself days before Christmas and on December 25 was self-isolating with her partner Wayne Barrett.
This meant she had to spend the holiday apart from her children, Cayden Taylor, 11, and Miley Taylor, nine, who are currently staying with their father.
The former stewardess also faces the prospect of losing her dog, Kasper, as a result of moving to temporary accommodation – the four-year-old family pet is not allowed in the new house.
Ms Sanded said: ‘I was completely incapacitated and my partner was really ill as well. He was cooking. We got to about 2.45pm and I was very drowsy. My partner was falling asleep too.
‘He got the meat out of the oven and put it on the side and we both fell asleep. I woke up when I heard a crackling sound and saw smoke drifting across the room.
‘Wayne went into the kitchen to have a look and there was a small fire by the oven.
‘He went and soaked some blankets in water to put over the fire but oxygen got hold of the flames and the fire just grew.’
The former Virgin Atlantic stewardess pictured with her two children. She contracted the disease herself days before Christmas and on December 25 was self-isolating with her partner
The ceiling had been burned through and appliances melted by the flames, which left black scorch marks across the walls.
Ms Sanded said that fire crews told her it might be weeks before anyone could enter her home and months before it could be lived in again.
She added: ‘We were Covid positive and homeless. I explained it all and their out-of-hours team said, ‘don’t worry, we’ll find you emergency accommodation’.’
But she was later told no bed and breakfasts in the area were willing to house her because she had coronavirus. She was able to stay with her mother, who was also isolating after taking her to hospital, for one night.
The next day, Ms Sanded received a call from the council saying she had been booked into a nearby hotel.
But when she rang the hotel to check the details, she found it had not been told she had tested positive for Covid-19. Once the hotel knew, it was unable to accept her.
Following this, Ms Sanded was told by the council she would have to be wait until Tuesday, December 29, for the authority to find her accommodation as this was when all staff would return to work.
Four days after the fire the council found her a two-bedroom property in Seaford. Ms Sanded said this would ‘not be ideal’ as her children were aged 11 and nine. Then things got worse.
She said: ‘We have been told we need to permanently rehouse our dog, Kasper. He can’t come with us. I don’t know what the kids will do when they find out.
‘After the fire, the first thing they asked for was a picture of him. We have had him since he was a puppy.’
She and her partner will have to pay around £1,700 a month for the temporary accommodation, compared to the £430 she was paying for her home previously.
Ms Sanded said: ‘We have lost everything except for the clothes on our back.’
But she added that the support from the Newhaven community has been ‘overwhelming’.
Ms Sanded with Matt LeBlanc. Four days after the fire the council found her a two-bedroom property. Ms Sanded said this would ‘not be ideal’ as her children were aged 11 and nine
The former stewardess pictured with Richard Branson. Ms Sanded said that the support from the Newhaven community has been ‘overwhelming’
Many people and businesses have donated items to help the family and a GoFundMe page set up by her sister has already collected more than £1,470.
Ms Sanded is now looking forward to seeing her children again, with her isolation period ending on Saturday.
‘My little girl is ten in a couple of weeks,’ she said. ‘She has been sending me messages counting down the days until we can see each other again. This is the longest she has ever been away from me.’
A Lewes District Council spokesman said: ‘We sympathise greatly with the most difficult and challenging position Ms Sanded, her family and her partner have found themselves in.
‘Most importantly, no one was hurt in the fire and our team will be liaising with the fire service to assess the damage to the property.
‘The two-bedroom flat that we found for Ms Sanded was the only available property our officers could find in the circumstances, a search that was obviously complicated by her positive Covid-19 test.
‘Our team have provided details of how she can apply for an emergency grant to assist with purchasing essential items. We are in regular contact to ensure she has what she needs and have provided her with details of support agencies.’
Will the shops shut? Can I still go into the office? And will I get fined for seeing my mum? As ALL of England is put in Tier Three or Four – apart from 2,000 living on Isles of Scilly – what the new rules mean for you
Millions more Britons were plunged into the toughest tier four lockdown restrictions today, while the rest of the country was moved up into tier three.
Among the areas of England moving to tier four from midnight tonight are the Midlands, parts of the North East and North West and parts of the South West.
An additional 20million people will moved to the highest tier. This means a total of 44million people will be in tier four, or 78 per cent of England’s population.
Some 12million people will be in tier three, or 22 per cent of the population, while no area will be in tier two. Only the Isles of Scilly will be left in tier one.
The main restrictions in tier four include no household mixing allowed, although one person can meet one other person outside in a public space.
All non-essential shops and businesses must close, including personal care and indoor entertainment, and residents must not stay overnight away from home.
In tier three, the main restrictions are no household mixing allowed indoors or outdoors, except in parks and public gardens, and all hospitality is closed.
Here, MailOnline looks at what the rules mean for those in tiers three and four:
TIER FOUR – ‘Stay At Home’
Will my area be joining tier four?
A total of 44 million people will be living in tier four from 12.01am on Thursday, December 31. This is 78 per cent of the population of England.
The Midlands, North East, parts of the North West and South West are among those escalated to tier four, with almost all remaining areas escalated to tier three.
Some 20 million people have been added to tier four, in the following areas, which will apply from midnight tonight:
- Cheshire: Cheshire East, Cheshire West & Chester and Warrington
- Cumbria: Allerdale, Barrow-in-Furness, Carlisle, Copeland, Eden and South Lakeland
- Derbyshire: Amber Valley, Bolsover, Chesterfield, Derby, Derbyshire Dales, Erewash, High Peak, North East Derbyshire and South Derbyshire
- Dorset: Bournemouth, Christchurch & Poole
- Durham
- Gloucestershire: Cheltenham, Cotswold, Forest of Dean, Gloucester, Stroud and Tewkesbury
- Greater Manchester: Bolton, Bury, Manchester, Oldham, Rochdale, Salford, Stockport, Tameside, Trafford and Wigan
- Hampshire: Isle of Wight and New Forest
- Lancashire: Blackburn with Darwen, Blackpool, Burnley, Chorley, Fylde, Hyndburn, Lancaster, Pendle, Preston, Ribble Valley, Rossendale, South Ribble, West Lancashire and Wyre
- Leicestershire: Blaby, Charnwood, Harborough, Hinckley & Bosworth, Leicester, Melton, North West Leicestershire and Oadby & Wigston
- Lincolnshire: Boston, East Lindsey, Lincoln, North Kesteven, South Holland, South Kesteven and West Lindsey
- Northamptonshire: Corby, Daventry, East Northamptonshire, Kettering, Northampton, South Northamptonshire and Wellingborough
- Northumberland
- Nottinghamshire: Ashfield, Bassetlaw, Broxtowe, Gedling, Mansfield, Newark & Sherwood, Nottingham and Rushcliffe
- Somerset: Mendip, Sedgemoor, Somerset West & Taunton and South Somerset
- Staffordshire: Cannock Chase, East Staffordshire, Lichfield, Newcastle-under-Lyme, South Staffordshire, Stafford, Staffordshire Moorlands, Stoke-on-Trent and Tamworth
- Tees Valley: Darlington, Hartlepool, Middlesbrough, Redcar & Cleveland and Stockton-on-Tees
- Tyne & Wear: Gateshead, Newcastle upon Tyne, North Tyneside, South Tyneside and Sunderland
- Warwickshire: North Warwickshire, Nuneaton & Bedworth, Rugby, Stratford-on-Avon and Warwick
- West Midlands metropolitan county: Birmingham, Coventry, Dudley, Sandwell, Solihull, Walsall and Wolverhampton
- Wiltshire: Swindon
Is my area already in tier four?
The areas already in tier four are:
- Bedfordshire
- Berkshire
- Buckinghamshire
- Cambridgeshire
- East Sussex
- Essex
- Hampshire
- Hertfordshire
- Kent
- London
- Norfol
- Oxfordshire
- Suffolk
- Surrey
- West Sussex
What are the main restrictions in tier four?
- No household mixing allowed, though one person can meet one other person outside in a public space
- All non-essential shops and businesses must close, including personal care and indoor entertainment
- Nobody can enter or leave tier four areas unless they have a reasonable excuse
- Residents must not stay overnight away from home
Can I see my friends or family indoors?
No, unless they are in the same household. The rules for this are the same in tier three.
Can I see my friends and family outdoors?
Yes, but not in private gardens. You can only socialise with one other person in outdoor public spaces, including parks, beaches, countryside accessible to the public, a public garden, grounds of a heritage site or castle, or a sports facility.
Does the ‘rule of six’ apply in tier four?
No. The ‘rule of six’ only applies in tier three and below. In tier four, you can only meet with one other person in an outdoor public space. Larger gatherings are banned.
Can I go shopping?
Not for non-essential items. Supermarkets and other essential shops will stay open, but non-essential retailers, such as those selling clothes, must close.
The full list of businesses and venues allowed to remain open is as follows:
- essential retail such as food shops, supermarkets, pharmacies, garden centres, building merchants and suppliers of building products and off-licences
- market stalls selling essential retail may also stay open
- businesses providing repair services may also stay open, where they primarily offer repair services
- petrol stations, automatic (but not manual) car washes, vehicle repair and MOT services, bicycle shops, and taxi and vehicle hire businesses
- banks, building societies, post offices, short-term loan providers and money transfer businesses
- funeral directors
- laundrettes and dry cleaners
- medical and dental services
- vets and pet shops
- animal rescue centres, boarding facilities, and animal groomers (may continue to be used for animal welfare, rather than aesthetic purposes)
- agricultural supplies shops
- mobility and disability support shops
- storage and distribution facilities
- car parks, public toilets and motorway service areas
- outdoor playgrounds
- outdoor gym, pools, sports courts and facilities
- golf courses
- archery/driving/shooting ranges (outdoors)
- outdoor riding centres
- places of worship
- crematoriums and burial grounds
Can I go the pub or restaurant?
No. These all have to shut under law, except for takeaway and delivery.
Will it get fined if I break the rules?
The police can take action against people if they meet in larger groups by issuing a fine of £200 for the first offence, doubling for further offences up to a maximum of £6,400.
If you hold, or are involved in holding, an illegal gathering of more than 30 people, the police can issue fines of £10,000.
Can zoos and gardens stay open?
Yes. Certain outdoor venues, such as botanical gardens, heritage sites, and zoos and other animal attractions may stay open, although indoor elements at these attractions must close.
Can I get a takeaway?
Yes. Hospitality settings, such as pubs, cafes and restaurants are allowed to continue sales by takeaway, click-and-collect, drive-through or delivery services.
Just 2,000 people on the Isles of Scilly are left in Tier 1 – with everyone else in England now under the highest Tier 3 and 4 lockdowns from midnight
What venues have to stay shut?
The majority of entertainment and tourist venues must close, as is the case in tier three, including:
- indoor play centres and areas, including trampolining parks and soft play
- casinos
- bingo halls
- bowling alleys
- skating rinks
- amusement arcades and adult gaming centres
- laser quests and escape rooms
- cinemas, theatres and concert halls
- snooker halls
Can indoor attractions at outdoor venues stay open?
No. Indoor attractions at mostly outdoor entertainment venues must also close.
Can leisure and sports facilities stay open?
No. Leisure centres, indoor gyms, indoor swimming pools, indoor sports courts, indoor fitness and dance studios, indoor riding centres and indoor climbing walls must all close.
Can I attend a live sports event?
No. There should be no public attendance at spectator sport or indoor performances and large business events should not be taking place. However, elite sport events may continue to take place without spectators.
Can large outdoor events take place?
No. The likes of performances and shows should not take place.
Can I still go to church?
Yes. Places of worship remain open, but you must not attend with or socialise with anyone outside of your household or support bubble while you are there, unless a legal exemption applies.
Can a wedding take place?
Yes. weddings can go ahead with restrictions on the number of attendees – six people can attend the ceremonies, and receptions are not allowed.
Can I go to a funeral?
Yes. Thirty people can attend funeral ceremonies, and six people can attend linked commemorative events
Can organised outdoor sport take place?
No, for most people. However, organised outdoor sport for under 18s and disabled people will still be allowed.
Can indoor sport take place?
No. Indoor gyms and sports facilities will close.
Can I still travel to places?
You must not leave your home unless you have a reasonable excuse, such as for work or education purposes.
If you need to travel you should stay local – meaning avoiding travelling outside of your village, town or the part of a city where you live – and ‘look to reduce the number of journeys you make overall’.
The list of reasons you can leave your home and area include, but are not limited to:
- work, where you cannot work from home
- accessing education and for caring responsibilities
- visiting those in your support bubble – or your childcare bubble for childcare
- visiting hospital, GP and other medical appointments or visits where you have had an accident or are concerned about your health
- buying goods or services from premises that are open in Tier 4 areas, including essential retail, but these should be within your local area wherever possible
- outdoor recreation or exercise. This should be done locally wherever possible, but you can travel a short distance within your Tier 4 area to do so if necessary (for example, to access an open space)
- attending the care and exercise of an animal, or veterinary services
Can I go on holiday to other parts of Britain?
No. You cannot leave your home or the place where you are living for holidays or overnight stays unless you have a reasonable excuse for doing so.
You are only allowed to stay overnight away from your home if you:
- are visiting your support bubble
- are unable to return to your main residence
- need accommodation while moving house
- need accommodation to attend a funeral or related commemorative event
- require accommodation for work purposes or to provide voluntary services
- are a child requiring accommodation for school or care
- are homeless, seeking asylum or a vulnerable person seeking refuge
- are an elite athlete or their support staff or parent, if the athlete is under 18 and it is necessary to be outside of the home for training or competition
Can I go abroad?
Yes, but with tight restrictions. For international travel see the Foreign, Commonwealth and Development Office travel advice for your destination and the travel corridors list.
You can also only travel internationally – or within the UK – where you first have a legally permitted reason to leave home.
The Government also advises that people should consider the public health advice in the country they are visiting.
TIER THREE – ‘Very High Alert’
Will my area be joining tier three?
A total of 12million people will be living in tier three from December 31. This is 22 per cent of the population of England.
The following areas will move into tier three from midnight tonight:
- Cornwall
- Devon: East Devon, Exeter, Mid Devon, North Devon, Plymouth, South Hams, Teignbridge, Torbay, Torridge and West Devon
- Dorset
- Herefordshire
- Liverpool City Region: Halton, Knowsley, Liverpool, Sefton, St. Helens and Wirral
- North Yorkshire: Craven, Hambleton, Harrogate, Richmondshire, Ryedale, Scarborough and Selby
- Rutland
- Shropshire, including Telford & Wrekin
- Somerset: Bath & North East Somerset
- Wiltshire
- Worcestershire: Bromsgrove, Malvern Hills, Redditch, Worcester, Wychavon and Wyre Forest
- York
Which areas are already in tier three?
The following areas are already in tier three:
- Bristol
- Humber
- North Somerset
- South Gloucestershire
- South Yorkshire
- West Yorkshire
What are the main restrictions in tier three?
- No household mixing indoors or outdoors, except in parks and public gardens
- All hospitality is closed, except for takeaways and deliveries
- All accommodation and entertainment venues are closed
What does tier three mean?
This is a ‘very high’ alert level – the highest of the three-tier system – for areas with a very high or very rapidly rising level of infections, where tighter restrictions are in place.
Can I see my friends or family indoors?
No, unless they are in the same household. The rules for this are the same in tier four.
Can I see my friends and family outdoors?
Yes, but not in private gardens. You can only socialise in groups of up to six people in other outdoor public spaces, including parks, beaches, countryside accessible to the public, a public garden, grounds of a heritage site or castle, or a sports facility.
Does the ‘rule of six’ apply in tier three?
Yes. It applies to when you meet people from other households in outdoor public spaces. You cannot mix with other households indoors or in private gardens.
Can I go shopping?
Yes. Non-essential shops can remain open.
Will it get fined if I break the rules?
The police can take action against people if they meet in larger groups by issuing a fine of £200 for the first offence, doubling for further offences up to a maximum of £6,400.
If you hold, or are involved in holding, an illegal gathering of more than 30 people, the police can issue fines of £10,000.
Can I go the pub or restaurant?
No. These all have to shut under law, except for takeaway and delivery.
Can I get a takeaway?
Yes. Hospitality settings, such as pubs, cafes and restaurants are allowed to continue sales by takeaway, click-and-collect, drive-through or delivery services.
What venues have to stay shut?
The majority of entertainment and tourist venues must close, including:
- indoor play centres and areas, including trampolining parks and soft play
- casinos
- bingo halls
- bowling alleys
- skating rinks
- amusement arcades and adult gaming centres
- laser quests and escape rooms
- cinemas, theatres and concert halls
- snooker halls
Can indoor attractions at outdoor venues stay open?
No. Indoor attractions at mostly outdoor entertainment venues must also close, although indoor shops, through-ways and public toilets at such attractions can remain open.
This includes indoor attractions within:
- zoos, safari parks, and wildlife reserves
- aquariums, visitor attractions at farms, and other animal attractions
- model villages
- museums, galleries and sculpture parks
- botanical gardens, biomes or greenhouses
- theme parks, circuses, fairgrounds and funfairs
- visitor attractions at film studios, heritage sites such as castles and stately homes
- landmarks including observation decks and viewing platforms
Can leisure and sports facilities stay open?
Yes, with restrictions. Group exercise classes including fitness and dance should not go ahead. Saunas and steam rooms should also close.
Can I attend a live sports event?
No. There should be no public attendance at spectator sport or indoor performances and large business events should not be taking place. However, elite sport events may continue to take place without spectators.
Can large outdoor events take place?
No. The likes of performances and shows should not take place, with the exception of drive-in events.
Can I still go to church?
Yes. Places of worship remain open, but you must not attend with or socialise with anyone outside of your household or support bubble while you are there, unless a legal exemption applies
Can a wedding take place?
Yes. weddings can go ahead with restrictions on the number of attendees – 15 people can attend the ceremonies, and receptions are not allowed.
Can I go to a funeral?
Yes. Thirty people can attend funeral ceremonies, and 15 people can attend linked commemorative events
Can organised outdoor sport take place?
Yes. Organised outdoor sport, and physical activity and exercise classes can continue, however you are advised to avoid contact with other people.
Can indoor sport take place?
No. Organised indoor sport, physical activity and exercise classes cannot take place indoors.
There are exceptions for indoor disability sport, sport for educational purposes and supervised sport and physical activity for under-18s.
Can I still travel to places?
Yes, although you are advised to stay local and avoid travelling outside your local area, which means your village or town, or part of a city.
You should also continue to travel for reasons such as work, education, medical attention or if you have caring responsibilities.
You can also still travel to venues that are open, or for reasons such as work or education, but ‘should reduce the number of journeys you make wherever possible’.
Can I go on holiday to other parts of Britain?
No. You should ‘avoid travelling to other parts of the UK’, including for overnight stays other than where necessary, such as for work, education, youth services, to receive medical treatment, or because of caring responsibilities.
However, you can travel through other areas as part of a longer journey.
Can I go abroad?
Yes, with restrictions. For international travel see the Foreign, Commonwealth and Development Office travel advice for your destination and the travel corridors list.
The Government advises that people in tier three should ‘carefully consider whether they must travel abroad, and should follow the rules in their area’.
What about tiers two and one?
No areas will be in tier two from December 31.
Just 2,000 people remain in tier one – the population of the Isles of Scilly. The main restrictions in tier one are:
- The ‘rule of six’ must apply indoors and outdoors
- There must be table service in hospitality venues, with last orders at 10pm and closing time at 11pm
- Large sporting and entertainment events are allowed but with a limited audience.
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