Travel ban implemented to protect public health following South Africa COVID-19 outbreak

passengers travelling from South Africa into England from 9am Thursday 24 December will not be permitted to enter, reflecting increased risk from new strain of coronavirus
British and Irish Nationals, visa holders and permanent residents arriving from South Africa will be able to enter but are required to self-isolate for 10 days along with their household
travellers urged to continue to check the latest advice from the FCDO

The government has responded urgently to new evidence which demonstrates the need to temporarily suspend entry for passengers arriving from South Africa to England.

From 9am Thursday 24 December 2020, visitors arriving into England who have been in or transited through South Africa in the previous 10 days will not be permitted entry and direct flights will be banned. This excludes cargo and freight without passengers.

This does not include British and Irish Nationals, visa holders and permanent residents, who will be able to enter but are required to self-isolate for 10 days along with their household.

The decision follows the release of further information from health authorities in South Africa reporting an outbreak of coronavirus (COVID-19), with a variant strain spreading in some provinces.

This is different to the UK variant, meaning a travel ban is critical to prevent further domestic infection.

The UK does not currently have a travel corridor with South Africa, and so anyone who has returned from the country recently should already be self-isolating for 10 days and should continue to do so.

Any exemptions usually in place – including for those related to employment – will not apply and passengers arriving in England from South Africa after 9pm on 23 December cannot be released from self-isolation through Test to Release.

People who share a household with anyone self-isolating after returning from South Africa will now also need to self-isolate until 10 days have passed since anyone they live with was last in South Africa.

The UK government is working closely with international partners to understand the changes in the virus that have been reported in South Africa and we are conducting a programme of further research here in the UK to inform our risk assessments.

British and Irish Nationals, visa holders and permanent residents who are arriving from South Africa will be required to show a complete passenger locator form on arrival into the UK. This is critical in being able to track the virus in case of any local outbreaks.

The Home Office will step up Border Force presence to ensure that those arriving to England from South Africa are compliant with the new restrictions.

The ban and expanded self-isolation measures will be kept under review.

Decisions on border measures can be changed rapidly if necessary to help stop the spread of the disease. Likewise travel advice is constantly updated with the latest information for British and Irish nationals. Britons in South Africa should continue to check the Foreign, Commonwealth and Development Office travel advice and sign up to email alerts.

£400 million of new funding to support Scotland through Covid-19

New funding of £800 million is being guaranteed for the devolved administrations in Scotland, Wales and Northern Ireland to support people, businesses and public services with the ongoing impact of Covid-19.

Today’s announcement increases the UK Government’s unprecedented upfront guarantee this year to at least £16.8 billion on top of funding outlined in Spring Budget 2020.

This funding can be spent on priorities such as the NHS and business support.

This means a further £400 million for the Scottish Government, £200 million for the Welsh Government and £200 million for the Northern Ireland Executive.

Any changes to devolved funding are normally confirmed towards the end of the financial year – but in July the UK Government introduced an unprecedented guarantee to provide them with funding certainty to respond to Covid-19.

Today’s announcement ensures that all parts of the UK can continue their response to Covid-19 through the winter months.

The Chief Secretary to the Treasury Steve Barclay MP said:

We’ve already committed unprecedented levels of support to Scotland, Wales and Northern Ireland.

This extra funding will provide the nations with the certainty they need to plan through these difficult months.

We remain committed to an economic recovery for the whole of the United Kingdom and will continue to work closely with the devolved administrations to support people and businesses.

Scottish Secretary, Alister Jack said

The UK Government is committed to supporting people in all parts of the UK during this difficult time which is why today we have given £400 million extra to the Scottish Government for their Covid-19 response. This brings our total additional Covid-19 support to Scotland to £8.6 billion since Spring Budget 2020.

This is on top of direct UK Government Covid-19 support to people and businesses in Scotland, including the furlough and self-employment schemes, business loans, VAT cuts for the hardest hit sectors and investing billions in our Plan for Jobs and our welfare safety net.

The UK Government is also providing the bulk of Covid-19 testing in Scotland and we invested £6 billion to ensure we were the first country in the world to roll out the first vaccine.

The strength of the Union and support offered by the UK Treasury has never been more important. Together, we will continue to get through these challenging times.

People and businesses in Scotland, Wales and Northern Ireland will also continue to benefit from the UK Government’s unprecedented £280 billion UK-wide economic response package.

This includes schemes such as the Coronavirus Business Interruption Loan Scheme and the Bounce Back Loan Scheme providing billions in support to businesses across the three regions.

Alongside this, millions of jobs in the three regions continue to be supported through the Coronavirus Job Retention Scheme and the Self-Employment Income Support Scheme.

£400 million of new funding to support Scotland through Covid-19

Today’s announcement increases the UK Government’s unprecedented upfront guarantee this year to at least £16.8 billion on top of funding outlined in Spring Budget 2020.

This funding can be spent on priorities such as the NHS and business support.

This means a further £400 million for the Scottish Government, £200 million for the Welsh Government and £200 million for the Northern Ireland Executive.

Today’s announcement ensures that all parts of the UK can continue their response to Covid-19 through the winter months.

The Chief Secretary to the Treasury Steve Barclay MP said:

We’ve already committed unprecedented levels of support to Scotland, Wales and Northern Ireland.

This extra funding will provide the nations with the certainty they need to plan through these difficult months.

We remain committed to an economic recovery for the whole of the United Kingdom and will continue to work closely with the devolved administrations to support people and businesses.

Scottish Secretary, Alister Jack said

The UK Government is committed to supporting people in all parts of the UK during this difficult time which is why today we have given £400 million extra to the Scottish Government for their Covid-19 response. This brings our total additional Covid-19 support to Scotland to £8.6 billion since Spring Budget 2020.

This is on top of direct UK Government Covid-19 support to people and businesses in Scotland, including the furlough and self-employment schemes, business loans, VAT cuts for the hardest hit sectors and investing billions in our Plan for Jobs and our welfare safety net.

The UK Government is also providing the bulk of Covid-19 testing in Scotland and we invested £6 billion to ensure we were the first country in the world to roll out the first vaccine.

The strength of the Union and support offered by the UK Treasury has never been more important. Together, we will continue to get through these challenging times.

People and businesses in Scotland, Wales and Northern Ireland will also continue to benefit from the UK Government’s unprecedented £280 billion UK-wide economic response package.

This includes schemes such as the Coronavirus Business Interruption Loan Scheme and the Bounce Back Loan Scheme providing billions in support to businesses across the three regions.

Alongside this, millions of jobs in the three regions continue to be supported through the Coronavirus Job Retention Scheme and the Self-Employment Income Support Scheme.

Government tiers review update

From the beginning of 26 December, Norfolk, Suffolk, Cambridgeshire, Oxfordshire and most of Hampshire to be escalated to Tier 4, Cheshire and Northamptonshire escalated to Tier 3, and Cornwall and Herefordshire escalated to Tier 2
Latest data confirms rapid case rises are strongly linked to the new strain of coronavirus

After careful consideration of the latest data, the following local authority areas will move to Tier 4: Stay at Home from the beginning of 26 December:

Brighton and Hove
Cambridgeshire
remaining parts of East Sussex not already in Tier 4 (Eastbourne Borough Council, Lewes District Council and Wealden District Council)
remaining parts of Essex not already in Tier 4 (Colchester Borough, Tendring District, and Uttlesford District Councils)
Hampshire (Basingstoke and Deane Borough, East Hampshire District, Eastleigh Borough, Fareham Borough, Hart District, Rushmoor Borough, Test Valley Borough, Winchester City Councils)
Norfolk
Oxfordshire
Southampton
Suffolk
Waverley Borough
West Sussex

The following local authority areas will move to Tier 3: Very High:

Bristol
Cheshire East
Cheshire West and Chester
Gloucestershire
Isle of Wight
New Forest District
North Somerset
Northamptonshire
Somerset
Swindon
Warrington

The following local authority areas will move from Tier 1: Medium to Tier 2: High:

The latest analysis shows a strong correlation between areas with the most rapid rise of cases and prevalence of the new strain of COVID-19. The government has decided to act ahead of the formal review point, in order to contain the spread of this new and more transmissible strain.

Since the end of national restrictions, the situation in the South and East of England has deteriorated. New cases have continued to rise and hospital admissions have increased. Without urgent action this trend would continue at an increasingly rapid rate, leading to a rise in hospital admissions and deaths in the following 2 weeks and hitting the NHS at its busiest time of year.

New data suggests that the increasing speed of transmission in London, the South East and East of England is being driven by the new variant of the virus. There is no current evidence to suggest the new strain causes a higher mortality rate, or that it affects vaccines and treatments, but the latest NERVTAG analysis continues to indicate that the variant is more transmissible than other strains.

Between 9 and 16 December in the East of England the weekly case rate rose sharply to 380 per 100,000 – a 100% increase on the previous week. Rates in the South East have increased to 349 per 100,000 – a 77% increase on the previous week. Rates in the South West have increased to 123 per 100,000 – a 46% rise on the previous week.

All available data has been assessed by the Government, including the Health and Social Care Secretary, NHS Test and Trace including the Joint Biosecurity Centre (JBC), Public Health England (PHE), the Chief Medical Officer and the Cabinet Office.

As confirmed on Monday 21 December, all clinically extremely vulnerable individuals will be asked to shield if they reside in Tier 4 areas. People living in the additional Tier 4 areas announced today will be sent a letter or email with advice and details of support. In the meantime they should follow the shielding advice set out on GOV.UK.

Tier 3 and 4 areas will continue to be prioritised for community lateral flow testing, with over 100 local authorities now having signed up to the enhanced testing support programme, and some Tier 2 areas also eligible. More than 2 million tests have already been deployed to over 100 local authorities to start community testing through the Directors of Public Health programme. Scientists at PHE Porton Down have confirmed that Lateral Flow Device tests can successfully detect the new variant of SARS-CoV-2.

Data assessed includes how quickly case rates are going up or down, cases in the over 60s, pressure on the NHS and local circumstances. Where regions are densely populated with lots of people travelling between areas, tiers must be targeted at the appropriate level to protect people and control transmission.

The next formal review of tiering decisions will take place by 30 December. The government keeps the data under constant review and will take immediate action to protect local communities.

Full details on all of today’s changes

Overview

A novel variant of SARS-CoV-2 is circulating in England. The strain shows apparent increased transmissibility. There is currently no evidence that the variant is more likely to cause severe disease or mortality, but this is still under investigation. As of 20 December 2020, 144 lower-tier local authorities have identified at least 1 case genomically, although the vast majority of cases identified are in London, the South East and the East of England.

The evidence shows that infection rates in geographical areas where this particular variant has been circulating have increased faster than expected, and the modelling evidence has demonstrated that this variant has a higher transmission rate than other variants in current circulation. Speed of case rate growth is closely correlated with presence of the new variant.

East Midlands

Area	Narrative
Northamptonshire (Tier 3: Very High)	In the past week the picture in Northamptonshire has deteriorated, with case rates in all ages broadly increasing across the area. South Northamptonshire, Wellingborough, Kettering and Daventry are local authorities of particular concern, with cases rates increasing between 60% and 80% in these areas from the previous week. The number of daily COVID hospital admissions in the local NHS (Northamptonshire STP) has stabilised in the last 14 days. The daily COVID bed occupancy is above the national acute hospital average but has stabilised. Three local authorities in the area (East Northamptonshire, South Northamptonshire and Wellingborough) border with current Tier 4 areas, where there is a rapid deterioration in epidemiology indicators. The rapid deterioration of the epidemiology indicators is concerning and warrants escalation to Tier 3.

Area

Narrative

Northamptonshire
(Tier 3: Very High)

In the past week the picture in Northamptonshire has deteriorated, with case rates in all ages broadly increasing across the area. South Northamptonshire, Wellingborough, Kettering and Daventry are local authorities of particular concern, with cases rates increasing between 60% and 80% in these areas from the previous week. The number of daily COVID hospital admissions in the local NHS (Northamptonshire STP) has stabilised in the last 14 days. The daily COVID bed occupancy is above the national acute hospital average but has stabilised. Three local authorities in the area (East Northamptonshire, South Northamptonshire and Wellingborough) border with current Tier 4 areas, where there is a rapid deterioration in epidemiology indicators. The rapid deterioration of the epidemiology indicators is concerning and warrants escalation to Tier 3.

East of England

Area	Narrative
Cambridgeshire and Peterborough (Tier 4: Stay at Home)	In the last 7 days, the picture in Cambridgeshire and Peterborough has deteriorated significantly. Case rates have increased by 50% or more in all local authorities in this area. Case rate increases have been greatest in Huntingdonshire (165%) and South Cambridgeshire (133%) which are bordering Peterborough which is currently under Tier 4 restrictions, and Cambridge (122%). Testing positivity is above 5% in all local authorities. Case rates people aged 60 years and older have also increased in South Cambridgeshire, Fenland, Huntingdonshire and Peterborough. Of particular concern is Fenland where the case rate in people aged 60 years and older has increased to 154/100,000 per week. The situation in Peterborough remains highly concerning with a case rate of 385 per 100,000 and a percentage of individuals who test positive of 13%. The number of daily COVID hospital admissions in the local NHS (Cambridgeshire and Peterborough STP) continues to rise. The daily COVID bed occupancy is below the national acute hospital average but continues to rise as does the critical care occupancy. The epidemiological indicators are sufficiently concerning that the entire area requires escalation to Tier 4, with Peterborough remaining in Tier 4.
Essex, Thurrock and Southend-on-Sea (Tier 4: Stay at Home)	In the last 7 days, the picture in Essex, Thurrock and Southend-On-Sea has deteriorated significantly. Case rates are very high and have been increasing rapidly across the area and over the last 7 days; case rates are above 500 per 100,000 in 10 out of 14 local authorities and have increased by more than 90% in the last 7 days in all local authorities apart from Basildon. Case rates in people aged 60 years and older throughout the region are also very high and are above 200 per 100,000 in 11 of 14 local authorities. Areas currently in Tier 4 restrictions of particular concern include Basildon (case rate 1002 per 100,000 per week), Thurrock (case rate 1061 per 100,000 per week, an increase of 174% on the previous week), Epping Forest (case rate 970 per 100,000 per week, an increase of 154% for the previous week) and Brentwood (case rate 884 per 100,000 per week). The remaining areas not in Tier 4 (Uttlesford, Colchester and Tendring), yet bordering Tier 4 are also concerning, and the situation is quickly deteriorating; case rates in all three have increased rapidly and are now above 200 per 100,000 per week. In the local NHS (Hertfordshire and West Essex STP) the number of daily COVID hospital admissions continues to rise steeply. The daily COVID bed occupancy has risen well above the national acute hospital average in the last 7 days and continues to rise as does the critical care occupancy. In Mid and South Essex 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 very high. In Suffolk and North East Essex STP COVID admissions are increasing significantly. The daily COVID bed occupancy is now above national average and rising. The proportion of critical care beds or beds with mechanical ventilation occupied by COVID patients remains high but stable. Local authorities not already included in Tier 4 (Colchester, Uttlesford and Tendring) have seen a continued deterioration in the epidemiological situation and require escalation to Tier 4.
Norfolk (Tier 4: Stay at Home)	In the past week the picture in Norfolk has deteriorated significantly, with case rates in all local authorities increasing by 30% or more. The most worrying increase in case rate is seen in Breckland, with an increase in cases of 106% since last week. Rapid increases are also seen in Broadland (90%) and North Norfolk (71%). The case rate in people 60 years and older is highest in Kings Lynn and West Norfolk at 153 per 100,000 and Breckland at 138 per 100,000 with increases seen in both local authorities. Test positivity is above 5% in 6 out of 7 local authorities. The number of daily COVID hospital admissions in the local NHS (Norfolk & Waveney STP) continues to rise steeply. The daily COVID bed occupancy has now risen to the national acute hospital average and continues to rise. Critical levels are stable. The rate of increase of the epidemiological indicators is concerning and warrants that Norfolk is escalated to Tier 4.
Suffolk (Tier 4: Stay at Home)	In the past week the picture in Suffolk has deteriorated significantly, with most areas showing case rate increases close to or above 100% since last week. The most worrying increases in case rates are seen in Babergh, West Suffolk and Mid Suffolk, which are all above about 140%. Two of these local authorities, Babergh and West Suffolk, also border with current Tier 4 areas, where epidemiology indicators are high and rapidly deteriorating. The case rates in people 60 years and older are highest in Ipswich at 191 per 100,000 and Mid Suffolk at 156 per 100,000. Mid Suffolk has seen a particularly rapid rise in this age group. Test positivity is at or above 5% in all local authorities in the area. COVID admissions are increasing significantly in the local NHS (Suffolk & North East Essex STP). The daily COVID bed occupancy is now above national average and rising. The proportion of critical care beds or beds with mechanical ventilation occupied by COVID patients remains high but stable. The rate of increase of the epidemiology indicators in this area which borders existing Tier 4 areas and the increase in hospital admissions are concerning and warrant escalation to Tier 4.

North West

Area	Narrative
Cheshire and Warrington (Tier 3: Very High)	In the last week the picture in Cheshire and Warrington has deteriorated, with all epidemiological indicators increasing across all three local authorities. Case rates have increased by over 50% in all three local authorities in the last seven days. Warrington is of particular concern with a case rate over 200 per 100,000. Cheshire West & Chester and Warrington both have a case rate in people aged 60 years and older above 150 per 100,000. The most recent data shows an increase for all local authorities and is particularly marked in Warrington. COVID admissions to hospitals in the local NHS (Cheshire and Merseyside STP) have seen a slight increase in the past week, but prior trend was downwards. G&A bed occupancy remains high, but static. Critical care position is stable, with significantly greater proportion of beds occupied by non-COVID patients than COVID patients.Due to the rate of increase of epidemiological indicators the situation in Cheshire and Warrington is concerning and warrants escalation from Tier 2 to Tier 3.

Area

Narrative

Cheshire and Warrington
(Tier 3: Very High)

In the last week the picture in Cheshire and Warrington has deteriorated, with all epidemiological indicators increasing across all three local authorities. Case rates have increased by over 50% in all three local authorities in the last seven days. Warrington is of particular concern with a case rate over 200 per 100,000. Cheshire West & Chester and Warrington both have a case rate in people aged 60 years and older above 150 per 100,000. The most recent data shows an increase for all local authorities and is particularly marked in Warrington. COVID admissions to hospitals in the local NHS (Cheshire and Merseyside STP) have seen a slight increase in the past week, but prior trend was downwards. G&A bed occupancy remains high, but static. Critical care position is stable, with significantly greater proportion of beds occupied by non-COVID patients than COVID patients.Due to the rate of increase of epidemiological indicators the situation in Cheshire and Warrington is concerning and warrants escalation from Tier 2 to Tier 3.

South East

Area	Narrative
East Sussex West Sussex, and Brighton and Hove (Tier 4: Stay at Home)	In the past 7 days the picture in East Sussex, West Sussex, and Brighton and Hove has deteriorated considerably. Case rates in all ages, case rates in people aged 60 years and older, and positivity are increasing in almost all local authorities. Of particular concern are the rapidly increasing case rates in the local authorities currently not under Tier 4 restrictions where 8 of the 11 local authorities have seen an increase in case rates above 100% in the last 7 days: Wealden, Eastbourne, Mid Sussex, Crawley, Lewes, Arun, Adur, Brighton and Hove. Whilst case rates are currently lower in Worthing (112 per 100,000), Horsham (108 per 100,000), and Chichester (106 per 100,000), when looking at the most recent data considerable increases are observed. The number of daily COVID hospital admissions in the local NHS (Sussex STP) continues to rise and now significantly exceeds the peak in Wave 1. The daily COVID bed occupancy also continues to rise, however whilst the proportion of critical care beds occupied by COVID patients is increasing it remains lower than wave 1 peak. The considerable and rapid deterioration of epidemiological indicators in this area as well as the increasing pressure on the NHS is of significant concern, and therefore warrants the escalation of Wealden, Eastbourne, Mid Sussex, Crawley, Lewes, Arun, Adur, Brighton and Hove, Horsham, and Chichester to Tier 4 (to align with Hastings and Rother currently in Tier 4).
Hampshire, Portsmouth and Southampton (Tier 4: Stay at Home for all but New Forest – Tier 3: Very High)	In the past 7 days the picture in Hampshire, Portsmouth, and Southampton has deteriorated. Case rates in all ages and in people aged 60 years and older, and positivity are increasing in almost all local authorities. Case rates in all ages are rapidly increasing in the majority of local authorities with 9/13 areas showing an increase from the previous 7 days above 80%. Of particular concern is Rushmoor, which borders Tier 4 local authorities. Rushmoor has an overall case rate above 300 per 100,000, which has increased by 134% in past 7 days. In addition Hart, East Hampshire, Basingstoke and Deane, and Test Valley, which also border Tier 4 areas have all experienced large increases in case rates in the past 7 days. Case rates are currently lower in Eastleigh (89 per 100,000) and New Forest (89 per 100,000), but in the most recent data considerable increases can be observed. The number of daily COVID hospital admissions in the local NHS (Hampshire & Isle of Wight STP) continues to rise steadily with increased numbers of COVID positive patients in critical care. Current bed occupancy is below the national average but is rising. The considerable and rapid deterioration of epidemiological indicators in this area as well as the continued increase in pressure on the NHS is of concern, and therefore warrants the escalation of Rushmoor, Hart, Fareham, East Hampshire, Southampton, Basingstoke and Deane, Winchester, Test Valley Eastleigh to (Tier 4 to align with Gosport, Havant, and Portsmouth currently in Tier 4). The lower case rates and slightly less concerning trajectory (18% increase in the last seven days) of the New Forest local authority does not yet warrant inclusion at Tier 4 and instead is being escalated to Tier 3. In addition, the area shares a larger proportion of its land borders with the lower prevalence areas of Dorset and Wiltshire.
Oxfordshire (Tier 4: Stay at Home)	In the past week the epidemiological picture in Oxfordshire has deteriorated rapidly with case rates rising 89% to 202 per 100,000. The most recent data shows the upwards trend continuing. Case rates are now about 150 per 100,000 in every LTLA in the area. Tier 2 areas of Oxfordshire that border Tier 4 areas include Cherwell, South Oxfordshire and the Vale of White Horse. These have seen a deterioration of the overall epidemiological situation with case rates now of 256 per 100,000 in Cherwell (128% increase), 158 per 100,000 in South Oxfordshire (42% increase) and 161 per 100,000 in the Vale of White Horse (99% increase). Case rates in people aged 60 years and older are of particular concern in Oxford (212 per 100,000/week, up over 100%) and are rising elsewhere in the area, with the exception of South Oxfordshire, where the case rate in the population aged 60 years and older is stable. The number of daily COVID hospital admissions continues to rise steadily in the local NHS (Buckinghamshire, Oxfordshire & Berkshire West STP) with increased numbers of COVID positive patients in critical care. Occupancy is currently at national average and rising. The rapid rate of increase of key epidemiological indicators and the proximity to concerning Tier 4 areas warrants that all local authorities in Oxfordshire are escalated from Tier 2 to Tier 4.
Surrey – Waverley (Tier 4: Stay at Home)	In the past week there has been significant increase in case rates within Waverley, Surrey (214 per 100,000, an increase of 139%). The rest of Surrey has been escalated to Tier 4, and the current situation in Waverley now warrants further escalation. The most recent data suggests that the case numbers are continuing to rise exponentially. In the local NHS (Surrey Heartlands STP) the number of daily COVID bed occupancy continues to increase. The proportion of critical care beds or beds with mechanical ventilation occupied by COVID patients remains high. The rapid rate of increase of the epidemiology indicators and hospital admissions data are concerning and warrants escalation to Tier 4 in line with the rest of Surrey (currently in Tier 4).
Isle of Wight (Tier 3: Very High)	In the past week there has been significant increase in case rates on the Isle of Wight (393% increase to 56 per 100,000). The most recent few days of data suggests that the case numbers are continuing to rise. The number of daily COVID hospital admissions in the local NHS (Hampshire & Isle of Wight STP) continues to rise steadily with increased numbers of COVID positive patients in critical care. Occupancy is below national average but rising. In addition, although not land bordering with other local authorities, key areas for transport to the area (Portsmouth and Gosport) are currently in Tier 4 and have high and deteriorating epidemiology indicators. The rate of increase of the epidemiology indicators is concerning and warrants escalation to Tier 3.

South West

Area	Narrative
Bristol (Tier 3: Very High)	In the last week, the picture in Bristol has deteriorated. The case rate in all ages has increased by 26% in the last 7 days and is now 151 per 100,000. The case rate in people aged 60 years and older has decreased in the last 7 days but remains high at 100 per 100,000. Test positivity is 5.2%. Admissions in the local NHS (Bristol, North Somerset & South Gloucestershire STP) have started to increase, however COVID occupancy and critical bed capacity remain below the national average. The rate of increase of the epidemiology indicators is concerning and warrants escalation to Tier 3.
Cornwall (Tier 2: High) Isles of Scilly (Tier 1: Medium)	In the last week, Cornwall has seen a 245% increase in its case rate. However, this is from relatively low level and the case rate is now 63 per 100,000. The case rate in people aged 60 years and older has increased to 41 per 100,000. Positivity remains relatively low at 2% but has increased from the previous week. The number of daily COVID hospital admissions in the local NHS (Cornwall & Isles of Scilly STP) has risen significantly in the last week although overall COVID occupancy remains low with none in critical care. Whilst they have increased from a relatively low level, the current trajectory of the epidemiology indicators and case levels is concerning and warrants escalation to Tier 2. The situation in the Isles of Scilly is unchanged with no new cases reported in the past week and is therefore not recommended for escalation from Tier 1.
Gloucestershire (Tier 3: Very High)	In the last week, the picture in Gloucestershire has continued to deteriorate. The case rate in all ages has increased in all local authorities and is particularly worrying in Cotswold where there has been a 214% increase in the last seven days. Two of the six local authorities (Gloucester and Forest of Dean) have a case rate above 200 per 100,000. The most recent data is also showing a considerable increase in cases. The case rate in people aged 60 years and older is above 100 per 100,000 in all local authorities and of most concern in Gloucester (170 per 100,000). Test positivity has increased to 6.1%. The number of daily COVID hospital admissions and critical care occupancy in the local NHS (Gloucestershire STP) has stabilised in the last few days, however COVID bed occupancy remains high and above the national average. The rate of increase of the epidemiology indicators is concerning and warrants escalation to Tier 3.
North Somerset (Tier 3: Very High)	In the last week the picture in North Somerset has deteriorated, with the area seeing a 26% increase in case rates from the previous week to 149 per 100,000. Also the most recent data shows a continued increase in cases. Admissions and COVID occupancy in the local NHS (Bath & North East Somerset, Swindon & Wiltshire STP) remain stable and below the national average and critical bed occupancy is slowly increasing. The rate of increase of the epidemiology indicators is concerning and warrants escalation to Tier 3.
Wiltshire (Tier 2: High) Swindon (Tier 3: Very High)	In the past 7 days the picture in Wiltshire and Swindon has deteriorated. Case rates in all ages and positivity have increased in both local authorities. In Swindon, positivity (8%) and case rates in all ages (176 per 100,000) are currently high and increasing (up 62% from the previous week). Also the most recent data shows a rapid increases in case rate in Swindon. Admissions and COVID occupancy in the local NHS (Bath & North East Somerset, Swindon & Wiltshire STP) remain stable and below the national average. Critical bed occupancy slowly increasing. Within the area there is a difference in current rates and trajectories of the epidemiological indicators between Swindon and Wiltshire. The situation is of greatest concern in Swindon and therefore it warrants escalation to Tier 3. However, the rest of Wiltshire has a much lower case rate for all ages and lower positivity and therefore does not warrant escalation to Tier 3.
Somerset (Tier 3: Very High)	In the past 7 days the picture in Somerset has deteriorated. The case rate in all ages is above 140 per 100,000 and has increased in all four local authorities. The increase in case rate is particularly worrying in Somerset West and Taunton where there has been a 102% increase in the last seven days. The case rate in people aged 60 years and older is highest in Mendip at 149 per 100,000. Positivity is around 5% for all local authorities. The number of daily Covid hospital admissions continues to rise in the local NHS (Somerset STP). The daily Covid bed occupancy is just below the national acute hospital average but continues to rise and has doubled in last 2 weeks. The rate of increase of the epidemiology indicators and rise in hospital admissions are concerning and warrant escalation to Tier 3.

West Midlands

Area	Narrative
Herefordshire (Tier 2: High)	In the past week the picture in Herefordshire has deteriorated, with case rates in all ages increasing by nearly 80% since last week. In the most recent few days the number of cases is continuing to increase rapidly. The number of daily COVID hospital admissions in the local NHS (Herefordshire & Worcestershire STP) continues to rise. The daily COVID bed occupancy is just below the national acute hospital average and stable and Critical Care occupancy has stabilised. The rate of increase of the epidemiology indicators and hospital admissions is concerning and warrants escalation to Tier 2.

Area

Narrative

Herefordshire
(Tier 2: High)

In the past week the picture in Herefordshire has deteriorated, with case rates in all ages increasing by nearly 80% since last week. In the most recent few days the number of cases is continuing to increase rapidly. The number of daily COVID hospital admissions in the local NHS (Herefordshire & Worcestershire STP) continues to rise. The daily COVID bed occupancy is just below the national acute hospital average and stable and Critical Care occupancy has stabilised. The rate of increase of the epidemiology indicators and hospital admissions is concerning and warrants escalation to Tier 2.

Background information

Full list of local restriction tiers in England by area

Tier 1

Tier 1 restrictions mean:

people must not socialise in groups larger than 6 people, indoors or outdoors, other than where a legal exemption applies. This is called the ‘rule of 6’
businesses and venues can remain open, in a COVID-secure manner, other than those which remain closed by law, such as nightclubs
hospitality businesses selling food or drink for consumption on their premises are required to:
provide table service only, for premises that serve alcohol
close between 11pm and 5am (hospitality venues in airports, ports, on transport services and in motorway service areas are exempt)
stop taking orders after 10pm
hospitality businesses and venues selling food and drink for consumption off the premises can continue to do so after 10pm as long as this is through delivery service, click-and-collect or drive-through
early closure (11pm) applies to casinos, cinemas, theatres, concert halls, museums, bowling alleys, amusement arcades, funfairs, theme parks, adventure parks and activities and bingo halls. Cinemas, theatres and concert halls can stay open beyond 11pm in order to conclude performances that start before 10pm
public attendance at outdoor and indoor events (performances and shows) is permitted, limited to whichever is lower: 50% capacity, or either 4,000 people outdoors or 1,000 people indoors
public attendance at spectator sport and business events can resume inside and outside, subject to social contact rules and limited to whichever is lower: 50% capacity, or either 4,000 people outdoors or 1,000 people indoors
places of worship remain open, but you must not attend or socialise in groups of more than 6 people while there, unless a legal exemption applies
weddings and funerals can go ahead with restrictions on numbers of attendees – 15 people can attend wedding ceremonies and receptions, 30 people can attend funeral ceremonies, and 15 people can attend linked commemorative events
organised outdoor sport, physical activity and exercise classes can continue
organised indoor sport, physical activity and exercise classes can continue to take place, if the rule of 6 is followed. There are exceptions for indoor disability sport, sport for educational purposes, and supervised sport and physical activity for under-18s, which can take place with larger groups mixing

See more details about Tier 1 restrictions

Tier 2

Tier 2 restrictions mean:

people must not socialise with anyone they do not live with or who is not in their support bubble in any indoor setting, whether at home or in a public place
people must not socialise in a group of more than 6 people outside, including in a garden or a public space – this is called the ‘rule of 6’
businesses and venues can continue to operate, in a COVID-secure manner, other than those which remain closed by law, such as nightclubs
pubs and bars must close, unless operating as restaurants. Hospitality venues can only serve alcohol with substantial meals
hospitality businesses selling food or drink for consumption on their premises are required to:
provide table service only, in premises which sell alcohol
close between 11pm and 5am (hospitality venues in airports, ports, transport services and motorway service areas are exempt)
stop taking orders after 10pm
hospitality businesses and venues selling food and drink for consumption off the premises can continue to do so after 10pm as long as this is through delivery service, click-and-collect or drive-through
early closure (11pm) applies to casinos, cinemas, theatres, museums, bowling alleys, amusement arcades, funfairs, theme parks, adventure parks and activities, and bingo halls. Cinemas, theatres and concert halls can stay open beyond 11pm in order to conclude performances that start before 10pm
public attendance at outdoor and indoor events (performances and shows) is permitted, limited to whichever is lower: 50% capacity, or either 2,000 people outdoors or 1,000 people indoors
public attendance at spectator sport and business events can resume inside and outside, subject to social contact rules and limited to whichever is lower: 50% capacity, or either 2,000 people outdoors or 1,000 people indoors
weddings and funerals can go ahead with restrictions on numbers of attendees – 15 people can attend wedding ceremonies and receptions, 30 people can attend funeral ceremonies, and 15 people can attend linked commemorative events such as wakes or stonesettings.
organised outdoor sport, and physical activity and exercise classes can continue
organised indoor sport, physical activity and exercise classes will only be permitted if it is possible for people to avoid mixing with people they do not live with (or share a support bubble with). There are exceptions for indoor disability sport, sport for educational purposes and supervised sport and physical activity for under-18s, which can take place with larger groups mixing

See more details about Tier 2 restrictions

Tier 3

Tier 3 restrictions mean:

people must not meet socially indoors, in a private garden or some outdoor public venues with anybody they do not live with or have a support bubble with. Everyone who can work from home should do so
people can see friends and family they do not live with (or do not have a support bubble with) in some outdoor public places – such as parks or public gardens in a group of up to 6
weddings and funerals can go ahead with restrictions on the number of attendees – 15 people can attend wedding ceremonies, wedding receptions are not allowed, 30 people can attend funeral ceremonies, 15 people can attend linked commemorative events
accommodation such as hotels, B&Bs, campsites, holiday lets and guest houses must close, other than where very limited exceptions apply
hospitality settings, such as bars (including shisha bars), pubs, cafes, restaurants, and social clubs must close except for takeaway, delivery, drive-through and click and collect services. Takeaway must cease between 23:00 and 5:00, but delivery, drive-through and click-and-collect may continue during this period. This includes restaurants and bars within hotels or members’ clubs
indoor entertainment venues, such as casinos, bowling alleys, and bingo halls must close. Outdoor entertainment venues, such as botanical gardens and heritage sites, may stay open, although indoor elements at these attractions must also close. Cinemas, theatres, and concert venues must close
leisure and sports facilities may continue to stay open, but group exercise classes (including fitness and dance) should not go ahead

See more details about Tier 3 restrictions

Tier 4

Tier 4 restrictions mean:

people must not leave their home or garden unless they have a ‘reasonable excuse’ including for work, education, exercise and essential activities such as medical appointments and to buy food
people must not meet socially indoors, in a private garden or some outdoor public venues with anybody they do not live with or have a support bubble with. Everyone who can work from home should do so
people can see only one other person that they do not live with (or do not have a support bubble with) in some outdoor public places – such as parks or public gardens
weddings and funerals can go ahead with restrictions on the number of attendees – 6 people can attend wedding ceremonies, wedding receptions are not allowed, 30 people can attend funeral ceremonies, 6 people can attend linked commemorative events
accommodation such as hotels, B&Bs, campsites, holiday lets and guest houses must close, other than where very limited exceptions apply
hospitality settings, such as bars (including shisha bars), pubs, cafes, restaurants, and social clubs must close except for takeaway, delivery, drive-through and click and collect services. Takeaway must cease between 23:00 and 5:00, but delivery, drive-through and click-and-collect may continue during this period. This includes restaurants and bars within hotels or members’ clubs
indoor entertainment venues, such as casinos, bowling alleys, and bingo halls must close. Outdoor entertainment venues, such as botanical gardens and heritage sites, may stay open, although indoor elements at these attractions must also close. Cinemas, theatres, and concert venues must close
all indoor leisure and sports facilities must close

See more details about Tier 4 restrictions

The government decides which tier applies in each area based on a range of indicators, which are available to view on the COVID-19 dashboard, and include:

analysis of cases across all age groups
analysis of cases in the over 60s
the rate by which cases are rising or falling
the percentage of those tested in local populations with COVID
pressures on the NHS

£149 million to support increased care home testing

Staff in all tiers will receive 2 rapid tests a week, in addition to the weekly PCR test
Care homes in all tiers given access to £149 million grant to support roll out of rapid testing
New grant will also help care homes in Tiers 1, 2 and 3 meet additional costs associated with visits, supporting residents to see friends and family

Staff will be asked to take rapid tests twice a week, in addition to the weekly PCR test they have already been receiving as part of urgent government action to protect those most at risk. A plan that has been accelerated in light of the new, more transmissible, strain of COVID-19. In the event of a positive test in a Tier 4 care home, all staff will additionally be tested daily for 7 days.

This will be supported by an additional £149 million to fund costs associated with testing staff, and to more safely support family visits in areas outside of Tier 4.

The money will pay for care home providers to set up safe testing areas, provide staff training and contribute towards staff time spent on administering and receiving the tests. This is in addition to the more than £1.1 billion Infection Control Fund and is supported by over 16 million rapid tests and 46 million items of personal protective equipment (PPE) delivered for free to care homes over the last month.

Health and Social Care Secretary Matt Hancock said:

We have worked throughout the pandemic to protect staff, and residents in care homes and today we are boosting rapid testing in care homes, with a further £149 million pounds to support that effort.

All those who work in care homes across England will receive 2 rapid tests a week, in addition to their weekly PCR test.

Visits to care homes can still take place in Tier 4 with arrangements such as substantial screens or visiting pods but, for the safety of loved ones, close-contact indoor visits supported by testing cannot take place in tier 4 areas.

Outside of Tier 4 areas friends and family are able to visit relatives in care homes that are not currently experiencing an outbreak if they receive a negative result prior to the visit, wear PPE and follow all other infection prevention and control measures.

This approach seeks to achieve the right balance between the increased risk of infection transmission and the clear benefits to the mental and physical health of residents and their families that visiting enables.

Minister for Care Helen Whately said:

Our priority is to keep care home residents and staff safe, and we have been working hard to make the most of our testing capacity to help people reunite with loved ones as safely as possible.

Now in the face of this new strain, which spreads much more quickly, we are increasing testing in all care homes to help protect those most at risk. This £149 million grant will give care homes the tools and support they need to test staff regularly and safely reunite families kept apart because of COVID-19.

Stopping staff movement in and between care settings is critical to minimise the risk of infection of COVID-19 and other viral illnesses. However, if care homes need to use staff who work in multiple locations in order to maintain safe staffing levels, rapid tests will help to manage the increased risk related to employing staff who are working in multiple settings.

The new strain transmits more easily than the previous variant but there is no evidence that it is more likely to cause severe disease or mortality.

Testing is only part of the approach and it’s essential visitors and staff wear PPE and follow all infection control methods to keep their loved ones, other residents and staff safe. Up to 1 in 3 people who have coronavirus have no symptoms and could be spreading it without realising it.

Care homes which are facing an outbreak will not be able to receive visitors, apart from in exceptional circumstances such as end of life.

Care homes will manage the number of visits to ensure they can enable safe visiting and the programme will be continuously reviewed.

The money will be made available early next year and will be distributed via local authorities. Allocations will also be announced early next year.

The grant will cover the infrastructure costs of the expanded testing programme including setting up testing areas and resource costs including gaining consent for tests, supervising the use of PPE and swab tests and then processing and logging the results.

See the new guidance for care homes.

Care home COVID-19 testing guidance (PDF)

The lateral flow tests being used have been rigorously evaluated by Public Health England and University of Oxford and are accurate and sensitive enough to be used safely in combination with other infection prevention and control measures.

Extensive testing has shown lateral flow devices are suitable for use in care homes where they can help to identify people who are most likely to spread the virus further and therefore support the prevention of transmission of the disease from visitors.

We will keep our testing strategy across all tiers under constant review.