Review of local restriction tiers 30 December 2020

Yesterday, we conducted the latest formal review of tier allocations across England. The allocations and a detailed rationale can be found below.

The new variant means that most of the country is now in Tier 4 and almost all of the country in Tiers 3 and 4. This is absolutely necessary. Where we still can give places greater freedoms, we will continue to do so.

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

These are:

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

These are not easy decisions, but they have been made according to the best clinical advice, and the best possible data from the JBC.

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

We will also deposit a comprehensive list and the data packs used to inform these decisions in the Libraries of both Houses.

These changes will apply from Thursday 31 December 2020. This list has also been published on GOV.UK and a postcode checker will be available for the public to check what rules apply in their local area.

Rationales for allocations

Overview

A novel variant of SARS-CoV-2 is circulating in England. The strain shows increased transmissibility. There is currently no evidence that the variant is more likely to cause severe disease or mortality, but investigations continue. The majority of the cases identified in London, the South East and the East of England are of the novel strain. Spread is increasing in the South West, Midlands and parts of the North West.

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.

Areas already under Tier 4 restrictions

London

In London the case rate in all ages and in people aged 60 and over continues to increase across all local authorities.

The weekly case rate in London is the highest of the nine regions of England at 814 per 100,000 and increased by 53% in the last week. The case rate in people aged 60 and over also increased by 71% over the last week and is now 551 per 100,000.

There is some variation across local authorities in London, with the lowest case rate in Kensington and Chelsea (524 per 100,000) and the highest in Havering (1290 per 100,000). Five local authorities now have case rates greater than 1000 per 100,000 (Havering, Redbridge, Bexley, Barking and Dagenham and Tower Hamlets). Across the London NHS Sustainability and Transformation Partnership areas (STPs) (South West London STP, South East London STP, North East London STP, North Central London STP, and North West London STP), the daily COVID bed occupancy is above the national average and continues to rise.

The proportion of critical care beds or beds with mechanical ventilation occupied by COVID patients remains high and continues to rise. South East London STP is experiencing the highest current COVID growth rate in London, with pressure remaining particularly acute for North East London STP (though growth rates have reduced since prior week). Overall, the picture remains very concerning and warrants London remaining in Tier 4.

East of England

In the East of England, the picture has continued to deteriorate, with a significant increase in case rates in all ages (up by 52% to 581 per 100,000 per week) and in people aged 60 and over (up by 62% to 326 per 100,000 per week). The region has the second highest case rates of the 9 regions and case rates are continuing to increase across all local authorities. There are 10 local authorities with case rates greater than 1000 per 100,000 (Brentwood, Epping Forest, Thurrock, Castle Point, Southend-on-Sea, Basildon, Broxbourne and Rochford.

Across the region case rates range from 182 per 100,000 in East Suffolk to 1510 per 100,000 in Brentwood. Across the East of England NHS STPs (Norfolk and Waveney STP, Cambridge and Peterborough STP, Hertfordshire and West Essex STP, Mid and South Essex STP, Bedford, Luton and Milton Keynes STP and Suffolk and North East Essex STP), the number of daily COVID hospital admissions is rising, with Hertfordshire and West Essex STP and Mid and South Essex STP in a critical position.

The daily COVID bed occupancy has now risen to, or above, the national acute hospital average (apart from Cambridge and Peterborough STP which is still below national average) and continues to rise. The proportion of critical care beds or beds with mechanical ventilation occupied by COVID patients has risen sharply. The COVID demand on local NHS hospitals remains high, and has been increasing steeply and shows fewsigns of reducing.

For the 2 critical STPs (Hertfordshire and West Essex STP and Mid and South Essex STP), the daily COVID bed occupancy is at critical levels, has risen well above the national acute hospital average in the last 7 days and continues to rise steeply. Overall, the picture remains very concerning and warrants all areas of the East of England remaining in Tier 4.

South East

The South East has the third highest case rate of the 9 regions of England; and the situation has continued to deteriorate across the majority of the region. Case rates have continued to increase in all ages (up by 36% to 476 per 100,000 per week) and in people aged 60 and over (up by 40% to 294 per 100,000 per week). Seven local authorities have seen case rates increase by over 100% in the last week (Eastleigh, Chichester, Worthing, Southampton, Adur, Horsham and Windsor and Maidenhead). Across the South East NHS STPs (Hampshire and Isle of Wight STP, Sussex STP, Frimley STP, Buckinghamshire STP, Oxfordshire and Berkshire West STP, Kent and Medway STP, Surrey Heartlands STP) the number of daily COVID hospital admissions and bed occupancy continue to rise.

In Kent and Medway STP the daily COVID bed occupancy is above the national acute hospital average and continues to rise, with the proportion of critical care beds or beds with mechanical ventilation occupied by COVID patients remaining high and has shown no signs of reducing in the last 10 days. In Surrey Heartlands STP additional ICU capacity in Ashford and St Peters has been opened and support has been provided to the Kent system. Overall, the picture remains very concerning and warrants the South East remaining in Tier 4.

Only areas which are being escalated to a higher Tier appear in the tables below.

South West

AreaNarrative
Gloucestershire (Tier 4)In the last week, the picture in Gloucestershire has further deteriorated with an increase in all epidemiological indicators in all 6 of the local authorities. The case rate for all ages is high across the area with the highest rates seen in Gloucester (304 per 100,000 per week), which is also showing the highest rates in people aged over 60 (246 per 100,000 per week). Increases in case rates of more than 60% have been seen in 3 of the local authorities in the past week, with the greatest increase seen in Cheltenham of 73% (to 175 per 100,00 per week). Test positivity is at or above 5% across the area with two local authorities above 8%. COVID admissions are high in the local NHS (Gloucestershire STP) and increasing whilst the numbers in bed is high and increasing, as is critical care. The rate of increase of the epidemiology indicators is concerning and warrants escalation to Tier 4.
Swindon (Tier 4) and Wiltshire (Tier 3)In the last week, the picture in Swindon and Wiltshire has deteriorated, with an increase in all epidemiological indicators in the two local authorities. In Swindon, positivity (9%) and case rate in all ages are high and increasing (242 per 100,000, up 36% from the previous week). In addition, the most recent data continues to show a rapid increase in case numbers in Swindon. Wiltshire has seen a rapid increase in cases to 155 per 100,000 per week (up by 53% since the previous week). Both Swindon and Wiltshire border with current Tier 4 areas, where there is a rapid deterioration in epidemiology indicators. COVID admissions, numbers of patients in beds and critical care beds are all increasing in the local NHS (Bath and North East Somerset, Swindon and Wiltshire STP). 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 4. However, the rest of Wiltshire is showing increases in case rate for all ages and therefore now warrants escalation to Tier 3.
Somerset (Tier 4)In Somerset, the picture has further deteriorated, with an increase in all epidemiological indicators in all four local authorities in the area. Most worrying are increases in cases seen in Sedgemoor (up by 80% to 275 per 100,000 per week) and Somerset West and Taunton (up by 58% to 248 per 100,000 per week). Case rates in people aged over 60 is also high in Somerset West and Taunton (170 per 100,000 per week) and Mendip (169 per 100,000 per week). Test positivity is above 5% for all local authorities in Somerset. COVID admissions in the local NHS (Somerset STP) are still high. Numbers in beds are stabilising after recent increases and critical care is stable. The rate of increase of the epidemiological indicators is concerning and warrants escalation to Tier 4.
Bath and North East Somerset (Tier 3)In the last week the picture in Bath and North East Somerset has deteriorated, with an increase in all epidemiological indicators in the local area. The case rate in all ages has quickly increased by 52% (to 158 per 100,000 per week). Test positivity is 5% for the area. COVID admissions, numbers of patients in beds and critical care beds are all increasing in the local NHS (Bath and North East Somerset, Swindon and Wiltshire STP). The rate of increase of the epidemiology indicators is concerning and warrants escalation to Tier 3.
Dorset (Tier 3)In the last week the picture in Dorset has deteriorated, with a rapid increase in case rates in all ages (up by 74% to 120 per 100,000 per week), though from a relatively low base.
Bournemouth, Christchurch and Poole (Tier 4)In Bournemouth, Christchurch and Poole the epidemiological indicators have quickly deteriorated (from a higher base), with case rates in all ages increasing by 65% to 219 per 100,000 per week, and test positivity over 6%. The case rate in people aged over 60 is also high at 147 per 100,000 per week. Within the area there is a difference in current rates and trajectories of the epidemiological indicators between the two local authorities. The situation is of greatest concern in Bournemouth, Christchurch and Poole and therefore it warrants escalation to Tier 4. The rest of Dorset is showing increases in case rate for all ages and therefore now warrants escalation to Tier 3.
Devon, Plymouth and Torbay (Tier 3)In the last week, the picture in Devon, Plymouth and Torbay has deteriorated. In five out of the ten areas the case rate is now above 150 per 100,000 per week. Case rate increases are particularly pronounced in Plymouth where case rate in all ages has grown by 102% to 179 per 100,000 per week and in West Devon where the case rate is 204 per 100,000 per week (an increase of 23%). Overall, the picture is concerning and warrants that Devon, Plymouth and Torbay be escalated to Tier 3.
Cornwall (Tier 3)In the last week, the picture in Cornwall has deteriorated with overall cases across all age groups increasing 50% to 97 per 100,000 per week. Test positivity rates have also increased slightly to over 3% and the case rate in people over 60 has increased 16% to 47 per 100,000 per week. In the local NHS (Cornwall and Isles of Scilly STP), the number of patients in beds is stable currently. The continued increase in case rates is concerning and warrants that Cornwall be escalated to Tier 3.
Isles of Scilly (Remain Tier 1)The Isles of Scilly will remain in Tier 1 as no cases have been recorded and the situation appears stable.

South East

AreaNarrative
Hampshire, Portsmouth, Southampton and Isle of Wight (Tier 4)In the last week, the situation in Hampshire, Portsmouth, Southampton and Isle of Wight has continued to deteriorate across the entire area. Local authorities currently in Tier 4 have seen continued steep increases in key indicators with areas such as Rushmoor seeing case rates increase 88% to 638 per 100,000. The Isle of Wight has seen an extremely concerning case rate increase of 268% in the last week, bringing it to 207 per 100,000 people. Test positivity has also increased to almost 8% across the area. While the New Forest still has the lowest rate within the area, sharp increases have been seen in case rates in all ages (a 63% increase to 147 per 100,000 per week) and in case rates in people aged over 60 (a 36% increase to 98 per 100,000 per week). In the local NHS (Hampshire and Isle of Wight STP), the number of daily COVID hospital admissions continues to rise steadily with increased numbers of COVID-positive patients in critical care, and in general beds. Occupancy is rising. The rate of increase of epidemiological indicators are concerning and warrants that the Isle of Wight and the New Forest are escalated to Tier 4.

East Midlands

AreaNarrative
Leicester City (Tier 4)The overall picture in Leicester City remains concerning. The case rate in all ages remains high at 310 per 100,000 despite having been under restrictions for a very significant period of time. The case rate in people aged over 60 increased by 19% over the last seven days and is now at 290 per 100,000. Positivity is also high at 11%. In the local NHS (Leicester, Leicestershire and Rutland STP), the daily COVID bed occupancy is above the national acute hospital average and continues to rise. The proportion of critical care beds or beds with mechanical ventilation occupied by COVID patients remains high. The level of the epidemiology indicators and bed occupancy is concerning and warrants allocation to Tier 4.
Leicestershire (Tier 4)In the past week the picture in Leicestershire has deteriorated, with case rates in all ages above 200 per 100,000 in all local authorities. Case rates in all ages and in people aged over 60, and positivity are high and increasing in almost all local authorities. In Harborough, case rates in all ages increased by 75% over the last seven days. Oadby and Wigston has the highest case rate in all ages (372 per 100,000) and case rate in people aged over 60 (256 per 100,000). In the local NHS (Leicester, Leicestershire and Rutland STP), the number of daily COVID hospital admissions is variable. The daily COVID bed occupancy is above the national acute hospital average and continues to rise. The proportion of critical care beds or beds with mechanical ventilation occupied by COVID patients remains high. The level of the epidemiology indicators and bed occupancy is concerning and warrants allocation to Tier 4.
Northamptonshire (Tier 4)In the past week, the picture in Northamptonshire has further deteriorated, with case rates in all ages increasing in all areas between 30% and 80%. Case rates in people aged over 60 are high and increasing in all local authorities, with exception of Northampton where it decreased by 10% over the last seven days and is now at 235 per 100,000. The deterioration and high level of the epidemiology indicators is concerning and warrants escalation to Tier 4.
Derby and Derbyshire (Tier 4)The situation in Derby and Derbyshire has deteriorated across the majority of the area. Case rate increases of above 20% have been seen in all local authorities apart from Bolsover and Derby and are most worrying in Derbyshire Dales and Erewash where there has been an 85% and 40% increase, respectively over the last seven days. Case rates in all ages are generally high and are of particular concern in Derby, Amber Valley, South Derbyshire, Bolsover and North East Derbyshire which are all over 200 per 100,000. Case rates in people aged over 60 are most concerning in South Derbyshire and Amber Valley where they are above 200 per 100,000 and increasing. In the local NHS (Joined Up Care Derbyshire STP), COVID admissions have been variable over the past 7 days, total number of COVID patients has increased, whilst occupancy is stable. The proportion of critical care beds or beds with mechanical ventilation occupied by COVID patients is higher than the national average. The deterioration and high level of the epidemiology indicators is concerning and warrants escalation to Tier 4.
Lincolnshire (Tier 4)There is a worrying picture in Lincolnshire. While five local authorities (Lincoln, West Lindsey, Boston, East Lindsey and South Holland) have remained steady or seen minor improvements to case rates in all ages, these are from a very high level and within this group only East Lindsey and South Holland have a case rate below 300 per 100,000. South Kesteven and North Kesteven are the most worrying local authorities, having seen an increase of over 40% in the last seven days bringing their case rates in all ages to 314 and 280 per 100,000 respectively. Positivity remains high across the region, particularly in Lincoln and Boston where it is at or above 11%. The local NHS (Lincolnshire STP) reports COVID admissions are volatile, and bed occupancy is increasing. The proportion of critical care beds occupied by COVID patients remains very high. The deterioration and high level of the epidemiology indicators is concerning, as is the NHS situation, and so the area warrants escalation to Tier 4.
Nottingham and Nottinghamshire (Tier 4)The past seven days have seen the overall situation deteriorate in Nottingham and Nottinghamshire, although there is a mixed picture in some areas. All areas now have an overall case rate above 200 per 100,000 per week. Ashfield and Rushcliffe have seen the steepest rises in overall case rates of 50% and 58% respectively. Mansfield and Bassetlaw have seen stable case rates, yet numbers remain high. In the local NHS (Nottingham and Nottinghamshire STP), COVID admissions bed occupancy and critical care occupancy remain stable at elevated levels. The epidemiological situation is concerning and warrants that the region be escalated to Tier 4.
Rutland (Tier 3)The overall picture in Rutland deteriorated over the last seven days. The case rate in all ages increased by 13% to 153 per 100,000. The case rate in people aged over 60 is low (79 per 100,000) but increased by 43% over the last seven days. In the local NHS (Leicester, Leicestershire and Rutland STP), the number of daily COVID hospital admissions is variable. The daily COVID bed occupancy is above the national acute hospital average and continues to rise. The proportion of critical care beds or beds with mechanical ventilation occupied by COVID patients remains high. Rutland is surrounded by local authorities in Tier 4 and case rates are slowly deteriorating, warranting escalation to Tier 3.

West Midlands

AreaNarrative
Birmingham and Black County (Tier 4)In the last seven days the situation in Birmingham and the Black Country has deteriorated and an increase in all epidemiological indicators in all five of the local authorities has been seen. Case rates in all ages are above 300 per 100,000 in each local authority and are of particular concern in Wolverhampton (419 per 100,000). Case rates in people aged over 60 increased between 15 and 40% over the last seven days and is the highest in Wolverhampton (268 per 100,000). Positivity is above 10% across the area. In the local NHS (Black Country and West Birmingham STP), there are high levels of activity. Increase in demand for critical care. The proportion of critical care beds occupied by COVID patients is high. In the Birmingham and Solihull STP, COVID admissions and COVID bed occupancy are increasing. Critical care occupancy remains high and increasing. The rate of increase of the epidemiology indicators is concerning and warrants allocation to Tier 4.
Warwickshire (Tier 4)In the last seven days the situation in Warwickshire has deteriorated. Case rates in all ages have increased with prevalence most concerning in Rugby (365 per 100,000) where positivity is above 10% and increasing. Stratford-on-Avon has the lowest case rate in all ages at 182 per 100,000 but has seen a 30% increase in the last seven days. The percentage increase in case rate in people aged over 60 is the highest in Nuneaton and Bedworth (46% in the last seven days) and is now at a rate of 206 per 100,000. In the local NHS (Coventry and Warwickshire STP), the number of daily COVID hospital admissions is variable. COVID bed occupancy is increasing. The proportion of critical care beds or beds with mechanical ventilation occupied by COVID patients remains high. The rate of increase of the epidemiology indicators and bed occupancy are concerning and warrants allocation to Tier 4.
Coventry (Tier 4)In the last seven days the situation in Coventry has deteriorated with all epidemiological indicators increasing. The case rate in all ages has increased by 27% in the last seven days and is now at 257 per 100,000. The case rate in people aged over 60 has increased by 49% in the last seven days and is now at 189 per 100,000. In the local NHS (Coventry and Warwickshire STP), the number of daily COVID hospital admissions is variable. COVID bed occupancy is increasing. The proportion of critical care beds or beds with mechanical ventilation occupied by COVID patients remains high. The rate of increase of the epidemiology indicators is concerning and warrants allocation to Tier 4.
Solihull (Tier 4)In the last seven days the situation in Solihull has deteriorated with all epidemiological indicators increasing. The case rate in all ages has increased by 38% in the last seven days and is now at 260 per 100,000. In the local NHS (Birmingham and Solihull STP), COVID admissions and COVID bed occupancy are increasing. Critical care occupancy remains high and increasing. The rate of increase of the epidemiology indicators is concerning and warrants allocation to Tier 4.
Herefordshire (Tier 3)In the last seven days the situation in Herefordshire has deteriorated with all epidemiological indicators increasing. The case rate in all ages has increased by 150% in the last seven days and is now at 198 per 100,000. Case rate in people aged over 60 is also concerning at 162 per 100,000 and with an increase of 267% over the last seven days. In the local NHS (Herefordshire and Worcestershire STP), bed occupancy is increasing. Critical Care occupancy has stabilised. The rate of increase of the epidemiology indicators is extremely concerning and warrants allocation to Tier 3.
Worcestershire (Tier 3)In the last seven days the situation in Worcestershire has deteriorated and an increase in all epidemiological indicators has been seen in all six local authorities. Case rates in all ages are above 200 per 100,000 in Bromsgrove, Redditch, Wychavon and Wyre Forest. Concerning increases in the last seven days have been seen in Wychavon (53%) and Worcester (112%). In Worcester and Malvern Hills, case rates in people aged over 60 increased by over 100% in the last week and are now at 219 and 165 per 100,000. In the local NHS (Herefordshire and Worcestershire STP), COVID bed occupancy is increasing. Critical Care occupancy has stabilised. The rate of increase of the epidemiology indicators is concerning and warrants allocation to Tier 3.
Shropshire and Telford and Wrekin (Tier 3)There is a mixed picture in Shropshire and Telford and the Wrekin. The local authority of Telford and Wrekin has seen increases in all the epidemiological indicators and the case rate in all ages is 167 per 100,000. In Shropshire the case rate in all ages (104 per 100,000), the case rate in people aged over 60 (69 per 100,000) and positivity (3.6%) remained relatively stable. In the local NHS (Shropshire, Telford and Wrekin STP), the proportion of critical care beds occupied by COVID patients is high. Despite the slightly less concerning epidemiological picture and NHS situation in Shropshire, leaving it as the only Tier 2 area in the West Midlands risks case rates increasing with increased mobility both within the area and across its borders. Shropshire and Telford and Wrekin therefore warrant escalation to Tier 3.
Staffordshire and Stoke-on-Trent (Tier 4)In the last seven days the situation in Staffordshire has deteriorated and all local authorities now have case rates in all ages greater than 200 per 100,000 per week. Of particular concern is the high case rate in people aged over 60, which is now above 150 per 100,000 per week in all local authorities. The overall testing positivity rate has remained steady at around 9%. In terms of growth rates there is a mixed picture with relatively stable numbers in East Staffordshire, Cannock Chase, Staffordshire Moorlands and Newcastle-Under-Lyme. Stoke-on-Trent has seen a falling case rate. However, Tamworth, Lichfield, South Staffordshire and Stafford have seen pronounced rises in the last week (by more than 30%). In the local NHS (Staffordshire and Stoke-on-Trent STP), the number of daily COVID hospital admissions remains variable. The daily COVID bed occupancy is above the national acute hospital average and continues to rise. COVID occupancy in mechanical ventilated beds remains high. The situation is concerning and warrants that Staffordshire and Stoke-on-Trent are escalated to Tier 4.

North West

AreaNarrative
Lancashire, Blackpool and Blackburn with Darwen (Tier 4)In the last week, the picture has deteriorated. The case rates in all ages increased in 11 of the 14 local authorities. Burnley and Pendle have the highest case rates at 499 and 434 per 100,000. The case rates in people aged over 60 remain high with Blackburn with Darwen and Burnley having the highest rates at 374 and 338 per 100,000, respectively. The number of daily COVID hospital admissions in the local NHS (Lancashire and South Cumbria STP) has seen an increase over the past seven days and are starting to rise back towards wave 2 peak. General and acute bed occupancy remains high. Royal Blackburn and Royal Preston are operating in surge capacity. The rate of increase of the epidemiology indicators is concerning and warrants escalation to Tier 4.
Liverpool City Region (Tier 3)In the last week, the picture in Liverpool City Region has deteriorated with an increase in all epidemiological indicators across all six local authorities. The case rate in all ages is high across the area with the highest rates seen in Wirral (210 per 100,000 population). Cases rates increased by more than 50% in five of the six local authorities over the last 7 days, with the greatest increase seen in Wirral (91%). Case rates in people aged over 60 are equal to or greater than 150 per 100,000 in St. Helens, Halton and Liverpool. COVID admissions to hospital remain broadly flat over the past seven days in the local NHS (Cheshire and Merseyside). General and Acute bed occupancy remains high, but static. The rate of increase of the epidemiology indicators is concerning and warrants escalation to Tier 3.
Cheshire and Warrington (Tier 4)In the last seven days, the picture in Cheshire and Warrington has deteriorated with an increase in all epidemiological indicators across all three local authorities. Warrington has the highest case rate in all ages (304 per 100,000), case rate in people aged over 60 (217 per 100,000), and test positivity. In the local NHS (Cheshire and Merseyside STP), COVID admissions to hospital remain broadly flat over the past seven days. General and acute bed occupancy remains high, but static. The rate of increase of the epidemiology indicators is concerning and warrants escalation to Tier 4.
Cumbria (Tier 4)Over the last seven days, case rates in all ages increased by more than 90% in Carlisle, Eden, Allerdale and Copeland. In South Lakeland and Barrow-in-Furness case rates in all ages are stable. The case rate in people aged over 60 decreased by 52% over the last 7 days in Barrow-in-Furness. The most concerning local authorities are Carlisle and Eden with case rates in all ages at 331 and 496 per 100,000, respectively. For these two local authorities case rates in people aged over 60 are high (219 and 330 per 100,000) and increasing rapidly (119% and 205%). In Lancashire and South Cumbria STP COVID admissions to hospital have seen an increase over the past seven days and are starting to rise back towards the second wave peak. General and acute bed occupancy remains high. Royal Blackburn and Royal Preston remain operating in surge capacity. In the North East and North Cumbria STP, COVID admissions, bed occupancy and critical care bed occupancy are all stable. The rate of increase of the epidemiology indicators is concerning and warrants escalation to Tier 4.
Greater Manchester (Tier 4)In the last week, the picture in Greater Manchester has deteriorated with an increase in the majority of the epidemiological indicators. Case rates in all ages increased by more than 50% in Tameside, Stockport and Trafford. In Oldham, Bolton and Rochdale case rates in all ages are stable. Trafford has the highest case rate in all ages (246 per 100,000) and experienced the highest case rate change (69%). Case rate in people aged over 60 increased in eight of the 10 local authorities. Test positivity in the area ranges between 7% and 10%. In the local NHS (Greater Manchester STP) COVID admissions to hospital have seen an increase over the past seven days but are still lower than the wave 2 peak. Critical care position is stable, with mutual aid available as required. General and acute bed occupancy remains high and is an area of particular concern. The rate of increase of the epidemiology indicators is concerning and warrants allocation to Tier 4.

North East

AreaNarrative
Tees Valley (LA5) (Tier 4)The situation in the Tees Valley (LA5) remains concerning, with case rates in all ages remaining greater than 230 per 100,000 per week in four of the five local authorities in the area (except Redcar and Cleveland), with Hartlepool particularly worrying at 418 per 100,000 (up by 36% in the past week). Case rates in people aged over 60 remain very high (above 150 per 100,000 per week) in four of the five local authorities in the area, especially in Hartlepool (327 per 100,000 per week). In the local NHS (North East and North Cumbria STP), COVID admissions, bed occupancy and critical care bed occupancy has been stable, but are now showing signs of increasing. The rate of increase of the epidemiology indicators is concerning and warrants allocation to Tier 4.
North East (LA7) (Tier 4)The overall picture remains concerning. Case rates in all ages and case rates in people aged over 60 remain greater than 100 per 100,000 per week in all local authorities in the area. Case rates in all ages are greater than 200 per 100,000 per week in four of seven local authorities (County Durham, Gateshead, Northumberland, South Tyneside). The situation is particularly concerning in County Durham and Gateshead where the case rates are 264 and 227 per 100,000 per week respectively (increases of 52% and 82%). The lowest case rate in all ages in the region is in Newcastle upon Tyne (144 per 100,000 per week). However, neighbouring areas remain high and the situation is still concerning. In the local NHS (North East and North Cumbria STP), COVID admissions, bed occupancy and critical care bed occupancy have been stable, but are now showing signs of increasing. The rate of increase of the epidemiology indicators is concerning and warrants allocation to Tier 4.

Yorkshire and the Humber

AreaNarrative
York and North Yorkshire (Tier 3)In the last week, the situation in the York and North Yorkshire region has deteriorated with case rates in all ages rising in the majority of the region. Case rate increases in all ages are particularly worrying in York (131% to 218 per 100,000 per week), Ryedale (125% to 146 per 100,000 per week) and Hambleton (207% to 238 per 100,000 per week). In Scarborough the case rate in all ages is high (241 per 100,000) though stable. In the local NHS (Humber, Coast and Vale STP), COVID admissions and bed occupancy has increased. The situation is concerning, particularly regarding percentage increase in all ages, and warrants escalation to Tier 3.

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