Covid cases levelling off as England prepares to re-enter tier system

Coronavirus infections are largely levelling off in England although prevalence remains high, data suggests, as 99% of the country prepares to enter the two strictest tiers of control measures from next week.

Government data shows 18,213 people in England were reported to have tested positive for coronavirus on Wednesday, down from a high of 33,470 on 12 November. Reported deaths reached a second-wave peak of 604 on Wednesday – although trends in the number of deaths typically lag behind changes in case numbers.

From 2 December will be divided into three different tiers of restrictions. They are slightly amended from the previous system.

Across all tiers, shops, personal care, gyms and the wider leisure sector are set to reopen. Collective worship and weddings – with a maximum of 15 in attendance – can also resume.

Tier one

Under the new system hospitality businesses in England can stay open until 11pm with table service only but last orders must be made by 10pm, in an effort to stagger departures. The “rule of six” will also remain in place indoors, meaning social household mixing is still allowed.

Spectator sport is set to resume, albeit with limits on numbers and abiding by social distancing. In tier 1, there will be a maximum crowd capacity outdoors of 50% of occupancy of the stadium or 4,000 people, whichever is smaller. Indoors, the maximum capacity is 1,000.

In tier 1, people will be encouraged to minimise travel and work from home where possible. Support bubbles – which allowed a single household to join with another household – are also being broadened across all tiers. Parents with a child under one will be able to form a support bubble, as well as those with a child under five who needs continuous care, such as a child with a disability. Also, in cases where there is a single adult carer, for a partner with dementia for example, they would also be able to form a support bubble.

How was it before?

In the least restrictive tier, also known as alert level “medium”, the rule of six applied indoors and outdoors, meaning up to half a dozen people from different households could gather. Hospitality businesses, such as pubs and restaurants, could stay open but were forced to shut by 10pm – a move that prompted much criticism, including from Conservative backbenchers.

Tier two

Under the new system, although hospitality venues will be allowed to stay open until 11pm – with last orders at 10pm – only those that serve substantial meals can operate. It means pubs and bars that do not will have to close.

As before, social mixing outside of households or support bubbles will not be allowed indoors. The rule of six will apply outdoors.

Spectators will be allowed to watch sport in tier 2, with a maximum crowd capacity outdoors of 50% of the capacity of the stadium or 2,000 people, whichever is smaller. Indoors, the maximum capacity is 1,000.

Indoor entertainment venues, such as cinemas, casinos and bowling alleys, must also close.

How was it before?

In the “high” alert level tier people were prohibited from mixing socially indoors with anybody outside of their household or support bubble but the rule of six remained in place outdoors. Hospitality businesses, such as pubs and restaurants, could open until 10pm but people were only allowed to visit with their household or support bubble.

Tier three

Hospitality venues will have to close, except for delivery and takeaway service. In tier 3, hotels and other accommodation providers must also close, except for specific work purposes where people cannot return home. Outdoor sports, including golf and tennis, will be allowed to continue in all tiers, as will amateur team sports such as football. Unlike the first two tiers, spectators will not be allowed to watch sport in tier 3.

How was it before?

In the most restrictive tier, known as the “very high” alert level that was endured by vast swathes of the north of England, mixing socially indoors between households – unless a support bubble was in place – was banned. Under baseline measures hospitality venues serving substantial food could remain open until 10pm. Up to six people from different households could socialise outdoors in public spaces, such as parks, beaches or public gardens.

Simon Murphy Political correspondent

Cases were falling in every English region between 19-21 November compared with a week earlier, according to data by specimen date, while test-and-trace figures show 8.8% of those tested having a positive result between 12-18 November, down from 9.6% the previous week.

Experts cautioned that such data might not give the full picture, however – not least as only symptomatic people are advised to get a test, while daily figures are also affected by the number of tests carried out in different areas.

Office for National Statistics (ONS) data from a survey of randomly selected households shows the positivity rate appeared to be levelling off in England in the week to 21 November, with about one in 85 people in the community thought to have Covid – a similar figure to the week before.

Cases are rising once again among secondary-school-aged children, although they have levelled off or fallen in other age groups, and there are regional variations, experts said.

“Over the last week, positivity rates have continued to increase in London, the east of England and the south-east. However, rates now appear to be decreasing in the north-west and the east Midlands,” the team reported.

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Similarly, data released by the MRC Biostatistics Unit estimates that on 22 November, R (the reproduction number) was about 1 in most regions, and less than 1 in north-east England and Yorkshire and the north-west, although it could be above 1 in the south-east.

The number of deaths occurring each day has already reached a peak in most regions, data suggests – although delays in reporting mean figures may appear to increase for some weeks.

While Prof Daniela De Angelis, the programme leader and deputy director of the unit, said R was lower in all regions than the week before, she cautioned against relaxing restrictions too far.

“We remain concerned that R may not have fallen to a level sufficiently below 1, which strongly suggests that effective measures to control infection rates must continue to be in place after the end of the current lockdown period,” she said.

Prof Tim Spector of King’s College London, the lead scientist on the Zoe Covid Symptom Study app, said the latest data based on swab results from users of the app over the two weeks up to 22 November reveals that the nationwide R value is now about 0.9.

He voiced dismay at the new restrictions. “I’m disappointed to see so many regions going into tier 3 when the latest data suggests that symptomatic cases are continuing to fall,” he said. “We need to consider more carefully the wider physical, social and mental health implications of excessive mandatory restrictions if they are not justified by the recent data.”