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Boris Johnson’s tier system will face its next revision on December 30, and there are caveats that the existing four tiers may not be enough.
Decisions about levels are made by ministers based on public health recommendations informed by the case detection rate, how quickly case rates increase or decrease, positivity in the general population, pressure on the NHS and its capacity, and the local context and exceptional circumstances such as local but contained outbreak.
If these indicators do not improve, an area may move up one level and if the trajectory improves, the area may move lower.
“Sizable portions” of the Midlands and the North are expected to be included in Tier 4 in the December 30 review, but there are growing calls for even more stringent measures.
Andrew Hayward, professor of infectious disease epidemiology at University College London and a member of the New and Emerging Respiratory Virus Threat Advisory Group (Nervtag), told BBC Radio 4’s Today program on December 29: “I think we’re getting in in a very dangerous new phase of the pandemic and we will need decisive, early national action to avoid a catastrophe in January and February.
“A 50 percent increase in transferability means that previous levels of restrictions that worked before will not work now, so Level 4 restrictions are likely to be necessary or even higher.
“I think we really are in a situation where we are approaching closure, but we have to learn the lessons of the first closure.”
Although ministers have ruled it out so far, the new stricter Tier 5 restrictions could close schools and universities, or raise the possibility of a new national shutdown in January.
A Whitehall source said that in the “immediate future” the expansion of Level 4 was more likely than Level 5, but below we explain what it might look like.
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