A Nightingale hospital for coronavirus patients in north-west England will reopen next week after the number of people being treated by medics in Liverpool surpassed the peak of the first wave.
Quick guide What are the three tiers of England’s Covid lockdown system?
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Tier one – medium
- The “rule of six” applies, meaning socialising in groups larger than six people is prohibited whether indoors or outdoors.
- Tradespeople can continue to go into a household for work and are not counted as being part of the six-person limit.
- Businesses and venues can continue to operate but pubs and restaurants must ensure customers only consume food and drink while seated, and close between 10pm and 5am.
- Takeaway food can continue to be sold after 10pm if ordered by phone or online.
- Schools and universities remain open.
- Places of worship remain open but people must not mingle in a group of more than six.
- Weddings and funerals can go ahead with restrictions on the number of people who can attend (15 and 30 respectively).
- Exercise classes and organised sport can continue to take place outdoors, and – if the rule of six is followed – indoors.
Tier two – high
- People are prohibited from socialising with anybody outside their household or support bubble in any indoor setting.
- Tradespeople can continue to go into a household for work.
- The rule of six continues to apply for socialising outdoors, for instance in a garden or public space like a park or beach.
- Businesses and venues can continue to operate but pubs and restaurants must ensure customers only consume food and drink while seated, and close between 10pm and 5am.
- Takeaway food can continue to be sold after 10pm if ordered online or by phone.
- Schools and universities remain open.
- Places of worship remain open but people must not mingle in a group of more than six.
- Weddings and funerals can go ahead with restrictions on the number of people who can attend (15 and 30 respectively).
- Exercise classes and organised sport can continue to take place outdoors but will only be permitted indoors if it is possible for people to avoid mixing with those they do not live with (or share a support bubble with), or for youth or disability sport.
- Travel is permitted to amenities that are open, for work or to access education, but people are advised to reduce the number of journeys where possible.
Tier three – very high
- People are prohibited from socialising with anybody they do not live with, or have not formed a support bubble with, in any indoor setting, private garden or at most outdoor hospitality venues and ticketed events.
- Tradespeople can continue to go into a household for work.
- The rule of six continues to apply to outdoor public spaces, such as parks, beaches, public gardens or sports venues.
- Pubs and bars are only permitted to remain open to operate as restaurants, in which case alcohol can only be served as part of a substantial meal.
- Schools and universities remain open.
- Places of worship remain open but household mixing is not permitted.
- Weddings and funerals can go ahead with restrictions on the number of people attending (15 and 30 respectively) but wedding receptions are not allowed.
- The rules for exercise classes and organised sport are the same as in tier 2. They can continue to take place outdoors but will only be permitted indoors if it is possible for people to avoid mixing with people they do not live with (or share a support bubble with), or for youth or disability sport. However, in Merseyside, gyms were ordered to close when it entered tier 3.
- Travelling outside a very high alert level area or entering a very high alert level area should be avoided other than for things such as work, education or youth services, to meet caring responsibilities or if travelling through as part of a longer journey.
- Residents of a tier 3 area should avoid staying overnight in another part of the UK, while people who live in a tier 1 or tier 2 area should avoid staying overnight in a very high alert level area.
Photograph: Peter Byrne/PA
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Prof Jane Eddleston, Greater Manchester’s medical lead on the coronavirus, said the huge makeshift facility in Manchester city centre would take recovering Covid patients from “the end of next week”.
Hospitals in the north-west of England are at the frontline of the second wave of coronavirus as the disease continues to spread rapidly, particularly in Greater Manchester and Liverpool, where medics are increasingly concerned about the number of over-60s becoming infected.
Dr Tristan Cope, medical director of Liverpool University hospitals, said the city was now treating more Covid-19 patients than they did in April at the peak of the first wave and that “numbers continue to rise”.
Liverpool’s three main hospitals were on Thursday treating 398 people with coronavirus, compared with 390 during their busiest day in the spring. Cope said hospital staff were under “a huge strain”, having to treat an increase in Covid patients alongside routine non-critical and emergency care.
In Greater Manchester, however, the picture is less alarming. In a briefing designed to counter some of the “selective statistics” released by Downing Street earlier this week, Eddleston said 35% of critical care beds in the region were currently occupied by Covid patients.
During the April peak, there were more than 300 patients filling critical care beds in Greater Manchester, of whom 260 had coronavirus. The latest figures, for Wednesday this week, showed 218 patients in critical care beds of whom 95 are being treated for Covid.
Eddleston, who appeared alongside Boris Johnson at a Downing Street press conference last week, said that although this number was “significant” the region was “in a different position now” and would bring in additional capacity where needed.
During the April peak there was capacity for more than 400 critical care patients, she said, and that it could reach this figure again if required.
“I don’t want to belittle the fact that this is a very serious condition and it’s challenging for the system,” she said, but added: “We are prepared and we are determined as a system that we will move in the system together. We won’t allow any one of our providers to unintentionally have an increase in pressure in their system.”
Eddleston said, however, that the number of non-critical Covid patients in Greater Manchester was approaching the level of the first peak. There were currently just over 600 coronavirus patients in acute hospital beds, she said, compared with just under 900 in April.
During the briefing, Manchester city council’s director of public health, David Regan, warned that the infection rate among older people was high and rising. There are currently 339 cases for every 100,000 people among the over-60s, he said, adding: “That is where we’ve got our greatest concern because, unfortunately, our older population are more at risk of developing complications from Covid, which may result in hospital admissions.”
Regan said there had been a marked drop in the infection rate among those aged 17 to 21 – falling from 3,350 cases for every 100,000 people on 3 October to 568 cases for every 100,000 currently.
This was due to the influx of 74,000 university students into Manchester in September, he said, although they had been able to bring the virus under control in part by quarantining at least 1,700 younger people in halls of residence – a measure which led to criticism at the time.
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