What Tier 5 restrictions could include, and who it might affect

The Government did not introduce a new, tougher tier on Dec 30. However, its decision to extend the current four tier system was met with warnings that the current restrictions may not be enough to stop the spread of Covid-19. Decisions on tiers are made by ministers based on public health recommendations informed by case detection rate,  how quickly case rates are rising or falling, positivity in the general population, pressure on the NHS and their capacity, and local context and exceptional circumstances such as a local but contained outbreak. If these indicators are not improving, an area may be moved up a tier and if the trajectory improves, the area may move to a lower tier. "Sizeable chunks" of the Midlands, the North East and parts of the North West are now living under Tier 4 restrictions, but there are growing calls for even tougher measures. Andrew Hayward, professor of infectious diseases epidemiology at University College London, and a member of the Government's New and Emerging Respiratory Virus Threats Advisory Group (Nervtag) , told BBC Radio 4's Today programme on Dec 29: "I think we are entering a very dangerous new phase of the pandemic and we're going to need decisive, early, national action to prevent a catastrophe in January and February. "A 50 per cent increase in transmissibility means that the previous levels of restrictions that worked before won't work now, and so Tier 4 restrictions are likely to be necessary or even higher than that. "I think we're really looking at a situation where we're moving into near lockdown, but we've got to learn the lessons from the first lockdown." Although ministers have so far ruled it out, tougher new Tier 5 restrictions could raise the prospect of a new national lockdown this month. The Government announced another U-turn on Dec 30, going back on their decision not to close schools. Secondary and primary schools are now facing a delayed start to term, in order to combat the spread of the virus, after schools warned they wouldn't be ready to implement mass testing in such a short time frame. What are the current Tier 4 restrictions? Rules in Tier 4 are similar to those of the last national lockdown: Pubs, bars and restaurants will only be able to serve takeaway Hotels must close their doors  Indoor gyms and leisure centres must close Personal care services and non-essential retail must close People living in Tier 4 cannot bubble with other households over Christmas Residents should stay at home as much as possible Residents should not enter or leave Tier 4 areas unless for essential reasons Residents from Tier 4 areas should not stay overnight in other areas They cannot go abroad apart from "limited exceptions" such as work People should work from home if they can Communal worship may continue  Weddings and civil partnerships can only take place in exceptional circumstances, with a limit of six attendees How would restrictions change in Tier 5? Although an outline of Tier 5 is not yet clear, it could be similar to the first lockdown back in March. Schools and Universities were closed, with learning taking place online instead. But many schools across the country are already facing two week closures, in order to stop the spread of the virus.  The first lockdown meant elderly and vulnerable people were forced to “shield”, this may mean staying home throughout Tier 5. Other options would include stricter limits on meeting others, as during the first lockdown. Then people were unable to meet anyone from another household, both indoors and out, even for a walk around the park. Also, you were only allowed to leave your home for certain reasons, and exercise was limited to one hour a day per person. These restrictions may be similar if Tier 5 is introduced. Travelling to holiday homes or second homes could be banned, and hotels may close. In the previous lockdown some playgrounds were shut, which may be considered if Tier 5 is put in place.  Why might Tier 5 be necessary?  The tougher restrictions were discussed by Boris Johnson and the Covid-19 Operations committee on the evening of Dec 29 after 53,135 cases were recorded that day.  Pressure has been mounting on ministers to expand Tier 4 restrictions in the face of increasing strain on hospitals in England, where the number of patients has surpassed the April peak of the first wave. On Dec 29, the NHS England chief executive Sir Simon Stevens warned that doctors and nurses are "back in the eye of the storm". Announcing the latest update to restrictions, Matt Hancock said figures from NHS England show there were 21,286 patients in NHS hospitals in England as of 8am on Dec 30, compared with the 18,974 patients recorded on April 12. "We can see the impact that this is having the threat to life from this virus is real, and the pressures on the NHS are real too," the Health Secretary said on Wednesday. Saffron Cordery, the deputy chief executive of NHS Providers, said some trusts were r

What Tier 5 restrictions could include, and who it might affect

The Government did not introduce a new, tougher tier on Dec 30. However, its decision to extend the current four tier system was met with warnings that the current restrictions may not be enough to stop the spread of Covid-19.

Decisions on tiers are made by ministers based on public health recommendations informed by case detection rate,  how quickly case rates are rising or falling, positivity in the general population, pressure on the NHS and their capacity, and local context and exceptional circumstances such as a local but contained outbreak.

If these indicators are not improving, an area may be moved up a tier and if the trajectory improves, the area may move to a lower tier.

"Sizeable chunks" of the Midlands, the North East and parts of the North West are now living under Tier 4 restrictions, but there are growing calls for even tougher measures.

Andrew Hayward, professor of infectious diseases epidemiology at University College London, and a member of the Government's New and Emerging Respiratory Virus Threats Advisory Group (Nervtag) , told BBC Radio 4's Today programme on Dec 29: "I think we are entering a very dangerous new phase of the pandemic and we're going to need decisive, early, national action to prevent a catastrophe in January and February.

"A 50 per cent increase in transmissibility means that the previous levels of restrictions that worked before won't work now, and so Tier 4 restrictions are likely to be necessary or even higher than that.

"I think we're really looking at a situation where we're moving into near lockdown, but we've got to learn the lessons from the first lockdown."

Although ministers have so far ruled it out, tougher new Tier 5 restrictions could raise the prospect of a new national lockdown this month.

The Government announced another U-turn on Dec 30, going back on their decision not to close schools.

Secondary and primary schools are now facing a delayed start to term, in order to combat the spread of the virus, after schools warned they wouldn't be ready to implement mass testing in such a short time frame.

What are the current Tier 4 restrictions?

Rules in Tier 4 are similar to those of the last national lockdown:

  • Pubs, bars and restaurants will only be able to serve takeaway
  • Hotels must close their doors 
  • Indoor gyms and leisure centres must close
  • Personal care services and non-essential retail must close
  • People living in Tier 4 cannot bubble with other households over Christmas
  • Residents should stay at home as much as possible
  • Residents should not enter or leave Tier 4 areas unless for essential reasons
  • Residents from Tier 4 areas should not stay overnight in other areas
  • They cannot go abroad apart from "limited exceptions" such as work
  • People should work from home if they can
  • Communal worship may continue 
  • Weddings and civil partnerships can only take place in exceptional circumstances, with a limit of six attendees

How would restrictions change in Tier 5?

Although an outline of Tier 5 is not yet clear, it could be similar to the first lockdown back in March.

Schools and Universities were closed, with learning taking place online instead. But many schools across the country are already facing two week closures, in order to stop the spread of the virus. 

The first lockdown meant elderly and vulnerable people were forced to “shield”, this may mean staying home throughout Tier 5.

Other options would include stricter limits on meeting others, as during the first lockdown. Then people were unable to meet anyone from another household, both indoors and out, even for a walk around the park. Also, you were only allowed to leave your home for certain reasons, and exercise was limited to one hour a day per person. These restrictions may be similar if Tier 5 is introduced.

Travelling to holiday homes or second homes could be banned, and hotels may close.

In the previous lockdown some playgrounds were shut, which may be considered if Tier 5 is put in place. 

Why might Tier 5 be necessary? 

The tougher restrictions were discussed by Boris Johnson and the Covid-19 Operations committee on the evening of Dec 29 after 53,135 cases were recorded that day. 

Pressure has been mounting on ministers to expand Tier 4 restrictions in the face of increasing strain on hospitals in England, where the number of patients has surpassed the April peak of the first wave.

On Dec 29, the NHS England chief executive Sir Simon Stevens warned that doctors and nurses are "back in the eye of the storm".

Announcing the latest update to restrictions, Matt Hancock said figures from NHS England show there were 21,286 patients in NHS hospitals in England as of 8am on Dec 30, compared with the 18,974 patients recorded on April 12.

"We can see the impact that this is having the threat to life from this virus is real, and the pressures on the NHS are real too," the Health Secretary said on Wednesday.

Saffron Cordery, the deputy chief executive of NHS Providers, said some trusts were reporting up to three times the number of Covid patients as at the peak of the first wave.

"This means hospitals and also ambulance services in Tier 4 areas and beyond are incredibly busy, compounded by increasing staff absences due to illness and the need to self-isolate," she said.