Pressure is growing for the expansion of the toughest coronavirus 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.
Health Secretary Matt Hancock is due to announce any changes to tier areas in a statement to the Commons on Wednesday.
An expert adviser to the Government said national coronavirus restrictions are needed to prevent a “catastrophe” amid rising infections, and the head of an organisation representing health trusts said “as much of the country as possible” should go into the harshest Tier 4.
The debate over the reopening of schools after the Christmas break is also continuing, with scientists and school leaders suggesting a delay might be needed amid rising cases.
The Government said it is “still planning for a staggered opening of schools” after Christmas but is keeping the approach under constant review,
Professor Andrew Hayward, of the Government’s New and Emerging Respiratory Virus Threats Advisory Group (Nervtag) said he thinks schools will have to return “maybe a little bit later” and reopening would mean “we’re going to have to have increased, strict restrictions in other areas of society to pay for that”.
Fellow Nervtag member Professor Neil Ferguson said there had been a “balancing act” since lockdown was initially eased to try to keep control of the virus while maintaining “some semblance of normal society” but that the new variant had made it more difficult.
He told BBC Radio 4’s World At One programme: “Clearly nobody wants to keep schools shut. But if that’s the only alternative to having exponentially growing numbers of hospitalisations, that may be required at least for a period.”
Geoff Barton, general secretary of the Association of School and College Leaders (ASCL), welcomed the Government’s plans for soldiers to offer remote support for testing in schools, but warned it is unlikely to be enough.
Prof Hayward, professor of infectious diseases epidemiology at University College London, said widespread Tier 4 restrictions – or even higher – are likely to be needed as the country moves towards “near-lockdown”.
He told BBC Radio 4’s Today programme: “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.”
Asked whether a national Tier 4 lockdown should be brought in, NHS Providers deputy chief executive Saffron Cordery told BBC Radio Five Live: “I think we need to see, yes, as much of the country as possible in Tier 4.”
She said some trusts are reporting up to three times the number of Covid-19 patients as at the peak of the first wave.
NHS England chief executive Sir Simon Stevens has warned that doctors and nurses are “back in the eye of the storm”.
Figures from NHS England show there were 20,426 patients in NHS hospitals in England at 8am on Monday, compared with 18,974 on April 12.
Sir Simon said: “Many of us have lost family, friends, colleagues and – at a time of year when we would normally be celebrating – a lot of people are understandably feeling anxious, frustrated and tired.
“And now, again, we are back in the eye of the storm with a second wave of coronavirus sweeping Europe and, indeed, this country.”
Sir Simon said there is a “chink of hope” in the various Covid-19 vaccines, with the Oxford/AstraZeneca jab expected to be approved imminently by the Medicines and Healthcare products Regulatory Agency, according to reports.
But the current vaccination target will have to be doubled to two million jabs a week to avoid a third wave of the virus, according to a projection from a London School of Hygiene and Tropical Medicine paper reported by the Telegraph.
Trusts in England were told in a letter just before Christmas to begin planning for the use of Nightingale hospitals, although concerns have been raised around staffing the sites.
One senior doctor said some trusts in London and the South East are considering the option of setting up tents outside hospitals to triage patients.
Emergency medicine consultant Simon Walsh said staff are working in “major incident mode” and called on the Government to set out a “coherent plan” to get through the coming weeks.
Paramedics in London are receiving support from other ambulance services in the South as they receive up to 8,000 emergency 999 calls each day.
South Central Ambulance Service (SCAS) said it is “pre-warning” the military and fire service that paramedics may need help after an average increase of 10% in 999 calls over the Christmas period and a threefold rise in 111 calls, along with a 60%-70% increase in absence rates with staff symptomatic or self-isolating.
The Government said a further 357 people had died within 28 days of testing positive for Covid-19 as of Monday, taking the UK total to 71,109.
The number of further lab-confirmed cases recorded in a single day in the UK also hit a new high of 41,385 at 9am on Monday, rising above 40,000 for the first time, according to Government figures.
The true number is likely to be higher because figures do not include information from Scotland and Northern Ireland, which did not report data between December 24 and 28.
It is not possible to make direct comparisons with the level of infection during the first wave of the virus, because mass testing was only introduced in the UK in May, but it has been estimated there may have been as many 100,000 cases a day at the peak in late March and early April.
More than six million people in east and south-east England went into the highest level of restrictions on Saturday, meaning 24 million – 43% of the population – are now affected.
Lockdown measures are also in place across the other three home nations, after mainland Scotland entered Level 4 restrictions from Saturday for three weeks, and a similar stay-at-home order is in place in Wales.
Northern Ireland has also entered a new six-week lockdown, and the first-week measures are the toughest yet, with a form of curfew in operation from 8pm, shops closed from that time and all indoor and outdoor gatherings prohibited until 6am.