Pressure is growing for the toughest coronavirus restrictions to be expanded across Britain in the face of increasing strain on hospitals in England where the number of Covid-19 patients is at its highest ever level during the pandemic.
British health secretary Matt Hancock is due to announce any changes to tier areas in a statement to the House of Commons on Wednesday.
With case rates rising in all regions of England, and record patient numbers, any changes are likely to involve areas moving up a tier rather than down.
Figures from NHS England showed there were 21,787 patients in NHS hospitals in England as of 8am on Tuesday, compared with 20,426 on Monday, and 18,974 at the first wave peak on April 12th.
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Five of the seven NHS regions in England are reporting a record number of Covid-19 hospital patients: eastern England, London, the Midlands, southeast England and southwest England.
The other two regions, northeast and northwest England, remain below peak levels that were set in mid-November.
One senior doctor said some hospital trusts in London and the southeast were considering the option of setting up tents outside hospitals – something normally reserved for sudden events such as terror attacks or industrial disasters – to triage patients.
Emergency medicine consultant Simon Walsh said staff were working in "major incident mode" and called on the government to set out a "coherent plan" to get through the coming weeks.
Dr Walsh, who is also deputy chairman of the British Medical Association’s UK consultants committee, said trusts were “having crisis meetings, they’re calling on staff to come in to work if they’re able to on their days off”.
“They are dealing with queues of ambulances outside many emergency departments, often with patients sat in the ambulances for many hours until they can be offloaded into the department because there simply isn’t any space to put them in.”
Record high
Total UK coronavirus cases hit a record on Tuesday, rising above 50,000 cases for the first time, to 53,135 lab-confirmed cases.
While the number is likely to have been inflated by a delay in the reporting of data across the UK over Christmas – with some of the total including people who tested positive before December 25th – Dr Susan Hopkins, senior medical adviser for Public Health England, said the figures were "largely a reflection of a real increase".
She said the “unprecedented levels” of Covid-19 infection across the UK was of “extreme concern”.
It is not possible to make direct comparisons with the level of infection during the first wave of the virus, because mass testing was introduced in the UK only in May, but it has been estimated there may have been as many as 100,000 cases a day at the peak in late March and early April.
An expert adviser to the British government said national coronavirus restrictions were 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.
Prof Andrew Hayward, of the government's New and Emerging Respiratory Virus Threats Advisory Group (Nervtag), said widespread Tier 4 restrictions – or even higher – were 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.” – PA