Millions of people across the UK at risk from Covid will be offered a single first dose of the Oxford/AstraZeneca vaccine, with a booster jab within three months, in a bid to return the country to some normality by the spring, the prime minister has said.

Helen Pidd www.theguardian.com

Rollout of the Oxford vaccine will begin on 4 January following its approval for emergency use by the Medicines and Healthcare products Regulatory Authority (MHRA). The government hopes the vaccine, of which it has ordered 100m doses, will transform prospects in the UK and check the spread of the rampaging coronavirus variant which has caused cases to surge. Pharmacies as well as GPs will be able to give the jabs to those at risk.

But the MHRA and the government’s advisory Joint Committee on Vaccinations and Immunisation delivered a surprise by announcing approval of a regime that was not trialled. Both the Oxford vaccine and the Pfizer/BioNTech jab which is already in use will be given to people as one shot, followed by another up to 12 weeks later, in order to extend some protection to as many people as possible as quickly as possible.

Boris Johnson said at a Downing Street press conference that the benefits from the vaccine would kick in within 21 days. “What that means is we can vaccinate and protect many more people in the coming weeks,” he said.

He hoped that by spring of 2021, many coronavirus restrictions would be able to be lifted. “If we’re right and the vaccination programme does have the positive effects that we think it can have, and I stress these are ifs, then clearly a lot of the non-pharmaceutical interventions … will recede into the past,” he said. “We’ll be able to do things very differently.”

The prime minister added that the public may need to carry on with “basic disciplines” such as washing hands and wearing masks “for a while after”.

The approval of the vaccine by the MHRA after weeks of examining trial data was greeted with excitement and relief by experts. The Pfizer/BioNTech vaccine already in use needs to be stored in the long-term at -70C and is hard to deploy. The Oxford vaccine, however, can be kept in a normal fridge at 2-8C and is easily transported from UK factories, meaning it will not have to be kept in central hospital and community hubs, enabling a swift rollout to GP practices and care homes.

Amid the widespread praise for Oxford University and AstraZeneca in gaining UK approval for a vaccine that is vital to the global prospects of ending the pandemic because of its low cost and normal refrigeration, some experts were anxious at the proposed mode of use. They said it was pragmatic to try to ensure as many people as possible had a first shot, giving them some protection, but that there were unanswered questions. These include the evidence for extending the time between injections to 12 weeks, which could lead to some people not returning for the second dose.

Pfizer/BioNTech said that their vaccine was not designed to be used in two shots 12 weeks apart. In a statement, the firms said there was no evidence the first shot continued to work beyond three weeks.

“Data from the phase 3 study demonstrated that, although partial protection from the vaccine appears to begin as early as 12 days after the first dose, two doses of the vaccine are required to provide the maximum protection against the disease, a vaccine efficacy of 95%. There are no data to demonstrate that protection after the first dose is sustained after 21 days,” they said.

The decision to approve the Oxford/AstraZeneca vaccine followed “rigorous clinical trials and a thorough analysis of the data by experts at the MHRA, which has concluded that the vaccine has met its strict standards of safety, quality and effectiveness”, the DHSC said.

AstraZeneca said its vaccine would be made available to some of the poorest regions of the world at a low cost and was not being manufactured for profit.

Talking to BBC Radio 4’s Today programme, its chief executive, Pascal Soriot, said the company could provide the UK with as many as 2m doses a week and would start shipping the first doses “today or tomorrow”.

He said: “Vaccination will start next week and we will get to 1m a week, and beyond that a week, very rapidly. The good news with this is we are going to be able to inject a lot of people with one dose very quickly, provide them with a reasonably good dose of protection until they get their second dose two to three months later. That will enable us to protect many more people because we can wait two to three months for the second dose.”

Matt Hancock, the UK health secretary, said every adult in the UK could eventually be offered vaccination.

Speaking to BBC Breakfast, he said: “Because we’ve got enough of this vaccine on order to vaccinate the whole population – we’ve got 100m doses on order – add that to the 30m doses of Pfizer and that’s enough for two doses for the entire population.

“So I can now say with confidence that we can vaccinate everyone, except of course for children because this vaccine has not been trialled on children, and anyway children are much, much less likely to have symptoms from the disease.”

Appraisal of the Oxford vaccine has taken longer than it did for the Pfizer/BioNTech product, which the UK was the first country to approve on 2 December. The dossier of testing and trial results for the Oxford vaccine was more complicated.

Pfizer/BioNTech, whose vaccine is based on novel mRNA technology, had clear results, with 95% efficacy from a single international trial involving 43,000 people. Oxford/AstraZeneca had 62% efficacy in their largest trial, of 11,636 people, but 90% efficacy in a small additional sub-group in the UK numbering 2,741 who were given half a dose of the vaccine followed by a whole dose four weeks later.

The MHRA in effect dismissed the finding from the trials that there was 90% efficacy in that subset, which was made up of fewer than 3,000 people in the UK, who were mostly under the age of 55, so was not typical of the population’s most vulnerable. However, the MHRA said it was not the age of the participants that caused the high efficacy rate. Instead, it suggested it may have been because there was a longer gap between the administration of the first and second doses of vaccine. More details of their assessment was to come, the authority said.

Overall, the MHRA said, the efficacy of the vaccine reached about 70% between three weeks and 12 weeks, when given as a single standard dose. The second dose, not later than 12 weeks afterwards, was necessary because the effect may not last without the booster shot, it said.

The MHRA acknowledged there was limited data on the effects of the vaccine in elderly people. Ongoing trials in the UK and US will supply more evidence, but it said it was satisfied the vaccine was safe and effective in the older population.

The researchers have pointed out that none of the volunteers in the trials who had the vaccine became seriously ill or were admitted to hospital.

Prof Andrew Pollard, the director of the Oxford Vaccine Group and the chief investigator of the Oxford trial, said: “The regulator’s assessment that this is a safe and effective vaccine is a landmark moment, and an endorsement of the huge effort from a devoted international team of researchers and our dedicated trial participants.

“Though this is just the beginning, we will start to get ahead of the pandemic, protect health and economies when the vulnerable are vaccinated everywhere, as many as possible as soon possible.”

The Labour leader, Keir Starmer, tweeted: “We now need a national effort to get vaccinations delivered across the country.”

Jonathan Ashworth, the shadow health secretary, welcomed the news, tweeting: “Now let’s go hell for leather to get jabs rolled out. We’ve seen how more virus circulating means opportunities for variants to emerge. This is now a race against time. We need vaccination ramped up especially for NHS staff urgently.”

Johnson said the UK had already vaccinated more than 800,000 people with the Pfizer/BioNTech jab.

Tesco, Pizza Hut and Superdrug are among more than a hundred firms “named and shamed” by the government for not paying workers the minimum wage.

BBC News www.bbc.co.uk

Almost 140 companies investigated between 2016 and 2018 failed to pay £6.7m to more than 95,000 workers.

The minimum wage ranges from £4.15 an hour for apprentices, to £8.72 an hour for over-25s.

Tesco, Pizza Hut and Superdrug said the underpayments were historic errors and staff had been swiftly reimbursed.

Ministers said the offending firms – which included hotels, restaurants, car washes and shops – short changed tens of thousands of workers, in what they described as a “completely unacceptable breach of employment law”.

Cases included employers taking deductions from wages for uniforms, training or parking fees or failing to raise employees’ pay after a birthday which should have moved them into a higher minimum wage bracket.

‘Wake-up call’

It is the first time the government has named firms for failing to pay the national minimum wage since 2018, following reforms to the process to make sure only the worst offenders are revealed.

The Business Minister Paul Scully said he was especially disappointed to see big household names on the list but he said it should be a “wake-up call” to bosses.

“It is never acceptable for any employer to short-change their workers, but it is especially disappointing to see huge household names who absolutely should know better on this list,” he added.

What is the minimum wage?

The UK national minimum wage sets out the least a worker can be paid per hour by law.

As of April 2020, it stood at £8.72 an hour for people aged 25 and older – the government refers to this main rate as the National Living Wage.

There are four minimum wages below this amount for younger workers and apprentices:

• The National Minimum Wage for 21 to 24-year-olds – £8.20
• For 18 to 20-year-olds – £6.45
• For under-18s – £4.55
• For apprentices – £4.15

TUC general secretary Frances O’Grady said may firms which failed to pay their workers the minimum wage still wouldn’t be named.

“The government raised the threshold for naming employers compared with the old scheme, meaning fewer bad bosses are exposed.”

Tesco said a technical issue in 2017 meant some workers’ pay “inadvertently” fell below the minimum wage and it had reported the issue itself to HMRC.

“In most cases the reimbursement was £10 or less,” the supermarket said.

Pizza Hut and Superdrug both said the error was related to a previous uniform policy, which required staff to wear a particular colour trousers and shoes.

“It is important to stress that there was never any intent to underpay our employees,” said Pizza Hut. Superdrug said it had changed its policy to make sure the issue did not happen again.

All University of Exeter students will be recommended to take a coronavirus test as soon as possible when they return to campus in the New Year – with advice saying they should complete two before beginning in-person teaching.

Daniel Clark www.devonlive.com 

The university will be offering free tests to all students, including postgraduate researchers, between January 4 and February 5 using their existing test centres on the Streatham and Penryn campuses.

All students are being recommended to book tests for when they arrive in their term-time accommodation and before starting any in-person teaching, or using study or social spaces on our campuses, and should isolate until they receive a result. Students should plan to take two Covid-19 tests before beginning in-person teaching.

Mike Shore-Nye, Registrar and Secretary, said: “It is essential that you allow enough time to take your test and you should book your test to be taken as soon as possible after you arrive at your accommodation. If your preferred slot is not available choose one as close as possible to your arrival time and try to keep away from other people.

“Only by testing can we identify those who are positive and support them to isolate, and this is how we can keep each other safe, avoid further outbreaks and find ways to return to a more normal University life. If you have tested positive for Covid-19 in the last 90 days, there is no need for you to take another test.

“Students should plan to take two Covid-19 tests before beginning in-person teaching.”

Speaking at a Team Devon Local Outbreak Engagement Board meeting in December, Sean Fielding, Director of Innovation, Impact and Business, had added: “We will do 50,000 tests over the first month of the new year. We don’t want people coming into the city and creating an infection risk.

“The return of students will be staggered and there will be a testing schedule as and when they arrive. Every student will be asked to do two tests.”

Examinations for some students begin on January 4, with all exams online, and teaching begins for all students on January 11, but for many students this will initially be online-only

Those degree programmes with placement or practical elements which cannot be delivered online will resume in-person teaching first, with most resuming from the week beginning January 11.

New postgraduate taught students will also begin their in-person teaching from the week beginning January 11, while other final year undergraduate students and returning postgraduate taught students will resume in-person teaching in the week beginning January 25

All other Undergraduate students will resume in-person teaching in the week beginning February 1, while postgraduate research students can resume their research from January 4.

Government guidance adds: “The return of students should be staggered over five weeks – this is to minimise transmission risks from the mass movement of students, with practical and placement students returning first.

“All students should be offered testing on return to university and students who returned home over the winter break should not be encouraged to return to their term-time accommodation until their face-to-face teaching is scheduled to resume

“To minimise the risk to themselves and others on their return to university, before travelling, students should act responsibly, follow local restriction tier guidance on social contact and use local community testing programme and take a test before travelling if they have spent the winter break in a local restriction tier 3 (very high) or tier 4 (stay at home) area where this fits with locally-targeted programmes led by the Director of Public Health.”

And:

Cllr Paul Arnott, Leader of East Devon District Council, said: “The threat from the new and more transmittable strain of the virus is extremely serious and the people of East Devon must do all they can to protect the health of both themselves and others.

“I wish everyone a happy new year and urge you to celebrate safely from your own home and respect at all times the increased safety obligations of Tier 3.”

Daniel Clark www.devonlive.com 

Devon’s move into Tier 3 restrictions has left MPs disappointed, but they felt it was inevitable.

The government has reviewed the tier restrictions, and Devon is to move up to Tier 3 from Thursday, December 31.

The rules means that you must not meet socially indoors with anybody who you do not live with, or you are not in a support bubble with and you must not meet socially outdoors (in a private garden or at most outdoor public venues) with anybody who you do not live with, or you are not in a support bubble with*.

Hospitality settings, such as bars, pubs, cafes, restaurants and social clubs must close except for takeaway, delivery and click and collect services. Food or drink bought via these must not be consumed on the premises including beer gardens.

Hotels, B&Bs, campsites, holiday lets and guest houses, must close, except for those travelling for work, while most tourist venues and entertainment must close, but some outdoor venues are permitted to remain open.

Steve Brown, Director of Public Health Devon (Designate) said: “Cases in Devon, while we have been in Tier 2, have been rising in all age groups, as per the national trend. Without further intervention with tighter restrictions, we are likely to have seen cases continuing to rise and therefore I feel this announcement was inevitable.

“The decision has been made to place us into Tier 3 and what is important now is we do everything we can to adhere to these tighter restrictions to help bring down cases in Devon

“We will have heard the welcome news today that a second vaccine has been approved for use from early January, but we cannot sit back and relax on the strength of that. Please keep up the effort, and remember the key messages, to social distance, wear your face coverings when in a public space where social distancing is not possible, and wash your hands properly and regularly.”

Anne Marie Morris, MP for Newton Abbot, said: “It is unsurprising that Devon has been placed in Tier 3, given the rising rates across the county & country. January is traditionally the busiest month of the year for the NHS and I would urge people to continue following the rules, in order to reduce the spread of this terrible disease and protect the most vulnerable in society. Alongside colleagues, I continue to call on the Government to publish data on the impact this pandemic is having on non-Covid health conditions.”

Ben Bradshaw MP for Exeter said: “This is clearly disappointing, as our figures are still among the lowest in the country, but I suppose the dire and deteriorating situation elsewhere & the huge pressure on the NHS made it inevitable. We are now paying the price of locking down too late in October, coming out of that lockdown too early & the chaos & confusion over Christmas. I fear we could see another national lockdown before the benefits of the vaccination programme begun to be felt.”

Simon Jupp, MP for East Devon, said; “Devon will move into Tier 3 tomorrow. Case numbers continue to rise across the county and our NHS remains under strain. There is hope and optimism following independent approval of the Oxford-AstraZeneca vaccine which will be rolled-out from next week. This is very welcome news, but we can’t let our guard down.”

Kevin Foster, MP for Torbay, said: “Whilst infection rates in our bay are still relatively low, they are steadily rising, and we cannot ignore the situation in the rest of Devon and the UK as a whole, especially relating to the new strain.

“I appreciate the hard work many in our tourism and hospitality industry have put in over the last month to keep our community safe whilst they were still trading, yet if South Devon were an island of Tier 2, with surrounding areas in Tier 3 and nearby Somerset in Tier 4, it is sadly all too predictable we could see activities and people gyrate towards our bay, potentially bringing the virus with them.

“It is therefore right we move into Tier 3, along with the rest of Devon and Cornwall, at this stage. Yet with the vaccination programme now set to step up massively, we can look forward to the Summer Season with confidence.”

Clodagh Murphy, Chairman of Exeter Chamber, said: “Exeter Chamber understands the need to take tough measures against this rapidly spreading new strain of Coronavirus to protect the NHS and our communities, but this must not be at the expense of further damage to our economy.

“With hospitality businesses already reporting an 80 per cent reduction in takings over the Christmas / New Year period, and now facing closure once again, we urgently call for emergency measures to support those businesses that are most affected by these new restrictions. These include, but not limited to, the hospitality, leisure and tourism sectors which are vital to both Devon and the wider Westcountry’s economic success.

“We want thank all of our local businesses and hospitality for all their hard work over the last nine months as we have tackled the changing landscape of this pandemic. These businesses are the lifeblood of the Devon economy and they have been tremendous.

“The rollout of the vaccine programme, and the approval of the Oxford/AstraZeneca vaccine, gives us all hope of a return to something approaching normality later in 2021. However, in the meantime, we must not allow businesses to fail due to lack of Government support in these final months, so that they are able to come back in the spring/summer and continue to help the region’s economy prosper and grow.”

Anthony Mangnall, MP for Totnes, said: “I have been a firm believer that an end to lockdown is very necessary but we also have to take into account that the numbers are increasing in the South West, along with the rest of the country. I do support the Government in the action today, but important that we have a second vaccine coming online and that will be a lot quicker to rollout.

“We are nearing the light at the end of the tunnel and hoping we can get it to those in most need of it. I understand the frustration – we are at the last moment and the light is almost darkest before the dawn – and we are like a marathon runner on the last mile and we have to focus on the rollout of the vaccine and getting life back to normal, but we have to do it without jeopardising the NHS and the capacity that goes with it.”

But the Oxford-AstraZeneca vaccine has been approved for use in the UK, with the first doses due to be given on Monday.

On the approval of the Oxford vaccine, Ms Morris said: “It is fantastic news that the Oxford/AstraZeneca vaccine has been approved for use by the MHRA. This is a game changer and will enable the NHS to significantly increase vaccination capacity, especially in harder to reach places such as rural care homes. The sooner we can roll out the vaccine, the sooner we can begin to head back to ‘normality’.”

Kevin Foster, MP for Torbay, said: “This is a triumph for British Science and a leap forward in our fight against Covid-19 both in the UK and globally, given it can be distributed via existing vaccination routes due to it being able to be stored in a fridge. I know plans for using it are already well advanced in our bay, including ensuring it reaches the most vulnerable living in care homes.”

“Whilst there will still be some difficult days ahead, the Oxford Vaccine holds out the hope of a more normal summer season for our bay and its tourism industry, but for now we cannot let our guard down.”

Sir Gary Streeter, MP for South West Devon said: “”The approval of the Oxford vaccine is wonderful news. I hope we can vaccinate around two million per week starting almost immediately and also people in care homes.”

MP for Exeter, Ben Bradshaw, said: “It’s great news that the Oxford vaccine has been approved, as this is the one that most of us will get, as it is easier to deploy. The Goverment must now ensure that the NHS has the resources and staff to administer the vaccines round the clock so we can get on top of this pandemic as soon as possible.

“I also agree with those who argue that administering one dose to as many people as possible as quickly as possible would be better than two doses to fewer people, as all the vaccines provide a very good level of protection at one dose and doing that is likely to get us out of this crisis sooner.”

Cllr Paul Arnott, Leader of East Devon District Council, said: “The threat from the new and more transmittable strain of the virus is extremely serious and the people of East Devon must do all they can to protect the health of both themselves and others.

“I wish everyone a happy new year and urge you to celebrate safely from your own home and respect at all times the increased safety obligations of Tier 3.”

A previous post from Owl headed:  “Otter restoration project: stop the swamp, or future proof against climate change?” exposed some of the emotion swirling around this project. There have been over 500 comments from members of the public.

So it is interesting to see how the case, which will be determined by EDDC’s planning committee next Wednesday, is summarised by DevonLive’s democratic reporter.

The Exmouth Journal publishes today rather than on its usual Wednesday but does not cover the story.

Daniel Clark www.devonlive.com 

Multi-million pound plans to restore the Otter Estuary to its natural and historic flood plains to avoid a catastrophic failure of sea defences are set to be given the go-ahead next week.

East Devon District Council’s planning committee are being recommended to approve the Lower Otter Restoration Project, which will create 55 hectares of mudflats, saltmarsh and other valuable estuarine habitats.

The project, led by landowner Clinton Devon Estates and the Environment Agency, would see the Big and Little Marsh floodplains around Budleigh Salterton restored, with breaches created in the Little Bank, the Big Bank and the River Otter Embankment to allow water to flow through.

The Lower Otter valley is the subject of plans from the Environment Agency

The funding will support the Lower Otter Restoration Project’s aims of climate change adaptation by working with natural processes to provide benefits for people and wildlife.

It follows the significant risk that a major flood or extreme tidal event could lead to catastrophic failure of embankments, with unpredictable environmental and social impacts, with recent years having seen part of the South West Coast Path that runs along the embankments closed to the public for significant periods due to erosion caused by such events.

As part of the plans to restore the historic floodplain of the River Otter, breaches in existing embankments would be created to allow water from both the River Otter and the Estuary to inundate the site, creating intertidal saltmarsh and mudflats.

In addition, South Farm Road will be realigned and raised at a point just to the south of the existing road, and a small car park created at its western end and a new road bridge will be required, and a new footbridge to the South. Existing footpaths will be realigned and the landfill site capped and planted with grassland and woodland.

The spit to the South will be allowed to evolve naturally, necessitating the removal of the southern part of the loop path known as Donkeys Turn.

The cricket club will be moved from its current location to land off of East Budleigh Road, permission for which has already been granted under a separate planning application. Floods have left part of their current Ottermouth home under water on three occasions in the last 10 years, with a plan to relocate to Janie’s Field on the outskirts of the town having been agreed.

Recommending approval, the report of planning officers says: “This is a significant application within the Lower Otter Valley which will result in a change to the existing landscape, which has been managed over the past two centuries. The proposal would clearly significantly change the area, particularly by way of breaches to the embankments which would irreversibly change the habitat and visual appearance of the estuary.

“The ambition to return the river to a more natural watercourse will result in the inundation of water to the project area and will result in large areas of new habitat creation. In addition, significant rerouting of the existing South Farm Road is required, and there will be a requirement for additional car parking and a new footbridge to provide adequate facilities for those accessing the area by car, on foot or by bike.

Option 3 – Big and Little Marsh Floodplain Restoration (estimated cost £8-9m) for the Lower Otter Restoration project

“The scheme is widely supported by a number of significant conservation bodies which have an interest in the site, this is a result of a number of years of consultation on the project including working groups.

“The Flood Risk Assessment and modelling have fully considered the impact of the scheme on nearby residents and businesses, and have concluded that the risk is minimal.

“Concerns have been raised regarding the positioning and size of the proposed car park which will be addressed by a planning condition, which will also include the requirement for a footpath from the proposed car park and impacts on trees, local landscape, the setting of heritage assets, use of the estuary and contamination have also been addressed.

“It is considered that the proposal is acceptable subject to appropriately worded conditions relating to archaeology, materials of the footbridge, access details and public rights of way, contamination, a construction management plan, groundwater levels, adequate car parking, the provision of a footpath, arboricultural and tree protection details.”

The Environment Agency has submitted plans to East Devon District Council on behalf of LORP as the £15 million project enters its final phase and if approved, work will start in 2021 and be completed by spring 2023.

The River Otter

The Lower Otter project is largely funded by the European Interreg programme through an initiative called Promoting Adaptation to Changing Coasts (PACCo). It is partnered with a similar project in the Saâne Valley in Normandy, France.

Both schemes aim to demonstrate that early adaptation to climate change brings greater benefits than a delayed response or inaction. If successful, the adaptation model for these two projects will be rolled out to other locations in the UK and France.

East Devon District Council’s planning committee meets on Wednesday, January 6, to determine the fate of the application.

Devon and Cornwall move up to Tier 3 tomorrow

https://www.gov.uk/guidance/tier-3-very-high-alert

Josh Halliday www.theguardian.com 

Millions more people in England will be placed under stay-at-home orders from New Year’s Eve, the government has confirmed, after the new variant of Covid-19 contributed to a record rise in infections across the country.

The health secretary, Matt Hancock, announced that 75% of England – including all of the north-east, Greater Manchester, large parts of the Midlands and the south-west – would be in the strictest tier 4 rules from Thursday morning.

They will join nearly 24 million people in England already under the “stay at home” restrictions, meaning the closure of non-essential shops and strict one-to-one outdoor meeting limits between households.

There have been growing calls for tighter coronavirus restrictions in England as cases continue to rise and hospitals report mounting pressure. All of mainland Scotland, Wales and Northern Ireland are already in the tightest restrictions, meaning the closure of hospitality and non-essential retail.

The number of Covid-19 patients in English hospitals surpassed the first-wave peak on Sunday, with 21,787 people in hospital with the disease on Tuesday morning and numbers expected to rise further as cases climb.

The infection rate in England increased by a third in the week to Christmas Eve, while the number of Covid-19 patients admitted to hospital rose by 8% on the week before – to 14,915 people.

On Tuesday, cases reached a record high, with 53,135 reported in the UK, including 47,164 in England. The Covid variant discovered earlier this month accounted for a majority of all new cases in London, the south-east and east of England, Hancock said on Wednesday.

Areas moved into tier 4 include all of the Midlands except Worcestershire, Herefordshire, Shropshire, Telford and Wrekin and Rutland, which will all be in tier 3. In the north-west, Greater Manchester, Lancashire, Blackpool and Blackburn with Darwen, Cheshire, Warrington and Cumbria will be in tier 4. Liverpool will be moved up to tier 3.

In the south-west, Gloucestershire, Swindon, Somerset, Bournemouth, Christchurch and Poole will be in tier 4, while the remainder of the region – including Cornwall, Devon and Dorset – will be moved up to tier 3. The Isles of Scilly, which have a population of 2,224 people, will be the only part of England not in tiers 3 or 4.

Hancock told the Commons that Wednesday was “a day of mixed emotions” due to the announcement of the new restrictions hours after the Oxford/AstraZeneca vaccine was approved by the UK’s medical regulator.

He told MPs: “It brings forward the day on which we can lift the restrictions that no one in this house wants to see any longer than are absolutely necessary. But we must act to suppress the virus now, not least because the new variant makes the time between now and then even more difficult.

“And so whilst we have the good news of the vaccine today, we also have to take some difficult decisions.”

Hancock said he knew the measures would place a significant burden on businesses and livelihoods but that it was “absolutely necessary because of the number of cases that we have seen”.

From the Western Morning News:

Tougher restrictions to slow the spread of coronavirus are expected to be announced today as rising cases put an increasing strain on hospitals.

Health Secretary Matt Hancock will address the recalled House of Commons after MPs have passed key legislation on the post-Brexit trade deal with the European Union.

With case rates rising in all regions of England, as well as the number of Covid-19 patients in hospitals, any changes are likely to involve areas moving up a tier rather than down.

Devon’s director of public health designate, Steve Brown, said before Christmas he was surprised the county had not been put into Tier Three at the last review. Cornwall was raised from Tier One to Tier Two from Boxing Day, but Devon stayed where it was. 

Mr Brown said: “Given our rising case numbers and emergence of the new variant, I am surprised that Devon has not yet been lifted into Tier Three.”

Last night, Cornwall Council said it was becoming increasingly concerned at a 44% rise in cases in the last seven days.

Now an expert adviser to the Government has said national coronavirus restrictions are needed to prevent a “catastrophe”, and the head of an organisation representing health trusts said “as much of the country as possible” should go into the harshest Tier Four.

Exeter University’s expert in infectious diseases, Dr Bharat Pankhania, said it would be ‘prudent’ to delay schools reopening after Christmas and to increase the closure period beyond the one additional week announced by Michael Gove.

Owl has been keeping a record of the daily active Covid cases as estimated by the Covid Symptom Tracker App since the end of November. It is interesting to compare the trajectory of estimated cases per head of population (ppm so ten times larger than the usual measure) for East Devon and Cornwall (Cornwall with a larger sample presents less scatter). Looks like they are both on the rise, with Cornwall ahead.

Key dates:

Lockdown 2 ended Dec 2. East Devon moved to Tier 2, Cornwall placed in Tier 1.

Revised Tier system, raising Cornwall to Tier 2, introduced Dec 26

Anton Bailey had just taken a delivery of a new set of fishing nets and was patiently sorting them on the harbour-side at Brixham in Devon. The skipper, who first boarded a fishing boat four decades ago when he was just three, was feeling a mixture of optimism and frustration.

Steven Morris www.theguardian.com

He is optimistic that when he chugs out to fish for pollock with his fresh nets in the new year he will be lucky and return with a good catch, but frustrated that, to his mind, the Brexit fishing deal has sold the British industry short.

“The Europeans always get what they want. It’s a simple as that,” said Bailey.

His main gripe is that under the deal EU boats will be able to operate up to six miles off the UK coast while British boats will have to remain 12 miles off the beaches of mainland Europe. “How is that fair? We’re not allowed inside their 12, I don’t see why they should be allowed up to our six.”

Andy McLeod, who owns and skippers the Brixham beam scalloper van Dijck, is also puzzled over the six/12 mile disparity. “One thing I did hope for was that we would get the 12-mile limit,” he said. “It should be a level playing field.”

But he is not one of those who feels that every fish off the coast of Britain belongs to UK fishers. “I thought it was a bit harsh to try to cut the rest of Europe off from our fish completely,” he said. “To be honest we don’t have the fleet to catch all the fish. If they suddenly said: ‘All the fish is yours’, actually we don’t have anything to catch it with.”

Brixham bills itself as the birthplace of the trawling industry. It has been a fishing port since the middle ages, but in the 18th century pioneered the use of sailing trawlers, fast powerful robust boats that targeted demersal fish – cod, sole, plaice, haddock.

The port boasts England’s largest market by value of fish sold and this year enjoyed a run of million-pound weeks, with sales of the more than 40 types of fish landed here regularly reaching seven figures.

But, as McLeod points out, most of the Brixham boats have seen better days. McLeod’s vessel was already 16 years old when it arrived in Devon from the Netherlands 30 years ago.

“There’s never been much help for the fishing industry in the UK compared to other countries where their governments back them, give them grants for new boats,” he said. “That’s why our fleet is second-hand Dutch and Belgian boats. They get the grants, run them for 20 years and sell them to us.”

A seal bobbed its head up as Matt Shepherd, at 32 one of the younger skippers, prepared his small boat for a trip out. “You hear a lot about Brexit and the EU all the time. Some are for, some are against. I’m just trying to get on and make a living.”

But it is hard to forget Brexit. On the way into the town a “Fishing for Leave” banner with the slogan “Save Britain’s fish” still flutters in a farmer’s field.

Mike Sharp, the owner of two Brixham beam trawlers, took part in the Fishing for Leave protest on the Thames in London during the EU referendum campaign.

Four years on, he is furious at the EU deal. “I’m hoping the deal gets voted out by parliament. I doubt it. Boris came to Brixham and promised us everything. He’s used fishing as a lever to get whatever he wants. Fishing’s not important to them. I have a fish merchant friend who calls two-faced people kippers. Boris is a kipper.”

The government has promised a £100m funding package for the industry. “But £100m goes nowhere,” said Jim Portus, the chief executive of the South West Fish Producers Organisation. “You won’t be able to replace old vessels with new ones. You’ll just be patching up in the same way we have been doing for the last 20 years.”

Brixham-born Sean Irvine, 61, who has been fishing from the port since the early 1990s, said he was glad, at least, that there had been a deal but he is concerned about the new paperwork that will be needed to send fish to mainland Europe – as much as 80% of Irvine’s catch is exported.

“We’ll be catching the same fish in the same water as the French but we’ll have to produce a mountain of paperwork for it. It seems to me what we have achieved is minuscule when you think of the upsets it has caused in families and communities. All that effort for so little.”

The Labour Party has doubled down on demands for the Conservatives to launch an investigation into London mayoral candidate Shaun Bailey’s campaign over “fake” warnings sent out to voters appearing to threaten a council tax rise from City Hall. 

www.independent.co.u

In a letter obtained by The Independent, MP Angela Rayner, deputy leader and party chair of Labour, admonished the Conservative Party for failing to act in the weeks after Mr Bailey’s campaign sent out flyers made to look like official warnings from Mayor Sadiq Khan’s office that their Council Tax would be raised unless they “take action”. 

“The public rightly expects honesty and integrity from political parties, elected politicians,  candidates and their campaigners so it is extremely concerning to me that Mr Bailey, an  elected representative of the London Assembly, and your candidate for Mayor of London,  would continue to seek to deceive Londoners with false information presented as being from  trusted public bodies,” Ms Rayner wrote in the letter, which was addressed to MP Amanda Milling, co-chair of the Conservative Party, and dated to Sunday.

Noting that she had already written a previous letter “inquiring whether weaponising fake news is now official Conservative Party policy,” the Labour deputy leader said she was now writing again to demand that the Tories launch an investigation into the incident and push Mr Bailey’s campaign to issue a public apology. 

Ms Rayner also called on the Conservatives to publicly condemn the actions of the mayoral candidate’s campaign team. 

Mr Bailey’s campaign has faced significant scrutiny after being accused earlier this month of playing a “heartless, cheap trick” on voters by sending out the controversial flyers.

Liberal Democrat mayoral contender Luisa Porritt had initially flagged concerns around the initiative, demanding an immediate apology from Mr Bailey. 

The Tory candidate’s campaign team has defended the flyers, however, with a spokesperson telling The Independent that  “Londoners have a right to know the full facts. And the fact is Sadiq Khan’s planning to hike his share of council tax.”

The campaign accused Mr Khan of planning to raise Council Tax to “pay for the cost of his management”. 

However, the London mayor had previously only expressed that he was considering the possibility of raising Council Tax to cover gaps in TfL funding worsened by the Covid-19 pandemic and left unplugged by central government.

On 16 December, however, the day that Mr Bailey’s flyer campaign made it into headlines, Mr Khan issued a warning that a council tax rise was likely.

“I must sound a warning for Londoners that instead of providing the funding we need, Ministers are pushing for an extraordinary and significant increase in Council Tax in London and across the UK,” he said in a statement.

“I will be honest and upfront with Londoners about exactly what this means for your bills as soon as possible,” he added.

In Ms Rayner’s letter, the MP accuses Mr Bailey’s campaign of failing to acknowledge that much of TfL’s borrowing was incurred “under the previous Mayoralty, under a Conservative Mayor”. 

“By contrast, the current Mayor has dramatically cut TfL’s rate of borrowing and hugely improved its finances during his mayoralty,” she said in the letter, which can be seen below.

The MP further accused Mr Bailey’s campaign of failing to “acknowledge the devastating impact that Covid-19 has had on TfL finances, which as you know is the reason emergency funding was needed in the first place.”

In a statement sent to The Independent, a London Labor spokesperson said: “The Tory Mayoral candidate is now making a regular habit of deliberately lying to Londoners and spreading fake news.”

The spokesperson accused Mr Bailey’s campaign of exaggerating what a potential Council Tax increase might look like to “scare Londoners at a time when many are facing financial hardship because of the pandemic.”

“There is simply no way Sadiq would choose to increase council tax by anything like those levels. He should immediately withdraw these leaflets and apologise to Londoners for lying yet again,” the spokesperson said.

The Independent has contacted the Conservative Party for comment.

This article has been updated with a comment from London Labour.

By James Gallagher www.bbc.co.uk Health and science correspondent

The coronavirus vaccine designed by scientists at the University of Oxford has been approved for use in the UK.

It marks a major turning point and will lead to a massive expansion in the UK’s immunisation campaign, which is aimed at getting life back to normal.

The UK has ordered 100 million doses from the manufacturer AstraZeneca – enough to vaccinate 50 million people.

The approval, by the medicines regulator, means the vaccine is both safe and effective.

The Oxford-AstraZeneca vaccine was designed in the first months of 2020, tested on the first volunteer in April, and has since been through large-scale clinical trials involving thousands of people.

It has been developed at a pace that would have been unthinkable before the pandemic.

It is the second jab to be approved in the UK after the Pfizer-BioNTech vaccine was given the go-ahead in December.

More than 600,000 people in the UK have been vaccinated since Margaret Keenan became the first in the world to get that jab outside of a clinical trial.

But the Oxford-AstraZeneca vaccine will lead to a significant increase in vaccination as it is cheap and easy to mass produce.

Crucially it can be stored in a standard fridge – unlike the Pfizer-BioNTech jab which needs ultra cold storage at -70C – so it will be far easier to get the Oxford vaccine to care homes and GP surgeries.

Priority groups for immunisation – including the elderly, care home residents and health and care workers – have already been identified.

The new vaccine approval comes after Public Health England said the country was facing “unprecedented” levels of infections, and health officials in parts of Wales, Scotland and the south of England voiced concerns about the increasing pressure on the NHS.

How does it work?

The vaccine is a genetically modified common cold virus that used to infect chimpanzees.

It has been altered to stop it causing an infection in people and to carry the blueprints for part of the coronavirus, known as the spike protein.

Once these blueprints are inside the body they start producing the coronavirus’ spike protein, which the immune system recognizes as a threat and tries to squash it.

Then, when the immune system comes into contact with the virus for real, it already knows what to do.

Two full doses of the Oxford vaccine gave 62% protection, a half dose followed by a full dose was 90% and overall the trial showed 70% protection.

Next Wednesday, 6 January starting at 10.00am, is set to be a “Super Wednesday” in planning terms as EDDC determines two major planning applications. Both are concerned with reacting to flooding and both have divided local opinion. In both cases planning officers are recommending approval.

Agenda item 8: 20/2089/MFUL (Major) BUDLEIGH AND RALEIGH (Pages 20 – 79) 151 Hectares Of Land Within The Parishes Of East Budleigh, Budleigh Salterton And Otterton From Lime Kiln Car Park (SY072810) To South Of Frogmore House (SY074850) (The Lower Otter Valley). [The Lower Otter Restoration Project]

Agenda item 9: 20/1504/MOUT (Major) OTTERY ST MARY (Pages 80 – 128) Land Opposite Barrack Farm, Exeter Road, Ottery St Mary.  [Tipton St John primary school relocation] 

Here is what Devon live says on the the school relocation:

Planners urged to approve relocation of historic Devon school

Anita Merritt www.devonlive.com 

Plans to close a Devon primary school which has been in a village for more than 200 years and relocate it to a neighbouring town are set to be approved next week.

Proposals for outline planning permission to build a 210 space primary school and up to 150 new homes on land opposite Barrack Farm in Exeter Road, Ottery St Mary, are to be discussed by members of East Devon District Council’s planing committee next Wednesday, January 6.

The plans also include the construction of a new roundabout on Exeter Road, a new junction onto Cadhay Lane, and associated infrastructure.

Tipton St John Primary School, which has about 90 pupils, has suffered from repeated flooding with children being evacuated and the school being shut. It led school governors to take the decision to seek to relocate the school from its current location to a new site next to the King’s School.

The Thorne Farm Site from above (to the west of the King’s School)

In December 2018, Devon County Council’s Farm Estates Committee agreed that Thorne Farm be declared permanently surplus and that part of the site be transferred to the Dioceses of Exeter for the provision of a new primary school, subject to planning permission being agreed.

Land at the farm will also be sold off for housing which will held to raise the finance needed to build the new school.

The preferred option had been to try and relocate the school within the village, but after a £3.5m bid to the Government was rejected, and due to the flood risk, a rebuild on the current site was not viable, a move to Ottery St Mary was considered the only realistic option.

The new school will accommodate children from Tipton St John and will also meet the need for additional school places for children from the new developments in Ottery St Mary which cannot be met at the existing schools which are at capacity.

Concerned Tipton St John former parent Matt Davidson says he is anxious about the proposals because no plans have been shared about helping to transport young children from the village to the new school.

Flooding at Tipton St John Primary School

He said: “The ‘flooding’ pretext used to push this plan through has been proven false. There are zero lost school days due to flooding on record. With simple remedial work, we have now successfully rectified a brook which had previously created a photo opportunity for excess water on the site.

“Other schools, such as Sidbury, have all successfully mitigated their flood risk with investment and community help.

“Technically the plan avoids the language of closure, which in reality it would be for Tipton St John Primary School, and the derelict site that will remain in the village.

“The financial gains are very significant for Devon County Council and the governors/ governing bodies pushing for the plan. The building of new homes on previously earmarked educational land, and against the town plan, is also suspect and need investigating.

“Our own social media polls and Ofsted ratings show how successful the school is in its current format and location. Why is a fully stocked, top achieving school being targeted this way?

“No impact assessment in the village has been conducted over the past years leading up to this point. The school has been central to the Tipton St John community and surrounding areas for 200 years.

“With current Covid-19 troubles, we desperately want to reduce travel, retain and look after the youngest members of our community here in Tipton St John.”

In planning documents, committee members are being recommended to approve the application.

It states that although it represents a departure from the development plan and the officer recommendation is contrary to the views of the ward member and the parish council, the application needs to be considered in the context of sustainable development and whether the benefits of the proposal outweigh the harm of departing from the adopted allocation.

The report says: “The provision of housing on agricultural land outside of a Built-Up Area Boundary (BUAB), below policy level of affordable housing, and the visibility of the site from various viewpoints within the town and local area all weigh against the proposal.

“However, the overriding benefits of the proposal through providing a new primary school to replace an existing school which is required due to identified dangers from flooding, control of the impact from the housing at the reserved matters stage, together with provision of affordable housing within the town and the construction of a new roundabout which would improve highway safety are considered to outweigh the dis-benefits of the scheme.

“Accordingly, on balance, it is considered that the proposal is acceptable subject to the package of measures proposed in the application to mitigate any harm, secure affordable housing, including an overage clause, and habitat mitigation through a legal agreement and appropriately worded safeguarding conditions.”

Stephen Reicher, Stephen Reicher is a professor of psychology at the University of St Andrews and a member of Independent Sage. This piece was written after discussion and detailed input from other members of the group. www.theguardian.com 

The new variants of Covid-19 have changed the nature of the pandemic. We are no longer facing the same situation as in March or even November. Our response must change accordingly.

It is now clear that variant B117 of Covid-19 is already established in all parts of the UK. Being an estimated 56% more transmissible than pre-existing variants, it is likely to constitute 90% of all cases by mid-January. According to UK government briefings, even current tier 4 restrictions are insufficient to deal with its spread. Indeed, no single measure is likely to be sufficient to bring the pandemic back under control. Rather we need an integrated response that brings together all the instruments we have to deal with the infection.

How do we do this? My colleagues and I on Independent Sage are proposing a five-point emergency plan, which would allow the UK to start 2021 with a comprehensive strategy in place to deal with the crisis. All five parts of the plan must happen in concert and they need to be accompanied by a comprehensive communications campaign.

First, there’s the question of vaccination. The rollout of vaccines is a key part of the strategy to combat Covid-19 and must be accelerated as a matter of urgency. This should be organised through the over 8,000 GP practices in the UK, supported through additional staff and resources, and coordinated via local public health structures.

However, vaccination cannot be the entire strategy. This is because of the time taken to complete it (that’s even if we reach the target of 2 million vaccinations a week called for by members of the government’s influenza modelling group), uncertainties over its duration of immunity and impact on transmission, and restrictions on its use in some populations (eg children, pregnant women and breastfeeding mothers).

All this is exacerbated by the fact that, due to the increased infectiousness of the new variant, a higher proportion of people need to be vaccinated in order to achieve population immunity. In the medium term there will be pockets of the population in which the infection continues to circulate, with periodic outbreaks inevitable. Vaccination can complement but not supplant other interventions.

This takes us to the second point: national control measures are essential. Further restrictions are necessary in two main areas. The first of these is personal travel, especially international travel. This must be monitored and regulated effectively, with advance application for travel to and from the UK, a negative PCR test prior to travel and managed isolation on arrival. The second area is education. Schools should remain closed until buildings are made as safe as possible for pupils and staff. This includes smaller class sizes (achieved through hiring extra teachers and teaching rooms), adequate ventilation and free masks for all pupils.

Universities should move to online teaching as the default until Easter at least. This will allow students to study from home, avoiding issues arising from travel and crowded campus accommodation. For school, college and university students, there should be universal provision of computers and wifi connections to ensure everyone can study remotely. Schoolchildren without space for home study should be taught along with vulnerable children and children of key workers.

Our third point in the plan is about the UK’s test, trace and isolate regime. Throughout the pandemic, the government has reduced the issue of a testing system to the numbers of people who are tested. However, testing is only the first step in the process. It must be part of a strategy designed to trace contacts as quickly as possible so as to isolate them before they can infect others. This requires not only forwards tracing (identifying who you might have given the infection to) but also backwards tracing (where you got it from).

The government’s contracting out of the test and trace system has shown the private sector is not up to the job – and nor can it be. Effective tracing and supported isolation depend upon local public health staff who know their patch and are trusted by the community. The need for a “public health reset” of the testing system remains urgent.

Practical support is necessary in order to enable people to self-isolate. The continued failure to address this issue in the UK has led to continued low adherence (less than 20% for those with symptoms) and contrasts markedly with the 90-95% rates achieved in places like New York, which supports isolation with everything from financial assistance and hotel accommodation to pet care.

Next, workplaces. When the government relaxed restrictions in July, they handed over responsibility to employers and owners of facilities to make their premises safe but with limited guidance, minimal support, and virtually no formal regulation. While many enterprises have worked assiduously to ensure that adequate Covid mitigations are implemented, this is not true of all. It is now critical to ensure that we have robust systems to prevent the spread of infection. This should include funds for necessary changes, inspection of all premises and certification of those meeting the required standards. This would have the added advantage of increasing public confidence in using certified premises (shops, hospitality etc).

Finally, financial support for the public is crucial. Inequalities are playing a central role in this pandemic. The disease impacts more on vulnerable populations as do the measures used to control it. People on low incomes are more likely to lose jobs and suffer financially than the more affluent, many of whom have profited from this pandemic. The firm measures we propose here are both morally and practically untenable without enhanced support for individuals and local businesses that will be affected most.

At a time when the UK (population 67 million, Covid deaths 70,752) has been experiencing more than 30,000 new cases a day and prevaricating about what measures are needed, Australia (population 25 million, Covid deaths 909) instituted immediate and far-reaching restrictions in Sydney after an “outbreak” of 38 cases. One local person responded by saying: “Let’s go early, let’s go hard and let’s get this baby.” This makes a good mantra for the pandemic as a whole. Our plan is a minimum for what needs to be implemented – without delay.

The fleeing Britons were criticised on social media as selfish or foolish. Jacqueline Hamilton, a professor of atmospheric chemistry at the University of York, said: “Why the hell are people going on skiing holidays in the middle of a pandemic? And then to run away, like the selfish idiots they are.”

Owl recalls reporting that last March, Devon had emerged as the worst affected area for coronavirus outbreak as the government released the first breakdown by local authority. These cases were linked to individuals returning from skiing trips.

So have all these escapees fled to their second homes, maybe in Devon?

Charles Bremner, Paris | Greg Wilford www.thetimes.co.uk 

Hundreds of British skiers who slipped out of the resort of Verbier and travelled home to escape a Swiss quarantine have been called selfish idiots.

Hoteliers alerted the local authorities on Sunday morning after half their British customers failed to pick up breakfast trays outside their doors, according to officials. Up to 200 skiers were said to have left.

A mandatory quarantine had been imposed on British arrivals after the announcement of a variant of the coronavirus in the UK.

Swiss officials blamed each other as anger grew over the disappearance of the skiers. The leaders of Valais canton said that the federal authorities had failed to notify them of the details of newly arrived Britons who were ordered to self-isolate under retroactive rules imposed on December 21. It applied to arrivals dating to December 14.

About 400 were traced to Verbier, a favourite Alpine resort for Britons. They were asked to stay in their chalets or hotel rooms, where meals were left at their door, but many opted for a quick getaway during a foggy night.

Jean-Marc Sandoz, spokesman for the Bagnes municipality, which includes Verbier, told ATS, the Swiss news agency: “It was when they saw the meal trays untouched that the hoteliers noticed that the customers had gone. Many of them stayed in quarantine for a day before they set off unnoticed under the cover of darkness.

“We can’t blame them. In most cases, quarantine was untenable. Imagine four people staying in a hotel room of 20 square metres.”

The fleeing Britons were criticised on social media as selfish or foolish. Jacqueline Hamilton, a professor of atmospheric chemistry at the University of York, said: “Why the hell are people going on skiing holidays in the middle of a pandemic? And then to run away, like the selfish idiots they are.”

Beatrice Bass, a spokeswoman for the Liberal Democrats, wrote: “I still hope the selfish reckless culprits get caught and fined.”

Hugh Risebrow, chief executive of Latchmore Associates, a healthcare company, said: “Love skiing but unnecessary travel seems very risky (to self and others) under the circumstances.”

Adrian Faiers, a former NHS worker, said: “Perhaps Verbier is just another example of the overlap between the arrogant and the ignorant classes? ‘Regardless of the cost to others, we’ll decide how, when and if rules apply to us.’”

After reports on the higher transmission rate of the “British variant”, people in Switzerland became wary of UK visitors, the SonntagsZeitung newspaper reported on Sunday. “Anyone who speaks English is suspicious,” it said.

Many of the tourists appeared to have driven across the border to France in search of return flights because there were almost no flights between Switzerland and Britain at the weekend. French ski slopes are closed but resort hotels are open, with visitors free to practise Nordic skiing or snowshoe walking.

However, a tourism official said that the figure of a 200-strong British exodus was exaggerated. Simon Wiget, Verbier’s director of tourism, said most of those who left over the past three days had obeyed the rules and were at the end of their quarantine or had obtained permission to leave for Britain.

Verbier, long a favourite with the royal family, usually fills up with British tourists for the Christmas break. Britons make up about a fifth of the visitors there in the mid-winter. The resort had been hoping to save its season because, unlike surrounding nations, Switzerland remained open to winter sports visitors.

Many in Switzerland blamed Christophe Darbellay, head of the Valais cantonal government, who had defied advice and pushed to keep the resorts open. Many of the 10,000 Britons who arrived just before the announcement of the Swiss quarantine had travelled to the canton. Mr Darbellay said the Federal Office of Public Health “had made our work unnecessarily difficult” but the federal government rejected the claim, saying it had fully informed the cantons on its quarantine policy.

Brexiteer compares escape to flight of the Von Trapps

Andy Wigmore, a spokesman for Arron Banks, the Brexiteer who co-founded Leave.EU, has denied breaking the rules after he joined hundreds of British skiers in rushing home to escape the Swiss quarantine (Charlote Wace writes).

Mr Wigmore, 54, had boasted of his escape on social media, comparing it to The Sound of Music. He had been staying in a chalet at a ski resort in Wengen about an hour from Verbier when he heard about an imminent quarantine for UK arrivals.

He said that he and his family crossed the Swiss border last Tuesday afternoon with 20 minutes to spare. After taking local trains they reached Paris at midnight and caught the last Eurostar to London “just in time for Christmas”.

Mr Wigmore told The Times that he had received a tip-off from a local about the new rules. “We made a dash for it on the 22nd and managed to get over the border with about 20 minutes to go before they locked down Switzerland,” he said.

“The Wiggy von Trapps, like The Sound of Music, escaped over the border before they shut it down, except that we were escaping from Switzerland rather than to Switzerland”.

He had posted details of his escape on Instagram six days ago but yesterday made his page private after receiving abuse when people assumed he had broken quarantine restrictions.

“I haven’t broken any rules,” he said. “Absolutely not. That’s why I did it. Because if I had done it after that, I would have broken rules and the Swiss would be chasing me. But they’re not because I didn’t.”

Mr Wigmore is one of the “lab rats” for the Oxford vaccine programme and claimed it had made him “fully aware of the issues surrounding spread and what you should do”.

He suggested that the Verbier crowd who escaped had “probably thought it would be over by Christmas” and had not realised how seriously the rules would be taken.

Some of his friends have stayed in Switzerland but he said he was not aware of anyone who had broken the quarantine rules.

“If you’re in a nice chalet, great, but you can’t go skiing, you can’t go out, you can’t go shopping, can’t do anything. By the way, even if you go on your balcony, they will go for you. That’s how seriously the Swiss take it,” he said.

Up to two thirds of England could be living under the toughest coronavirus restrictions this week, with “sizeable chunks” of the Midlands and the North expected to be put into Tier 4.

By Amy Jones, Political Correspondent www.telegraph.co.uk 

Whitehall sources suggested millions more people would fall under the toughest rules when area banding is reviewed on Wednesday.

It comes as the number of Covid cases recorded in a single day rose above 40,000 for the first time and Public Health England (PHE) warned that hospitals “are at their most vulnerable”.

Ministers are understood to be concerned about the spread of the new South African variant and the “mutant” Kent strain, which has been detected across the country.

The Government has not ruled out tougher new “Tier 5” restrictions, which could close schools and universities, or the prospect of a new national lockdown in January. However, a Whitehall source said that in the “immediate future” the expansion of Tier 4 was more likely.

A health official said: “Coronavirus cases are rising across the country fuelled by the new variant, which has spread far beyond London and the South-East.

“I would expect more than half of England to move into Tier 4, but it wouldn’t surprise me if two thirds end up in the top tier. There is also real concern about the South African variant which seems to be spreading fast. Unfortunately, more action is needed to combat rising cases across the board.”

More than six million people in east and south-east England went into the highest level of restrictions on Saturday. The Tier 4 measures now affect 24 million people, representing 43 per cent of the population.

On Monday, the Cabinet Office minister Michael Gove failed to dismiss the suggestion that the whole of England could be moved into Tier 4, saying: “We review which tiers parts of the country should be in on the basis of scientific evidence.

“The Joint Biosecurity Centre will be making a recommendation to ministers, but I can’t pre-empt that because it obviously has to be a judgment based on the medical situation. The NHS is under pressure and these are difficult months ahead.”

It comes after the Scientific Advisory Group for Emergencies (Sage) warned Boris Johnson that a New Year national lockdown would need to be tougher than that ordered in November in order to keep the virus spread under control.

The Black Country is understood to be an area of particular concern, with Wolverhampton driving up infection rates in Staffordshire.

The latest figures show that the West Midlands city has a case rate of 407.8 per 100,000 of the population, while cases have also been rising in Stoke-on-Trent, Rugby and Lincoln.

Meanwhile, Cumbria could jump from Tier 2 to Tier 4 as rates in the county soar. Lancashire could also move up a tier after the areas of Pendle and Burnley saw “alarming” rises.

On Monday, the Government reported a further 41,385 lab-confirmed cases of coronavirus in the UK, while a further 357 people died within 28 days of testing positive.

Dr Yvonne Doyle, the medical director at PHE, said: “This very high level of infection is of growing concern at a time when our hospitals are at their most vulnerable, with new admissions rising in many regions.”

Experts have warned that the NHS is on track to have 20,000 coronavirus patients in its care on New Year’s Eve, surpassing April’s peak for cases in hospital.

Saffron Cordery, the deputy chief executive of NHS Providers, said: “We know that the rate of Covid-19 admissions is rising and some trusts are reporting up to three times the number of Covid patients than 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.”

Dr Katherine Henderson, the president of the Royal College of Emergency Medicine, described her experience of working in a hospital on Christmas Day as one of “wall-to-wall Covid”.

More than half of Great Britain’s daily electricity came from wind turbines for the first time on Boxing Day, as the country headed for its “greenest year on record”, due in part to the coronavirus.

Rob Davies www.theguardian.com

As Storm Bella arrived, bringing gusts of up to 100mph, wind provided 50.7% of Great Britain’s electricity according to data charting the power generation mix.

While wind briefly hit 60% in August, it had not previously sustained such levels for 24 hours.

“Britain has experienced a renewables revolution over the last decade with the growth of biomass, wind and solar power,” said Drax Electric Insights, part of coal and biomass power company Drax, which tracks the data.

The milestone follows a string of new low-carbon records set in 2020, as Covid-19 restrictions depressed power demand, helping wind and solar to claim a larger share of the mix. Fossil fuels have increasingly been edged out as a result, helping Great Britain enjoy its longest coal-free period since the Industrial Revolution.

Gas and coal power plants made up 36% of the electricity generated in England, Scotland and Wales in the year up to 21 December 2020, according to data from National Grid’s electricity system operator (NGESO), down from 46% in 2019.

Wind and solar farms delivered 29% of the electricity mix, rising from 23% of electricity generated in Great Britain last year, according to the early data report.

While Boxing Day set a record for the highest share of power generated by windfarms, it was not a record for the most power they have ever supplied. That was set earlier this month, when windfarms delivered 17.3 gigawatts. Because overall demand was higher at the time, their percentage share of total power generation was lower than it was on Boxing Day, at 40%.

The larger role for renewables has caused the “carbon intensity” of Great Britain’s electricity to fall to its lowest level on record of 181g of carbon dioxide per kilowatt-hour of electricity, compared with an average of 215g last year and 248g in 2018.

Rob Rome, NGESO’s head of national control, said: “2020 has been a record-breaking year for Great Britain’s electricity system. The grid continues to transform at an astonishing rate as we harness the growth of renewable power sources.

“We saw the highest ever level of solar generation in April, the longest period of coal-free operation between April and June, and the greenest ever month in May,” and the wind record set earlier this month illustrated the “changing nature of electricity in Britain”.

There was a blip during August and September, when the electricity system bucked the trend of declining carbon intensity as emissions rose despite lower demand for electricity, suggesting a higher use of fossil fuels.

Tom Edwards, an analyst at the energy consulting group Cornwall Insight, said the electricity system operator increased its reliance on gas-fired power plants by 20% in September compared with the year before, amid a slump in renewable energy generation.

“To compensate for the lower wind speeds and dunkelflautes – dark, still periods – we turned to gas and coal,” he said. “It’s part and parcel of relying more on weather driven capacity and interconnector exports, which makes us more reliant on the vagaries of the wind and sun.”

Steve Jennings, a partner at the consulting firm PwC, said the “key challenge on our pathway to net zero” is what the electricity system does “when the wind doesn’t blow or the sun doesn’t shine”.

The falling cost of energy storage – such as batteries – is expected to play a major role in Great Britain’s ability to use more renewable energy, and less fossil fuel power, alongside a more flexible approach to when major energy users consume electricity.

But Jennings said nuclear power and gas-fired power plants fitted with carbon capture technology would still be required if Great Britain hopes to avoid unabated fossil-fuel generation.

“Everyone is very positive about the UK’s green energy records but I think the microscope will begin to turn to what is happening on a daily basis rather than simply a cumulative basis,” he said.

The coronavirus pandemic reduced electricity usage overall in 2020 compared with a normal year, as large swathes of the economy have been forced to shut their doors for extended periods. Average power demand across the course of the year has dropped from 32.58GW in 2019 to 30.6GW so far in 2020.

It was back in January when Devon’s public health teams first became aware of a mysterious virus in China. And while the rest of world was getting on with life and preparing for Brexit, they started planning to respond if coronavirus made its way to Devon.

Daniel Clark, local democracy reporter www.radioexe.co.uk 

Public health head reflects on story so far

Eleven months later, more than 10,000 Devon residents have tested positive for covid-19 and nearly 300 people have died. Thousands have ended up in hospital.

But Devon has fared far better than other areas, and remains the area in England with the lowest death rate. At 37 per 100,000 population, the only place in England below the 40 per 100,000 mark. The worst hit area – Tameside – has seen nearly ten times that proportion of deaths. Only Cornwall, the Isle of Wight, Dorset and Wiltshire have had lower infection rates than Devon throughout the entire pandemic, and for smaller council areas the South Hams, Torridge, Teignbridge, West Devon and Mid Devon are among the bottom ten in England.

This is the story of how Devon’s public health teams responded to and dealt with a year like no other.

“We have pandemic flu plans ready to go”, said Steve Brown, Devon’s public health director designate, who also led the response in 2009 for the swine flu outbreak, when one of the first places in England were cases were confirmed was at Paignton Community College. “So we always had plans in place and we test and learn from those plans for any novel virus. It was mid-January when we started to get some information flowing through the public health route about this novel virus coming from China.

“That’s not unusual. We have experience of novel viruses around the world, so we kept a watching brief around how it was developing, but our interest pricked up significantly at the end of January when the first case in the UK was confirmed, so once we saw that and transmission into the country, you start to think this could be something serious.

“It was the beginning of February we started to look back and reflect on the pandemic flu plan – and although we had a pandemic flu plan, we didn’t have a covid-19 plan, so any plan while providing a helpful framework, needed to be adapted and amended to the challenges.”

“So in February and March, we started in Devon to put in place some of the work that should stand us in good time going forward, around the incident management team, to include the public health expertise, those in health protection, and those around data and intelligence, which is fundamental to managing an outbreak, so we started to get the right people in the room as we were allowed to then”.

And just like in the 2009 swine flu pandemic, Devon was hit early by covid-19. On 2 March, two cases of the coronavirus were in the county – a pupil and family member at Churston Ferrers Grammar School – while two Torquay GP surgeries were closed following advice from Public Health England. There had been two cases confirmed in Teignbridge on 1 March that received less publicity, but closures of other schools quickly followed, with Galmpton Primary, Collaton St Mary Primary, Berry Pomeroy Primary and Brixham Primary, while cases began to crop up across the rest of the county.

In the early stages, everyone was hospitalised, not necessarily through sickness Mr Brown said, but through a lack of clarity and understanding of the disease. By the first time that coronavirus was discussed inside a council chamber on 11 March, Devon County Council’s cabinet heard there was a low risk for anyone attending schools. Face masks were not recommended and there was no need to close any settings or send anyone home.

Those measures and message swiftly changed, with schools shut within 10 days and the country into full lockdown shortly after. Mr Brown said that the toughest challenge throughout the last nine months has been the changing guidance and trying to answer people’s questions when there is not absolutely clarity.

“Back at the beginning were talking about it being okay to meet outdoors, schools can continue, a mild to moderate flu symptoms for most, no face coverings needed, and pretty quickly as the evidence developed, those messages changed.

“At the beginning it wasn’t framed as ‘face, space, hands’ but was about hand washing and doing that for 20 seconds and signing Happy Birthday, but a continuous updating of the messages and action is clearly not helpful but we had to change and adapt, but does make things difficult when you say one thing on Friday and another on the Monday.”

Asked why Devon did well, with cases and deaths among the lowest in the country, Mr Brown said it was never one thing, but Devon has some natural advantages. “Let’s reflect on the rurality of Devon,” he said. “A disease that transmits for person to person and mainly in indoor settings, so us not having mass infrastructure like the underground means that we are not bringing lots of people together into indoor spaces where transmission can happen freely.

“The geography of Devon has played to our benefit and the timeliness of the first lockdown was absolutely the right time, and we saw high compliance in Devon which helped reduce infections, and even now, even though one death is too many, we are on the of the lowest in the country for deaths and in care homes, and that speaks highly of the work of staff in care homes. These are all things that collectively play out to put in is a good position compared to the rest of the country.”

And as the summer came and the first wave ended, coronavirus in Devon almost became a distant memory, with cases low, deaths low, and life returning to normal. But Mr Brown’s team knew that their work wasn’t done and that they fully expected as the season’s turned and summer became autumn, that a second wave was likely to hit.

Cases initially started to rise in August – mainly linked to returning holiday makers bringing the virus back with them, before a huge explosion in Exeter in September linked to the university.

“For us, we always knew it was a question of when, not if, there would be a second wave,” he said. “The only way there wouldn’t be if a vaccination was developed over the summer and we knew that was not going to be the case. We always expected in September with the return of schools and universities, people going back to work, we would see a rise in cases. The question we had to think about was how bad it would be, who would it affect the most, and are we prepared from a health and care perspective. We always knew it would happen as it absolutely played out as expected, with cases initially in the younger population, the 0-19 and 20-39, the younger age groups we saw the sharpest peak in cases, which was to be expected.

“We then saw that develop into the older adults, 40-59, again to be expected. With children and young people getting it, one of the best places for transmission, primary places for transmissions is households, and families, so if pupils get it, then mum and dad may get it, so see some household transmission. And then the rise, a month later, in the 60+ and 80+, so the profile and pattern of the disease was to be expected, but we didn’t know what quick and steep the peak was going to be.

At one stage, more than half of the total cases in Devon were linked to the university, but wider community spread and outbreaks taking off across the county never happened, and the swift, decisive and perhaps harsh measures taken to ban students from mixing indoors with others meant that when the term ended, only two students tested positive for covid-19 before returning home as part of the travel window.

“We always expected something as you don’t bring 20,000 people together and not have some cases, but I’d be lying if I said we expected it to escalate quite as quickly as it did but the work we put in place, the work the university did, liaising with others, allowed us when I got the phone call about three or four cases to have a meeting about it, and we had daily meetings with partners to get on top of it.”

Mr Brown continued: “Much of our energy every day is looking at all the confirmed cases, identify where they live, how old are they, what’s their occupation, is it high risk, are they in hospital, how many people have died, so the data comes together which allows us to get a really clear picture of the transmission in Devon, where is it happening, and important to allow us to track the virus.

“We have to ask ourselves all the time ‘where did this person pick it up from?’ We look at information around their age, where they live, are they at home, in care home, a hospital?

“The virus spreads best indoors and if someone is sharing house, that’s a clear way it could happen, but we do see cases in health and care settings and in hospitals, so that’s people going into hospital with covid, but also people going into hospital for non-covid reasons, they get testing on entry, and are positive with no symptoms at all.

“So it’s really important that regardless if you have symptoms, you do the social distancing, wash hands, and when we do finds outbreaks, we will have an outbreak control team meeting and we will discuss cases and Identify how the individuals became positive, give advice and support to the settings, and agree a number of actions to help bring down infections in that setting, which is standard operating procedure.”

But despite the most recent doom and gloom with cases, hospitalisations and deaths rising across the county, there are some clear shoots of optimism around vaccines, which have begun to be rolled out across Devon, he said. “The virus hasn’t gone away and we do know indoors there is a risk, not just of going into a lockdown again, but people will be infected, become ill, end up in hospital, and there will be people who die as a result of it. So message is don’t let guard down when there is a light at the end of the tunnel.

“Each one of the vaccines comes with challenges and storage that we are working through and the undertaking cannot be underestimated as it’s vaccinating the population twice, as its two doses, and will take months to get through the process for everyone. A significant undertaking, not to be underestimated.”

Asked when he thought that some of the restrictions could be lifted, and life could begin to return to normal, he said: “There’s a lot of ifs and buts, but hopefully looking for late spring, that assuming vaccinations have been agreed, have been rolled out, people do adhere to the guidance.

“We saw throughout the summer when numbers were low and people were sensibly socialising, and I hope that by the end of spring, we should be in that position. What we do know in the summer is that the virus not as effective as transmitting from person to person, so we have reasons to be optimistic that next summer will be better than the current summer that we have had.

“But now is not the time to take the foot off the pedal. There are green shoots coming but we need to get through the next two of three months over the winter period as we need to all we doing the right things, keeping our social distancing, wearing the face coverings, washing our hands, and everyone has a role to play to protect the most vulnerable over this most challenging period.”

An army of more than 10,000 medics and volunteers has been recruited by the NHS to help deliver the Oxford Covid-19 vaccine, once it is given approval. 

By Lucy Fisher, Deputy Political Editor and Sarah Knapton, Science Editor www.telegraph.co.uk

The Telegraph has learned that teams are trained and ready to begin giving the jab at sports stadia and race courses across the country, with a target of vaccinating at least a million people each week. 

The Oxford/AstraZeneca jab could be approved early next week by the independent Medicines and Healthcare products Regulatory Agency (MHRA), after the final cut of data was submitted by the Government last Monday.

Officials have pinpointed January 4, 2021, as the date the rollout of the mass vaccination programme will begin.  

A Government source said: “At the moment, we are operationalising everything for the 4 January for the first Oxford/AstraZeneca jabs in arms. You’ll see it everywhere, while we’ll also be carrying on with Pfizer.”  

The source added: “Tens of thousands of vaccinators and support staff have been recruited.”

They are expected to be delivering at least a million jabs a week to the vulnerable by the middle of next month, once manufacturing has been scaled up.

Village halls, community centres and other local sites overseen by GPs will be used to administer the vaccine alongside vast regional hubs.

The Telegraph can also reveal that ministers are looking at proposals to triple the length of the time between taking a first and second dose of a vaccine in order to speed up the delivery of the vaccine before Easter.

It comes as frontline NHS workers have been told they will soon receive the Oxford vaccine, and amid calls for teachers to be prioritised alongside health workers for the jab to help keep schools open. 

The head of AstraZeneca, Pascal Soriot, has also revealed the company has come up with a “winning formula” which has boosted the effectiveness of the jab so that it matches the Pfizer/BioNTech vaccine. 

Britain has ordered 100 million doses of the Oxford jab, with 40 million expected to be available by the end of March. Manufacturing is due to scale up significantly from the second half of January. 

The ease of delivering the vaccine, compared with the complicated cold chain required for the Pfizer jab, and low cost mean its approval is viewed as a game-changing development in Westminster.

The rollout of the Oxford jab is a core element of the Government’s exit strategy from tough lockdown measures, as concerns grow over the damage to the economy wrought by keeping whole sectors shut.

Ministers are aiming for all vulnerable Britons included in its priority list of nine vulnerable groups, which cover around a quarter of the population, to receive a first dose of the jab by the end of February, and a second dose by the end of March.

Once this feat is achieved, mortality from the illness will be reduced by up to 99 per cent.

It is hoped the tougher lockdown restrictions can be lifted at that point.

At present, 43 per cent of the population is living under Tier 4 restrictions, which require Britons to stay at home and the hospitality industry and non-essential retail to close, after emergency measures were implemented on Boxing Day ahead of the fortnightly review scheduled for December 30. 

Ministers will still meet on Wednesday to review the latest data, with a series of other areas set to be plunged into Tier 4. Burnley, Cumbria and Lincoln are thought to be at risk of moving into the toughest tier.

On Sunday night senior doctors warned the NHS is in danger of being overwhelmed, as the number of coronavirus patients in hospital is about to exceed the peak of the first wave.

Former Tory party leader Lord Hague of Richmond last week warned the Prime Minister to undertake “a national mobilisation of resources on a scale never before seen outside of war” to accelerate the vaccine rollout in the face of the new hyper-infectious mutant strain of Covid-19.

Government insiders have credited Minister for the Vaccine Rollout, Nadhim Zahawi, UK vaccine taskforce chief Kate Bingham, and St John Ambulance, for scaling up infrastructure and personnel ready for the rollout next month.

A high proportion have been recruited by St John Ambulance, which reached out to its network of 25,000 volunteers, while also partnering with the Royal Voluntary Service, British Red Cross and other charities. 

Ministers have a target of enlisting 10,000 vaccinators, 14,350 care volunteers to observe people after they have received the jab, and 6,150 patient advocates to welcome and process people arriving at centres.

Retired doctors and nurses, pharmacists and trained first aiders have been drafted in to administer jabs, while other members of the public have signed up as support staff.

A Government source also revealed that ministers are looking at proposals to triple the length of the delay between taking a first and second dose of a vaccine in order to give millions more a single dose more quickly, while waiting for more deliveries of doses.

Proposals to offer Britons only a single dose have been shelved, but ministers are examining the idea of extending the time between doses from between three and four weeks to around 12 weeks.

A Government source said: “Everyone will get two doses, nobody will only get a half dose, but it could be a longer period, up to 12 weeks, between jabs. You could get a better impact.

“The MHRA will look at this stuff and decide what’s the best thing to do to get the most effective vaccination programme in the fastest, safest way possible.”

However, the insider added that a longer delay between doses would become redundant once sufficient quantities of the jab became available, saying: “We’re getting the volume coming now with Oxford/AstraZeneca, so it could become academic.”

The Pfizer results were based on a regime of two doses 21 days apart, while the Oxford vaccine was given 28 days apart. 

The MHRA determines the dosing regime based on submitted evidence, so moving to a single dose, or a delayed second dose regime, would be experimental and could leave the government liable to legal action. 

While those waiting longer for a jab would not be disadvantaged in the long term, they would be more at risk in the delay period before the second injection.

However, the Government could decide to initiate a clinical trial within the general rollout and monitor the efficacy of a delayed second jab among consenting participants.

Previous studies of vaccines have shown that delaying a second dose does not usually result in reduced long-term efficacy. 

Results from the Pfizer trials show that after dose one an efficacy of around 80 per cent was achieved, and this is unlikely to decline over time. 

Overcrowded housing has helped to spread Covid-19 in England and may have increased the number of deaths, according to research by the Health Foundation.

Denis Campbell www.theguardian.com

People living in cramped conditions have been more exposed to the coronavirus and were less able to reduce their risk of infection because their homes were so small, the thinktank found. Overcrowding was a key reason why poorer people and those from ethnic minority backgrounds in particular had been disproportionately affected by the pandemic, it said.

Health Foundation researchers also concluded that overcrowding, together with other housing problems such as damp and insecure tenancies, had led to a rise in physical and mental health ailments.

“Since March many of us have spent a lot more time at home. For many, the quality of their home has made their experience of the pandemic even worse than it needed to be,” said Adam Tinson, a co-author of the analysis and a senior analyst at the thinktank.

“While some have weathered lockdown in large homes with gardens and plenty of living space, others have struggled in overcrowded and unsafe conditions. Overcrowding is associated with the spread of Covid-19, making self-isolation more difficult and allowing the virus to spread through more people if one becomes infected.”

Data for 2019-20 released earlier this month showed that just before the pandemic hit in March, 830,000 households in England were overcrowded, especially rented properties. That was 200,000 more than the number in that situation a decade earlier.

“People’s housing environments have affected their ability to shield themselves and others from Covid-19. People have been encouraged to stay in their homes as much as possible, but within-household transmission has played a serious role in the spread of the virus,” the analysis says.

“Overcrowding, which has been increasing in the years prior to the pandemic, makes it harder to self-isolate and shield, and may have contributed to higher death rates in poorer areas.”

He added that 8% of households with the lowest income lived in overcrowded homes, compared with fewer than 1% of those with the highest earnings.

Similarly, “Ethnic minority households are five times more likely to be overcrowded than white households, illustrating just one of the ways in which existing housing disparities are combining with the pandemic to further widen inequalities in health.”

People being forced to spend more time in overcrowded homes during this year’s various lockdowns has also caused or worsened mental health problems, especially those suffering distress. “Distress is generally higher for overcrowded households, and data from the pandemic period seem to show this intensifying during the more severe lockdown in April 2020, when 39% of people in overcrowded households were indicating psychological distress”, compared with 29% of those whose homes were not overcrowded, the analysis concludes.

“This analysis shows that mental ill-health has been a particular issue for those in overcrowded households during the pandemic, especially in the first lockdown. The chronic lack of affordable housing options, combined with years of reductions in support for housing costs, have led us to this point,” said Tinson.

The restrictions on movement and social mixing had also deepened loneliness among those living alone, the report said.

Major changes to housing policy, such as more secure private tenancies, reversing cuts to housing benefit and building more social housing, are needed to reduce the impact of poor-quality homes on people’s health, the Health Foundation recommends.

Pampered peers lodged a string of complaints about the House of Lords canteen – including one who moaned there were not enough British chefs in the kitchen.

It must be so hard being a Lord these days – Owl

See reference for full article

Mikey Smith www.mirror.co.uk

Hospitals have been ordered to mobilise their “surge capacity” over new year as they face a triple whammy of soaring infections, rising staff sickness and longer patient stays.

Andrew Gregory, Health Editor www.thetimes.co.uk

Doctors are bracing themselves for a spike in admissions — already at their highest level since mid-April — over the next fortnight after cases increased by 57% last week.

The threat was underlined in a leaked letter to hundreds of local NHS bosses on Wednesday from the service’s chief operating officer, Amanda Pritchard. In the six-page memo on NHS winter priorities, she ordered trusts “to safely mobilise all of their available surge capacity over the coming weeks”. She added: “This should include maximising use of the independent sector, providing mutual aid, making use of specialist hospitals and hubs to protect urgent cancer and elective activity, and planning for use of funded additional facilities such as the Nightingale hospitals, Seacole services and other community capacity.”

However, there are concerns about how extra facilities such as the seven Nightingale hospitals in England could be used because of the lack of staff. Thousands of NHS staff were already off last week with mounting numbers infected or self-isolating.

“Remember that we were more than 80,000 staff short even before the pandemic took hold,” said Saffron Cordery, deputy chief executive of NHS Providers, which represents hospital trusts. “It’s clear we are now embarking on the most testing time in the history of the health service.”

Hospital capacity was a problem before the coronavirus hit. The NHS has among the lowest per capita numbers of doctors, nurses and hospital beds in the western world.

A King’s Fund analysis of data from 21 countries, collected by the Organisation for Economic Co-operation and Development (OECD), found the UK had the third-fewest doctors among the 21 nations, with just 2.8 per 1,000 people, barely half the number in Austria, which has 5.1 doctors per 1,000.

The UK also had the sixth-fewest nurses for its population: 7.9 per 1,000 people — way behind Switzerland, which has the most, at 18 nurses. As for hospital beds, the UK has just 2.6 for every 1,000 people, less than a third of the number in Germany, which has the most — 8.1 beds — and leaves the UK 18th overall out of the 21 countries for which the OECD gathered figures.

“The pressure on beds is growing,” Cordery said. “The overall bed base is down by 11,000 because of social distancing measures, and the number occupied by Covid-19 patients is rising relentlessly. Trust leaders tell us it’s proving very difficult to discharge Covid-positive patients once they are medically fit to leave because of the need to find safe, suitable care.”

The staffing and beds crisis is being compounded by an emerging trend of Covid patients spending longer in hospital. Improvements in care coupled with the advent of new drugs and treatments means many who might have died in the first wave of the pandemic are now surviving — but taking up vital beds.

Those fighting for their lives in hospitals now are also slightly younger and healthier to start with. While Covid case rates have increased across all age groups, the highest rate of 434.6 infections per 100,000 population is for those aged between 30 and 39.

While the prospect of more people surviving after being taken to hospital with the coronavirus is a welcome one, it has implications for hospital capacity. Dr Chaand Nagpaul, chairman of the British Medical Association, said the NHS was “in a very precarious position” and in danger of becoming completely overwhelmed. Britain would usually see about 1,000 new respiratory-related admissions a day at this time of year. It is already close to double that for the coronavirus alone.

“We must not be under any illusion of the serious state the NHS is in and the impact that will soon have on patients, not just with Covid, but a whole host of other serious illnesses at this time,” Nagpaul added.

The NHS had made great strides over the summer to catch up on delayed treatment and resume routine operations. But officials privately admit those efforts have been derailed by Covid for months.

Some hospitals are now having to cancel some planned surgery in January and February. In addition to the coronavirus crisis, next year could bring with it the longest NHS waiting times for decades.

Nagpaul said the NHS was in “desperate need” of more staff and had been for years before the pandemic hit.

But with the training of more doctors and nurses likely to take years, medics say that in the meantime all NHS staff must be vaccinated to slash the risk of them getting ill with coronavirus.

“Without a universal policy to vaccinate frontline patient-facing staff as a priority, we could be facing avoidable staff sickness and absence over the already difficult winter months,” said Dr Zainab Najim, of the Doctors’ Association UK. “We call on Matt Hancock to act on this immediately and prevent what will be a potential disaster this winter.”