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Why has ALL of Kent been put in Tier 3? Plight sums up fury of rural areas who say they've been unfairly locked down because they are in same county as urban hotspots

Towns and villages across Britain were furious tonight after Boris Johnson confirmed all but three places in England will be plunged into the toughest brackets despite many of the local cases being in small urban hotspots in the same authority areas.      

The move prompted fury from rural areas in Kent, which was placed under the Tier Three coronavirus restrictions today, who said they had been unfairly locked down by spiralling cases in urban centres.  

The county has an overall infection rate of 260.6 cases per 100,000 people in the week ending November 20, according to the latest data from the Department of Health, putting it into the top third most-infected areas in England.

But they vary drastically between the boroughs, with rural Ashford recording the lowest levels at 120 per 100,000, almost four times less than Swale at 541.7 per 100,000. 

Under the allocations announced today, just 700,000 people - one per cent of the population - will be subject to the loosest grade of restrictions. Before November 5 there were 29million in the lowest tier. 

Meanwhile, around 55million residents will be in the toughest two levels after the blanket national lockdown ends on December 2. 

The new rules have sparked a huge backlash, with anger at the lack of firm thresholds for entering and leaving Tiers, and many local MPs in low-infection areas enraged at being lumped together with nearby hotspots.   

The Derbyshire Dales and Stratford-upon-Avon in Warwickshire were among the counties to suffer the same fate as Kent after they were lumped into the toughest restrictions because of their neighbours.

Both will enter Tier Three from next Thursday when national lockdown lifts, but have infection rates significantly below the average (204 per 100,000), and falling.

In the Derbyshire Dales the rate is 171 but it is part of a Tier Three rule across the entire county and Derby City, which PHE data shows had infection rates of 212 and 249, respectively.

In Stratford upon Avon there were just 108 positive tests per 100,000 people in the week to November 22, but the town will be subjected to a Tier Three lockdown for the whole of Warwickshire (195). 

Meanwhile Greater Manchester has also been placed in Tier Three despite many parts of the region having lower infection rates than London boroughs. 

Above is the county of Kent alongside its varying infection rates. The highest levels are in Thanet, Swale and the separate county of Medway

Above is the county of Kent alongside its varying infection rates. The highest levels are in Thanet, Swale and the separate county of Medway

Department of Health data shows a closer view of the areas in Kent with the highest infection rates. Exact numbers weren't revealed in the areas in white because fewer than three people tested positive

Department of Health data shows a closer view of the areas in Kent with the highest infection rates. Exact numbers weren't revealed in the areas in white because fewer than three people tested positive

WHAT'S THE INFECTION RATE IN KENT BOROUGHS? 

Kent Borough

Swale

Thanet

Gravesham

Dartford

Maidstone 

Dover 

Canterbury

UK 

Tonbridge

Folkestone

Sevenoaks

Tunbridge Wells

Ashford 

Infection rate

541.7

491.1

386.2

282.4

272.4 

266.7

251.5

200.6

195.2

192.9

168.9

120.4

120

% change

-8.2%

-6.7%

+24.8%

-10.2%

+23.8% 

+30.7% 

-0.2%

-20.1%

-9.3%

+32.1%

-5.1%

-2.1%

-9.8%

% urban residents

71%

95%

81% 

88%

75%

65%

83%

 

70%

63%

52%

63%

65% 

The data in the columns infection rate and % change is from the Department of Health. The figures in the column % urban residents are from a 2019 report from Kent County Council on the local population.

Areas placed in Tier 3 from December 2 include:

This week Swale hit the headlines after it recorded the highest level of Covid-19 infections in the UK, although this has since begun to decline, Government statistics show. As many as eight of Kent's 12 boroughs are seeing declines in their Covid-19 case numbers. 

Tory MP Damian Green has said he was 'hugely disappointed' by the decision to move Kent into Tier Three

Tory MP Damian Green has said he was 'hugely disappointed' by the decision to move Kent into Tier Three

Kent MP Damian Green, who represents Ashford, said he was 'hugely disappointed' with the Government's decision to plunge Kent into Tier Three and said their full analysis must be made public. 

And North Thanet MP Sir Roger Gale said he feared it would mean people would 'skip the boundary' and go to the pub in neighbouring Tier Two areas. But Swale's council leader Roger Truelove said he agreed with the county-wide restrictions, saying we are 'all in this together'. 

Several Kent MPs wrote to Health Secretary Matt Hancock on Wednesday asking that different areas of the county be placed in different restrictions, in recognition of the wildly varying levels of infection. Ministers said they had looked at Geography to determine Tiers and how people travel through the county. 

Infection rates across Kent - which was under Tier One in the first system - were markedly higher in urban areas, suggesting picturesque rural villages were dragged into tougher restrictions with them. 

In Thanet - the most urbanised borough according to a 2019 report by the council where 95 per cent of the population live in large towns - the second highest infection rate of the 12 boroughs was recorded at 491.1 per 100,000.

And in the second most urbanised areas of Dartford and Canterbury - where 88 per cent and 83 per cent of the population live in large towns - the infection rates were the fourth and sixth highest, respectively, at 282.4 and 251.1 per 100,000. 

But in the most rural borough of Sevenoaks - where just over half the population live in big settlements - the third from lowest infection rate was recorded at 168.9 per 100,000. And the second most rural where 63 per cent are in large towns, Tunbridge Wells, had the second lowest infection rate at 120.4 per 100,000.

In Ashford, which has the county's lowest infection rate, 65 per cent of the population lives in towns. 

Eight of Kent's boroughs are also recording declines in Covid-19 infections, according to the Department of Health, suggesting the outbreak may no longer be growing in the county because of the national lockdown.

Hospitals are running low on beds in some parts of Kent and having to rely on their neighbours in the county for assistance, a Department of Health spokesman said. 

But Dartford and Gravesham Hospitals, East Kent Hospitals, and Maidstone and Kent hospitals - three of the biggest in the county - all had between 86 and 88 per cent of their beds occupied in the week ending November 22, according to NHS data. Ashford and St Peter's Hospital had 93 per cent of beds occupied.      

Mr Green, MP for Ashford, wrote on Twitter: 'I'm hugely disappointed that the whole of Kent has been put into Tier Three.

'Before lockdown we were in Tier One, so what has lockdown achieved? We need the full analysis made public.' 

Sir Gale also criticised the Government's decision, telling Sky News: 'The objective of the exercise has been trying to introduce a scheme that the public will accept.

'We know that it's high in Thanet, in Ashford it's nothing like as high (in terms of infection rates).

'Are they going to be happy with that? No they're not and what will happen of course is people will skip over the boundary, or try and skip over the boundary, to go to a pub or a restaurant that is able to be open if there is one in Tier Two or in Tier One fairly nearby. That's the last thing we want.'   

Jo James, chief executive of Kent Invicta Chamber of Commerce, said the decision was 'disappointing'. 

'I have spoken to a few and they are absolutely devastated by it but on the whole it was expected,' she said. 'I think there is no doubt about it, it's disappointing that we have been placed in Tier Three.

'I can understand why, because we do have some of the highest levels of infection in some of our districts, but, that said, we do have some of the lowest levels of infection. 

'It's such a shame that somewhere like Kent, that is one of the biggest counties in the country, has to be taken as a whole.'  

Meanwhile Greater Manchester has placed in Tier Three despite many parts of the region having lower infection rates than London boroughs.

Eight parts of Manchester have infection rates above the England average (204 positive tests per 100,000 people), compared to seven parts of the capital.

Trafford, for example, had a coronavirus infection rate of 164 cases for every 100,000 people in the week ending November 22. This had fallen by 47 per cent from a week earlier, marking the fourth fastest decline in the country.

Likewise, nearby Stockport saw its infection rate drop by 38 per cent from 319 per 100,000 to 198.

The two will be put into the Tier Three lockdown, despite having significantly lower infection rates than many parts of London, including Havering, where there were 319 cases per 100,000 in the most recent week. 

How does government decide what Tiers areas are put into? 

Boris Johnson promised to base Tier allocation on 'common sense', and the government's 'Winter Plan' set out a series of metrics to be used. They are:

However, there are no specific numerical trigger points, and the document added that there will be 'some flexibility to weight these indicators against each other as the context demands'. 

'For example, hospital capacity in a given area will need to be considered in the light of the capacity in neighbouring areas and the feasibility of moving patients,' the document said. 

'Case detection rates will need to be weighted against whether the spread of the virus appears to be localised to particular communities.' 

Elsewhere the council leader of the district with the lowest Covid-19 infection rate in England has described it as a 'slap in the face' to be put into Tier 2.

Alan Connett, leader of Teignbridge District Council, said he was 'hugely disappointed' for the area, which has the lowest rate of infections in England over the last seven days.

The county of Devon has been placed in the second highest level of restrictions, partly due to pressure on local NHS resources.

Teignbridge has 52.9 infections per 100,000 people, while South Hams has 60.9 and Torridge has 68.8.

'I'm hugely disappointed for Teignbridge, and even more saddened for the businesses that will be adversely affected by this decision,' Mr Connett, a Liberal Democrat, said.

'We're very unlucky that we've been placed in a higher tier than many expected, and it does feel like a slap in the face for everyone who has worked so hard to keep our infection rates low, keep our high streets and businesses Covid-safe and stick to the rules.

'But what we need to focus on now is keeping our rates down, helping get our NHS through this critical period, and supporting our local communities to recover.

'It's not going to be easy - we're already seeing big increases in claims for Universal Credit, council tax relief and hardship funds, and our economy is being hit hard.'

Exeter MP Ben Bradshaw tweeted: 'Anyone explain why Devon with Covid-19 rates below 100 per 100,000 has been lumped in with Plymouth and Torbay with higher rates, which seems to have pushed us into Tier 2 rather than Tier 1, when elsewhere councils have been treated differently?'

Devon County Council leader John Hart, who is chair of the county's local outbreak engagement board, said: 'Devon has done well so far in keeping case numbers relatively low and I would like to thank everyone for their actions during the latest lockdown, so I'm disappointed that we have been placed in Tier 2.

'It's even more vital now that we all stick to the guidelines and maintain social distance, wash our hands regularly and wear masks where required so we can get cases down and get into Tier 1.

'And working with MPs and Team Devon partners, I will be strongly lobbying the Government to provide tailored support for our hard-hit hospitality industry, which is losing out significantly during what's usually their most lucrative period.

'I'm pleased local shops will be able to reopen in the run-up to Christmas and begin to help our economy recover, but in Devon, hospitality businesses are crucial and they need targeted support. 

Swale has the highest infection rate in the UK at 541.7 per 100,000, according to the Department of Health. Its high street is pictured above

Swale has the highest infection rate in the UK at 541.7 per 100,000, according to the Department of Health. Its high street is pictured above 

Under the new rules all but three places in England will be plunged into the toughest brackets despite many of the local cases being in small urban hotspots

Under the new rules all but three places in England will be plunged into the toughest brackets despite many of the local cases being in small urban hotspots

In Stratford upon Avon there were just 108 positive tests per 100,000 people in the week to November 22, but the town will be subjected to a Tier Three lockdown for the whole of Warwickshire (195). Authorities bordering Stratford have similar rates – Daventry (123) and Cherwell (100) – but escape Tier Three because they're over county lines in Northamptonshire and Oxfordshire

In Stratford upon Avon there were just 108 positive tests per 100,000 people in the week to November 22, but the town will be subjected to a Tier Three lockdown for the whole of Warwickshire (195). Authorities bordering Stratford have similar rates – Daventry (123) and Cherwell (100) – but escape Tier Three because they're over county lines in Northamptonshire and Oxfordshire

The Derbyshire Dales and Stratford-upon-Avon in Warwickshire have suffered the same fate, lumped into the toughest restrictions because of their neighbours. Both will enter Tier Three from next Thursday when national lockdown lifts, but have infection rates significantly below the average (204 per 100,000), and falling

The Derbyshire Dales and Stratford-upon-Avon in Warwickshire have suffered the same fate, lumped into the toughest restrictions because of their neighbours. Both will enter Tier Three from next Thursday when national lockdown lifts, but have infection rates significantly below the average (204 per 100,000), and falling

Teignbridge has had 52.9 positive cases per 100,000 people, while nearby South Hams had 60.9 and Torridge 68.8. A council leader in Devon, which has been put in Tier Two despite one of the lowest infection rates in the country, said the new lockdown rules were 'a slap in the face'

Teignbridge has had 52.9 positive cases per 100,000 people, while nearby South Hams had 60.9 and Torridge 68.8. A council leader in Devon, which has been put in Tier Two despite one of the lowest infection rates in the country, said the new lockdown rules were 'a slap in the face'

'In the meantime, I would renew my appeal to people to stick to the rules to keep themselves and their families and neighbours safe and minimise the pressure on our local health services.

'I welcome the opening of the Nightingale Hospital in Exeter but, as Boris Johnson has conceded, the South West still lacks hospital beds and this must be urgently addressed.'  

Under Tier Three restrictions restaurants and pubs are forced to remain offering take-away only, which it is warned has crippled many local businesses.

But in Tier Two they are able to re-open, offering many a vital line of income to allow them to stay afloat.

Most of England has been placed into Tier Two including areas with a higher Covid-19 infection rate than Ashford, Sevenoaks, Tunbridge Wells and others. 

Havering, in London, is in Tier Two despite having an infection rate at 318.6 per 100,000, alongside Redbridge, where the rate is 295.8 per 100,000 and Barking and Dagenham, where it is 248.5 per 100,000. In some parts of East London the infection rate is even rising. 

Several Kent MPs, including Sir Gale and Mr Green, wrote to Health Secretary Matt Hancock yesterday asking that different areas of the county be placed in different restrictions.

They wrote in their letter: 'We must allow businesses to prosper and not be held back by restrictions not suitable for their area.

Roger Truelove, the leader of Swale Borough Council, said he supported the decision to move to Tier Three

Roger Truelove, the leader of Swale Borough Council, said he supported the decision to move to Tier Three

'We trust that the Government will introduce restrictions on a Borough or District basis to ensure that the right approach is used across each community.'

Justifying its decision to place Kent in Tier Three, the Department of Health said: 'Case rates are high and continuing to rise, with large increases in case rates in almost all areas in the last seven days.

'Some of the highest case rates in the country are currently seen in Kent. Rising case rates in people aged over 60 are a particular concern.

'Positivity is also increasing in 10 of the 13 lower-tier local authorities.

'Kent And Medway STP (Sustainability and Transformation Partnership) are reporting hospital admissions are increasing and mutual aid necessary across the county.' 

Roger Truelove, leader of Swale Borough Council, said he agrees with county-wide Tier 3 restrictions for Kent.

He said: 'I appreciate that that is what we have to be, we have to be in Tier 3. I hope that that's an incentive for local people to comply as much as possible with the guidance so we get our numbers down.' 

'I fully understand other boroughs that have not got such a high rate as us, but the fact is that the level of Kent is going up … and I think it is much better from a public health point of view if you are all in the same tier.'

He added that if different boroughs had different restrictions it was likely there would be a 'lot of migration of people from one borough to another'. 

Officials have refused to reveal the threshold a county would need to drop its infection rate to in order to get out of Tier Three. 

Tonight Boris Johnson begged people to get on board with new coronavirus tiers insisting there is an 'escape' route for areas in the higher levels.

At a Downing Street press conference, the PM insisted the system will be less 'intrusive' than the blanket lockdown that it is intended to replace from December 2.

He stressed there was a mechanism for areas that manage to bring down their infection rates to have curbs eased. 'Your tier is not your destiny, every area has the means of escape'.

However, Professor Whitty immediately struck a very different tone, suggesting there is little chance of anyone going down to Tier 1 as restrictions are so lax that inevitably cases rise. He said it was only possible for places that currently have extremely low case rates. 

Under plans unveiled on Monday, three-household 'Christmas Bubbles' will not have to socially distance between December 23 and 27, to allow family gatherings to go ahead unimpeded.  

Only Cornwall, Scilly and the Isle of Wight have been put into the loosest Tier 1, which allows socialising inside homes and pubs subject to the Rule of Six.

WHY YOU ARE IN YOUR TIER, ACCORDING TO THE GOVERNMENT
Region Sub-region Allocation Reason
North West Greater Manchester Very high (tier 3) While there has been continued improvement in Greater Manchester, weekly case rates remain very high, especially amongst those aged over 60, at around 260 per 100,000 people. The pressure on the local NHS is decreasing in some areas but remains a concern; Manchester University hospital and Pennine Acute Trust remain under significant pressure.
Lancashire, Blackpool, and Blackburn with Darwen Very high (tier 3) While there have been improvements in some areas, case rates and the proportion of tests which are positive for COVID-19 remain high. Case rates in over 60s are very high (over 200 per 100,000) in 6 lower tier local authorities. There is still pressure on the NHS in this region.
Liverpool City Region High (tier 2) There is continued improvement across the Liverpool city region. Case rates (including for the over 60s) are decreasing rapidly with some notable improvements in Liverpool, Knowsley and Sefton. Cases have fallen by 69% over 6 weeks. However, despite improvements, case rates in over 60s remain high at 150+ per 100,000 people in all lower tier local authorities.
Cheshire (including Warrington) High (tier 2) Case rates are continuing to decline across Warrington and Cheshire, with a 27.4% fall to 209 people per 100,000, in line with Liverpool City Region. However, case rates in those over 60 remain high (175/100,000) though falling. Positivity is 8.1%. Warrington and Halton Teaching Hospitals NHS foundation Trust has 150 inpatients with COVID-19.
Cumbria High (tier 2) The picture in Cumbria is broadly improving although case rates in Carlisle and South Lakeland are increasing with increases likely due to a large school outbreak. Case rates in over 60s are above 100 per 100,000 in Carlisle and Barrow-in-Furness. These case rates are too high for allocation to tier 1 but Cumbria's trajectory does currently not warrant inclusion in tier 3.
North East Tees Valley Combined Authority Very high (tier 3) While case rates are now decreasing in all lower tier local authorities, they remain very high at 390 people per 100,000 across the region, with positivity also very high at 13.3%. The case rate in over 60s remains very high at 292 per 100,000. NHS admissions in the area have remained high in November.
North East Combined Authority Very high (tier 3) The region continues to see very high case rates, overall 318 people per 100,000, although this figure is either stable or falling in all parts of the region. Case rate in over 60s remains very high at 256 per 100,000. NHS admissions in the area have remained high in November.
Yorkshire and The Humber The Humber Very high (tier 3) The picture in Humber is improving with case rates now falling in 3 of the 4 lower tier local authorities. However, case rates in all ages and in over 60s remain very high (431/100,000 and 344/100,000 respectively). Positivity is 12.6%. There is ongoing pressure on the local NHS.
West Yorkshire Very high (tier 3) This area is improving with case rates falling in all 5 lower tier local authorities. However, case rates in all ages and rates in over 60s remain very high (389/100,000 and 312/100,000 respectively). Positivity is 13.9%.
South Yorkshire Very high (tier 3) This area is improving with case rates falling in all 4 lower tier local authorities. However, case rates in all ages and rates in those over 60 remain very high (274/100,000 and 223/100,000 respectively). Positivity is 11.0%. There is pressure on local NHS Trusts.
York and North Yorkshire High (tier 2) Overall case rates (including for those over 60) in this region are improving in 7 of the 8 local authorities and lower than other parts of Yorkshire and The Humber but remain high overall (202/100,000 in all age groups and 145/100,000 for those aged over 60). Positivity is 8.5%. Rates in Scarborough are significantly higher than the rest of the region (334/100,000 in all age groups and 247/100,000 in those aged over 60) but falling rapidly.
East Midlands Leicester and Leicestershire Very high (tier 3) Improvements have been seen in overall case rates in all but one lower tier local authority, but remain very high at 355 per 100,000, including in over 60s at 250 per 100k. The pressure on the local NHS remains very high.
Derby and Derbyshire Very high (tier 3) There has been improvement in this area, but case rates remain very high at 275 per 100,000, and in those over 60 it is 220 per 100,000. The pressure on the local NHS remains high.
Lincolnshire Very high (tier 3) There has been an overall improvement, but case rates remain high throughout the county, at 307 per 100,000 and in the over 60s it is 281 per 100,000. NHS pressures in Lincolnshire remain high and show signs of increasing, particularly for the units treating the more serious cases
Nottingham and Nottinghamshire Very high (tier 3) There has been an improvement, but case rates remain very high in the over 60s at 211 per 100,000. The overall case rate is 244 per 100,000 and positivity is 10%. The proportion of hospital beds taken up by COVID-19 patients is high but appears to be falling.
Northamptonshire High (tier 2) Although improvements in the overall case rates have been seen recently, there is a continued rise in rates of COVID-19 in the over 60s. Over 60s case rate is 154 per 100,000. There is some evidence that the local NHS is seeing the proportion of people with COVID-19 being admitted and subsequently occupying beds stabilising, however COVID and non-COVID patients occupying beds in units treating more serious cases is high.
Rutland High (tier 2) This area is improving with a case rate of 125 per 100,000 and 118 per 100,000 for the over 60s, which while elevated is different from the surrounding areas. Positivity is 6.4%.
West Midlands Birmingham and Black Country Very high (tier 3) While case rates are improving (down 8.3%) they remain very high (390/100,000). There is a similar trend for positivity. Pressure on the NHS remains high.
Staffordshire and Stoke-on-Trent Very high (tier 3) While the situation is improving with case rates down 13.4%, case rates and test positivity are both very high across this area (391/100,000 and 11.1% respectively). The pressure on the local NHS remains very high, including in units treating the more serious cases.
Warwickshire, Coventry and Solihull Very high (tier 3) The case rate remains very high (though falling) across this area at 236/100,000. The case rate in over 60s remains very high at 182/100,000. There is a clear upward trend in case rates in over 60s in 3 of the 7 local authority areas. Positivity is 9.0%. The pressure on the local NHS remains high.
Shropshire and Telford & Wrekin High (tier 2) The case rate remains high (though falling) at 200/100,000. The case rate in over 60s remains high at 139/100.000 and is falling. Positivity is 7.2%.
Herefordshire High (tier 2) Herefordshire has a high case rate at 160.3/100,000. These rates are too high for allocation to tier 1 but the slight downward trajectory a fall of 1.9% - does currently not warrant inclusion in tier 3.
Worcestershire High (tier 2) While there has been a decline in case rates in all lower tier local authorities they do remain high (201/100,000),including in the over 60s (141/100,000), These case rates are too high for allocation to tier 1 but the downward trajectory with a fall of 18.3% - does currently not warrant inclusion in tier 3. Hospital admissions of patients with COVID-19 have started to stabilise
London London High (tier 2) The trajectory of key indicators of COVID-19 in an area (including all age case rates, over 60s case rates and positivity) have been increasing until very recently. The situation in London is not uniform throughout the city. 13 of the 33 boroughs have case rates which are 10% or more higher than a week ago and ten boroughs where case rates for over 60s are above 150 per 100,000. Hospital admissions continue to increase in the East and North London in particular, although they are still well below the spring peak. Taken as a whole, the situation in London has stabilised at a similar case rate and positivity to other parts of the country in tier 2.
East of England Bedfordshire and Milton Keynes High (tier 2) The overall case rate is still increasing in two of the 3 lower tier local authorities. The overall case rate is high at 178/100,000 and it is 113/100,000 in the over 60s although this rises to 185/100,000 in Luton. Positivity 6.9%. There is pressure on the local NHS.
Essex, Thurrock and Southend on Sea High (tier 2) Overall the rate is 159/100,000 and rising. The rate in over 60s is 100/100,000 and falling. Positivity is 6.4%.
Norfolk High (tier 2) The majority of Norfolk is improving. Case rates are 123/100,000 and positivity is 5.0%. Case rates for over 60s remain over 100 per 100,000 in Great Yarmouth, Norwich and South Norfolk (with increasing trajectories in the last two areas).
Cambridgeshire and Peterborough High (tier 2) An improving picture with decreasing case rates across 5 of the 6 local authorities although the case rate is still high at 123/100,000 overall). Case rates in over 60s are also decreasing (58/100,000). Positivity has dropped to 5.2%.
Hertfordshire High (tier 2) There is an improving picture across the majority of Hertfordshire the case rate has fallen to 147/100,000 overall with drops in rates in 9 of the 10 local authorities. Case rates in over 60s are falling also (102/100,000) but they are greater than 100/100,000 in 6 local authorities. Positivity is 6.3% falling.
Suffolk High (tier 2) There is an improving picture across the majority of Suffolk. The case rate has fallen to 82/100,000 with drops in rate in 4 of the 5 local authorities. There has been a >40% increase in weekly case rate to 128/100,000 in Ipswich compared to the previous week. Across Suffolk, case rates in over 60s are also falling (72/100,000). Positivity is 3.7%.
South East Hampshire, Portsmouth and Southampton. High (tier 2) There is a mixed picture across this area although the overall case rate is now 152/100,000 and falling in almost all areas. NHS admissions were increasing rapidly until mid-November and are now stable.
Isle of Wight Medium (tier 1) The case rate is low and decreasing at 71 per 100,000 and lower in over 60s at 44 per 100,000. COVID-19 pressure on the NHS is low.
East and West Sussex, and Brighton and Hove High (tier 2) Case rates in Sussex are at 120 per 100,000 with a total positivity of 4.5%. However, the trend is increasing in several areas. NHS admissions have been fairly stable in the last month but there is increasing occupancy in units treating more serious cases.
Surrey High (tier 2) Case rates are stable or improving in all areas with the overall rate at 139 per 100,000. The most concerning lower tier local authorities are those that neighbour London (Spelthorne and Runnymede) with case rates over 200 per 100,000, and high case rates in the over 60s are observed in neighbouring Surrey Heath and Woking. Surrey Heartlands Health & Care Partnership report admissions to hospital from COVID-19 patients were fairly stable in the last month.
Reading, Wokingham, Bracknell Forest, Windsor and Maidenhead, West Berkshire High (tier 2) An improving picture across the area with the exception of Slough and Reading. Slough has high case rates (326 per 100,000 overall and 219 per 100,000 for the over 60s) and relatively high positivity of 12%. The case rate and positivity away from Slough do not justify inclusion at tier 3.
Slough Very high (tier 3) The weekly case rate in Slough is much higher than surrounding areas at over 320 per 100,000 people compared with 155 per 100,000 in the rest of Berkshire and 138 in Buckinghamshire. Test positivity is also much higher at 12%.
Buckinghamshire High (tier 2) A broadly stable or improving picture across Buckinghamshire with a case rate at 138 per 100,000 and positivity at 6.4%. These case rates remain too high for allocation to tier 1.
Oxfordshire High (tier 2) Positive improvements across key indicators across all areas in Oxfordshire, but case rates still too high for tier 1. Buckinghamshire, Oxfordshire And Berkshire West STP hospital admissions have been fairly stable in recent months.
Kent & Medway Very high (tier 3) Case rates are high and continuing to rise with large increases in case rates in almost all areas in the last 7 days. Some of the highest case rates in the country are currently seen in Kent. Rising case rates in people aged over 60 are a particular concern. Positivity is also increasing in 10 of the 13 lower tier local authorities. Kent And Medway STP are reporting hospital admissions are increasing and mutual aid necessary across the county.
South West Bristol, South Gloucestershire, North Somerset Very high (tier 3) The overall picture remains concerning with very high case rates overall (325/100,000) and in the over 60s (208/100,000). Positivity is 10.4%. Bristol, South Gloucestershire, and North Somerset are part of a wider travel to work area and thus form a natural geographic grouping, separate to the surrounding area.
Somerset and Bath and North East Somerset High (tier 2) There are very small increases in the case rates in this area, however overall case rates and those in over 60s remain high (154/100,000 and 102/100,000 respectively). Positivity is stable at 5.5%.
Dorset, Bournemouth, Christchurch and Poole High (tier 2) Case rates are falling across the area (131/100,000 in all cases and 99/100,000 in the over 60s). However the over 60 case rate is still high at 151/100,000 in Bournemouth, Christchurch and Poole. Positivity is 5.2%. In addition, the Dorset STP reports daily admissions to hospitals are increasing.
Gloucestershire High (tier 2) Case rates in Gloucestershire remain high at 162/100,000. While a decline has been seen in the case rate in the over 60s, this remains at 92/100,000. Positivity is 6.3%.
Wiltshire and Swindon High (tier 2) Case rates continue to fall in Swindon but are increasing in Wiltshire. Overall case rates are 143/100,000 and 93/100,000 in the over 60s. Positivity is 6.2%. Swindon and Wiltshire STP are reporting increasing admissions to hospital.
Devon High (tier 2) Case rates are 121/100,000 overall though there are higher rates in Plymouth, Torbay and Exeter. The case rate in the over 60s is 85/100,000 though significantly higher in Exeter (155.9/100,000). Positivity is 4.2%. There is pressure at the Royal Devon and Exeter Hospital.
Cornwall and Isles of Scilly Medium (tier 1) There are low case rates and test positivity in Cornwall and the case rates in all age groups are stable or declining. There have been no cases in the Isles of Scilly in the last 7 days meaning there is strong evidence to make an allocation to tier 1.
WHY YOU ARE IN YOUR TIER, ACCORDING TO THE GOVERNMENT Region Sub-region Allocation Reason North West Greater Manchester Very high (tier 3) While there has been continued improvement in Greater Manchester, weekly case rates remain very high, especially amongst those aged over 60, at around 260 per 100,000 people. The pressure on the local NHS is decreasing in some areas but remains a concern; Manchester University hospital and Pennine Acute Trust remain under significant pressure. Lancashire, Blackpool, and Blackburn with Darwen Very high (tier 3) While there have been improvements in some areas, case rates and the proportion of tests which are positive for COVID-19 remain high. Case rates in over 60s are very high (over 200 per 100,000) in 6 lower tier local authorities. There is still pressure on the NHS in this region. Liverpool City Region High (tier 2) There is continued improvement across the Liverpool city region. Case rates (including for the over 60s) are decreasing rapidly with some notable improvements in Liverpool, Knowsley and Sefton. Cases have fallen by 69% over 6 weeks. However, despite improvements, case rates in over 60s remain high at 150+ per 100,000 people in all lower tier local authorities. Cheshire (including Warrington) High (tier 2) Case rates are continuing to decline across Warrington and Cheshire, with a 27.4% fall to 209 people per 100,000, in line with Liverpool City Region. However, case rates in those over 60 remain high (175/100,000) though falling. Positivity is 8.1%. Warrington and Halton Teaching Hospitals NHS foundation Trust has 150 inpatients with COVID-19. Cumbria High (tier 2) The picture in Cumbria is broadly improving although case rates in Carlisle and South Lakeland are increasing with increases likely due to a large school outbreak. Case rates in over 60s are above 100 per 100,000 in Carlisle and Barrow-in-Furness. These case rates are too high for allocation to tier 1 but Cumbria's trajectory does currently not warrant inclusion in tier 3. North East Tees Valley Combined Authority Very high (tier 3) While case rates are now decreasing in all lower tier local authorities, they remain very high at 390 people per 100,000 across the region, with positivity also very high at 13.3%. The case rate in over 60s remains very high at 292 per 100,000. NHS admissions in the area have remained high in November. North East Combined Authority Very high (tier 3) The region continues to see very high case rates, overall 318 people per 100,000, although this figure is either stable or falling in all parts of the region. Case rate in over 60s remains very high at 256 per 100,000. NHS admissions in the area have remained high in November. Yorkshire and The Humber The Humber Very high (tier 3) The picture in Humber is improving with case rates now falling in 3 of the 4 lower tier local authorities. However, case rates in all ages and in over 60s remain very high (431/100,000 and 344/100,000 respectively). Positivity is 12.6%. There is ongoing pressure on the local NHS. West Yorkshire Very high (tier 3) This area is improving with case rates falling in all 5 lower tier local authorities. However, case rates in all ages and rates in over 60s remain very high (389/100,000 and 312/100,000 respectively). Positivity is 13.9%. South Yorkshire Very high (tier 3) This area is improving with case rates falling in all 4 lower tier local authorities. However, case rates in all ages and rates in those over 60 remain very high (274/100,000 and 223/100,000 respectively). Positivity is 11.0%. There is pressure on local NHS Trusts. York and North Yorkshire High (tier 2) Overall case rates (including for those over 60) in this region are improving in 7 of the 8 local authorities and lower than other parts of Yorkshire and The Humber but remain high overall (202/100,000 in all age groups and 145/100,000 for those aged over 60). Positivity is 8.5%. Rates in Scarborough are significantly higher than the rest of the region (334/100,000 in all age groups and 247/100,000 in those aged over 60) but falling rapidly. East Midlands Leicester and Leicestershire Very high (tier 3) Improvements have been seen in overall case rates in all but one lower tier local authority, but remain very high at 355 per 100,000, including in over 60s at 250 per 100k. The pressure on the local NHS remains very high. Derby and Derbyshire Very high (tier 3) There has been improvement in this area, but case rates remain very high at 275 per 100,000, and in those over 60 it is 220 per 100,000. The pressure on the local NHS remains high. Lincolnshire Very high (tier 3) There has been an overall improvement, but case rates remain high throughout the county, at 307 per 100,000 and in the over 60s it is 281 per 100,000. NHS pressures in Lincolnshire remain high and show signs of increasing, particularly for the units treating the more serious cases Nottingham and Nottinghamshire Very high (tier 3) There has been an improvement, but case rates remain very high in the over 60s at 211 per 100,000. The overall case rate is 244 per 100,000 and positivity is 10%. The proportion of hospital beds taken up by COVID-19 patients is high but appears to be falling. Northamptonshire High (tier 2) Although improvements in the overall case rates have been seen recently, there is a continued rise in rates of COVID-19 in the over 60s. Over 60s case rate is 154 per 100,000. There is some evidence that the local NHS is seeing the proportion of people with COVID-19 being admitted and subsequently occupying beds stabilising, however COVID and non-COVID patients occupying beds in units treating more serious cases is high. Rutland High (tier 2) This area is improving with a case rate of 125 per 100,000 and 118 per 100,000 for the over 60s, which while elevated is different from the surrounding areas. Positivity is 6.4%. West Midlands Birmingham and Black Country Very high (tier 3) While case rates are improving (down 8.3%) they remain very high (390/100,000). There is a similar trend for positivity. Pressure on the NHS remains high. Staffordshire and Stoke-on-Trent Very high (tier 3) While the situation is improving with case rates down 13.4%, case rates and test positivity are both very high across this area (391/100,000 and 11.1% respectively). The pressure on the local NHS remains very high, including in units treating the more serious cases. Warwickshire, Coventry and Solihull Very high (tier 3) The case rate remains very high (though falling) across this area at 236/100,000. The case rate in over 60s remains very high at 182/100,000. There is a clear upward trend in case rates in over 60s in 3 of the 7 local authority areas. Positivity is 9.0%. The pressure on the local NHS remains high. Shropshire and Telford & Wrekin High (tier 2) The case rate remains high (though falling) at 200/100,000. The case rate in over 60s remains high at 139/100.000 and is falling. Positivity is 7.2%. Herefordshire High (tier 2) Herefordshire has a high case rate at 160.3/100,000. These rates are too high for allocation to tier 1 but the slight downward trajectory a fall of 1.9% - does currently not warrant inclusion in tier 3. Worcestershire High (tier 2) While there has been a decline in case rates in all lower tier local authorities they do remain high (201/100,000),including in the over 60s (141/100,000), These case rates are too high for allocation to tier 1 but the downward trajectory with a fall of 18.3% - does currently not warrant inclusion in tier 3. Hospital admissions of patients with COVID-19 have started to stabilise London London High (tier 2) The trajectory of key indicators of COVID-19 in an area (including all age case rates, over 60s case rates and positivity) have been increasing until very recently. The situation in London is not uniform throughout the city. 13 of the 33 boroughs have case rates which are 10% or more higher than a week ago and ten boroughs where case rates for over 60s are above 150 per 100,000. Hospital admissions continue to increase in the East and North London in particular, although they are still well below the spring peak. Taken as a whole, the situation in London has stabilised at a similar case rate and positivity to other parts of the country in tier 2. East of England Bedfordshire and Milton Keynes High (tier 2) The overall case rate is still increasing in two of the 3 lower tier local authorities. The overall case rate is high at 178/100,000 and it is 113/100,000 in the over 60s although this rises to 185/100,000 in Luton. Positivity 6.9%. There is pressure on the local NHS. Essex, Thurrock and Southend on Sea High (tier 2) Overall the rate is 159/100,000 and rising. The rate in over 60s is 100/100,000 and falling. Positivity is 6.4%. Norfolk High (tier 2) The majority of Norfolk is improving. Case rates are 123/100,000 and positivity is 5.0%. Case rates for over 60s remain over 100 per 100,000 in Great Yarmouth, Norwich and South Norfolk (with increasing trajectories in the last two areas). Cambridgeshire and Peterborough High (tier 2) An improving picture with decreasing case rates across 5 of the 6 local authorities although the case rate is still high at 123/100,000 overall). Case rates in over 60s are also decreasing (58/100,000). Positivity has dropped to 5.2%. Hertfordshire High (tier 2) There is an improving picture across the majority of Hertfordshire the case rate has fallen to 147/100,000 overall with drops in rates in 9 of the 10 local authorities. Case rates in over 60s are falling also (102/100,000) but they are greater than 100/100,000 in 6 local authorities. Positivity is 6.3% falling. Suffolk High (tier 2) There is an improving picture across the majority of Suffolk. The case rate has fallen to 82/100,000 with drops in rate in 4 of the 5 local authorities. There has been a >40% increase in weekly case rate to 128/100,000 in Ipswich compared to the previous week. Across Suffolk, case rates in over 60s are also falling (72/100,000). Positivity is 3.7%. South East Hampshire, Portsmouth and Southampton. High (tier 2) There is a mixed picture across this area although the overall case rate is now 152/100,000 and falling in almost all areas. NHS admissions were increasing rapidly until mid-November and are now stable. Isle of Wight Medium (tier 1) The case rate is low and decreasing at 71 per 100,000 and lower in over 60s at 44 per 100,000. COVID-19 pressure on the NHS is low. East and West Sussex, and Brighton and Hove High (tier 2) Case rates in Sussex are at 120 per 100,000 with a total positivity of 4.5%. However, the trend is increasing in several areas. NHS admissions have been fairly stable in the last month but there is increasing occupancy in units treating more serious cases. Surrey High (tier 2) Case rates are stable or improving in all areas with the overall rate at 139 per 100,000. The most concerning lower tier local authorities are those that neighbour London (Spelthorne and Runnymede) with case rates over 200 per 100,000, and high case rates in the over 60s are observed in neighbouring Surrey Heath and Woking. Surrey Heartlands Health & Care Partnership report admissions to hospital from COVID-19 patients were fairly stable in the last month. Reading, Wokingham, Bracknell Forest, Windsor and Maidenhead, West Berkshire High (tier 2) An improving picture across the area with the exception of Slough and Reading. Slough has high case rates (326 per 100,000 overall and 219 per 100,000 for the over 60s) and relatively high positivity of 12%. The case rate and positivity away from Slough do not justify inclusion at tier 3. Slough Very high (tier 3) The weekly case rate in Slough is much higher than surrounding areas at over 320 per 100,000 people compared with 155 per 100,000 in the rest of Berkshire and 138 in Buckinghamshire. Test positivity is also much higher at 12%. Buckinghamshire High (tier 2) A broadly stable or improving picture across Buckinghamshire with a case rate at 138 per 100,000 and positivity at 6.4%. These case rates remain too high for allocation to tier 1. Oxfordshire High (tier 2) Positive improvements across key indicators across all areas in Oxfordshire, but case rates still too high for tier 1. Buckinghamshire, Oxfordshire And Berkshire West STP hospital admissions have been fairly stable in recent months. Kent & Medway Very high (tier 3) Case rates are high and continuing to rise with large increases in case rates in almost all areas in the last 7 days. Some of the highest case rates in the country are currently seen in Kent. Rising case rates in people aged over 60 are a particular concern. Positivity is also increasing in 10 of the 13 lower tier local authorities. Kent And Medway STP are reporting hospital admissions are increasing and mutual aid necessary across the county. South West Bristol, South Gloucestershire, North Somerset Very high (tier 3) The overall picture remains concerning with very high case rates overall (325/100,000) and in the over 60s (208/100,000). Positivity is 10.4%. Bristol, South Gloucestershire, and North Somerset are part of a wider travel to work area and thus form a natural geographic grouping, separate to the surrounding area. Somerset and Bath and North East Somerset High (tier 2) There are very small increases in the case rates in this area, however overall case rates and those in over 60s remain high (154/100,000 and 102/100,000 respectively). Positivity is stable at 5.5%. Dorset, Bournemouth, Christchurch and Poole High (tier 2) Case rates are falling across the area (131/100,000 in all cases and 99/100,000 in the over 60s). However the over 60 case rate is still high at 151/100,000 in Bournemouth, Christchurch and Poole. Positivity is 5.2%. In addition, the Dorset STP reports daily admissions to hospitals are increasing. Gloucestershire High (tier 2) Case rates in Gloucestershire remain high at 162/100,000. While a decline has been seen in the case rate in the over 60s, this remains at 92/100,000. Positivity is 6.3%. Wiltshire and Swindon High (tier 2) Case rates continue to fall in Swindon but are increasing in Wiltshire. Overall case rates are 143/100,000 and 93/100,000 in the over 60s. Positivity is 6.2%. Swindon and Wiltshire STP are reporting increasing admissions to hospital. Devon High (tier 2) Case rates are 121/100,000 overall though there are higher rates in Plymouth, Torbay and Exeter. The case rate in the over 60s is 85/100,000 though significantly higher in Exeter (155.9/100,000). Positivity is 4.2%. There is pressure at the Royal Devon and Exeter Hospital. Cornwall and Isles of Scilly Medium (tier 1) There are low case rates and test positivity in Cornwall and the case rates in all age groups are stable or declining. There have been no cases in the Isles of Scilly in the last 7 days meaning there is strong evidence to make an allocation to tier 1. Region Sub-region Allocation Reason RegionSub-regionAllocationReason North West Greater Manchester Very high (tier 3) While there has been continued improvement in Greater Manchester, weekly case rates remain very high, especially amongst those aged over 60, at around 260 per 100,000 people. The pressure on the local NHS is decreasing in some areas but remains a concern; Manchester University hospital and Pennine Acute Trust remain under significant pressure. North WestGreater ManchesterVery high (tier 3)While there has been continued improvement in Greater Manchester, weekly case rates remain very high, especially amongst those aged over 60, at around 260 per 100,000 people. The pressure on the local NHS is decreasing in some areas but remains a concern; Manchester University hospital and Pennine Acute Trust remain under significant pressure. Lancashire, Blackpool, and Blackburn with Darwen Very high (tier 3) While there have been improvements in some areas, case rates and the proportion of tests which are positive for COVID-19 remain high. Case rates in over 60s are very high (over 200 per 100,000) in 6 lower tier local authorities. There is still pressure on the NHS in this region. Lancashire, Blackpool, and Blackburn with DarwenVery high (tier 3)While there have been improvements in some areas, case rates and the proportion of tests which are positive for COVID-19 remain high. Case rates in over 60s are very high (over 200 per 100,000) in 6 lower tier local authorities. There is still pressure on the NHS in this region. Liverpool City Region High (tier 2) There is continued improvement across the Liverpool city region. Case rates (including for the over 60s) are decreasing rapidly with some notable improvements in Liverpool, Knowsley and Sefton. Cases have fallen by 69% over 6 weeks. However, despite improvements, case rates in over 60s remain high at 150+ per 100,000 people in all lower tier local authorities. Liverpool City RegionHigh (tier 2)There is continued improvement across the Liverpool city region. Case rates (including for the over 60s) are decreasing rapidly with some notable improvements in Liverpool, Knowsley and Sefton. Cases have fallen by 69% over 6 weeks. However, despite improvements, case rates in over 60s remain high at 150+ per 100,000 people in all lower tier local authorities. Cheshire (including Warrington) High (tier 2) Case rates are continuing to decline across Warrington and Cheshire, with a 27.4% fall to 209 people per 100,000, in line with Liverpool City Region. However, case rates in those over 60 remain high (175/100,000) though falling. Positivity is 8.1%. Warrington and Halton Teaching Hospitals NHS foundation Trust has 150 inpatients with COVID-19. Cheshire (including Warrington)High (tier 2)Case rates are continuing to decline across Warrington and Cheshire, with a 27.4% fall to 209 people per 100,000, in line with Liverpool City Region. However, case rates in those over 60 remain high (175/100,000) though falling. Positivity is 8.1%. Warrington and Halton Teaching Hospitals NHS foundation Trust has 150 inpatients with COVID-19. Cumbria High (tier 2) The picture in Cumbria is broadly improving although case rates in Carlisle and South Lakeland are increasing with increases likely due to a large school outbreak. Case rates in over 60s are above 100 per 100,000 in Carlisle and Barrow-in-Furness. These case rates are too high for allocation to tier 1 but Cumbria's trajectory does currently not warrant inclusion in tier 3. CumbriaHigh (tier 2)The picture in Cumbria is broadly improving although case rates in Carlisle and South Lakeland are increasing with increases likely due to a large school outbreak. Case rates in over 60s are above 100 per 100,000 in Carlisle and Barrow-in-Furness. These case rates are too high for allocation to tier 1 but Cumbria's trajectory does currently not warrant inclusion in tier 3. North East Tees Valley Combined Authority Very high (tier 3) While case rates are now decreasing in all lower tier local authorities, they remain very high at 390 people per 100,000 across the region, with positivity also very high at 13.3%. The case rate in over 60s remains very high at 292 per 100,000. NHS admissions in the area have remained high in November. North EastTees Valley Combined AuthorityVery high (tier 3)While case rates are now decreasing in all lower tier local authorities, they remain very high at 390 people per 100,000 across the region, with positivity also very high at 13.3%. The case rate in over 60s remains very high at 292 per 100,000. NHS admissions in the area have remained high in November. North East Combined Authority Very high (tier 3) The region continues to see very high case rates, overall 318 people per 100,000, although this figure is either stable or falling in all parts of the region. Case rate in over 60s remains very high at 256 per 100,000. NHS admissions in the area have remained high in November. North East Combined AuthorityVery high (tier 3)The region continues to see very high case rates, overall 318 people per 100,000, although this figure is either stable or falling in all parts of the region. Case rate in over 60s remains very high at 256 per 100,000. NHS admissions in the area have remained high in November. Yorkshire and The Humber The Humber Very high (tier 3) The picture in Humber is improving with case rates now falling in 3 of the 4 lower tier local authorities. However, case rates in all ages and in over 60s remain very high (431/100,000 and 344/100,000 respectively). Positivity is 12.6%. There is ongoing pressure on the local NHS. Yorkshire and The HumberThe HumberVery high (tier 3)The picture in Humber is improving with case rates now falling in 3 of the 4 lower tier local authorities. However, case rates in all ages and in over 60s remain very high (431/100,000 and 344/100,000 respectively). Positivity is 12.6%. There is ongoing pressure on the local NHS. West Yorkshire Very high (tier 3) This area is improving with case rates falling in all 5 lower tier local authorities. However, case rates in all ages and rates in over 60s remain very high (389/100,000 and 312/100,000 respectively). Positivity is 13.9%. West YorkshireVery high (tier 3)This area is improving with case rates falling in all 5 lower tier local authorities. However, case rates in all ages and rates in over 60s remain very high (389/100,000 and 312/100,000 respectively). Positivity is 13.9%. South Yorkshire Very high (tier 3) This area is improving with case rates falling in all 4 lower tier local authorities. However, case rates in all ages and rates in those over 60 remain very high (274/100,000 and 223/100,000 respectively). Positivity is 11.0%. There is pressure on local NHS Trusts. South YorkshireVery high (tier 3)This area is improving with case rates falling in all 4 lower tier local authorities. However, case rates in all ages and rates in those over 60 remain very high (274/100,000 and 223/100,000 respectively). Positivity is 11.0%. There is pressure on local NHS Trusts. York and North Yorkshire High (tier 2) Overall case rates (including for those over 60) in this region are improving in 7 of the 8 local authorities and lower than other parts of Yorkshire and The Humber but remain high overall (202/100,000 in all age groups and 145/100,000 for those aged over 60). Positivity is 8.5%. Rates in Scarborough are significantly higher than the rest of the region (334/100,000 in all age groups and 247/100,000 in those aged over 60) but falling rapidly. York and North YorkshireHigh (tier 2)Overall case rates (including for those over 60) in this region are improving in 7 of the 8 local authorities and lower than other parts of Yorkshire and The Humber but remain high overall (202/100,000 in all age groups and 145/100,000 for those aged over 60). Positivity is 8.5%. Rates in Scarborough are significantly higher than the rest of the region (334/100,000 in all age groups and 247/100,000 in those aged over 60) but falling rapidly. East Midlands Leicester and Leicestershire Very high (tier 3) Improvements have been seen in overall case rates in all but one lower tier local authority, but remain very high at 355 per 100,000, including in over 60s at 250 per 100k. The pressure on the local NHS remains very high. East MidlandsLeicester and LeicestershireVery high (tier 3)Improvements have been seen in overall case rates in all but one lower tier local authority, but remain very high at 355 per 100,000, including in over 60s at 250 per 100k. The pressure on the local NHS remains very high. Derby and Derbyshire Very high (tier 3) There has been improvement in this area, but case rates remain very high at 275 per 100,000, and in those over 60 it is 220 per 100,000. The pressure on the local NHS remains high. Derby and DerbyshireVery high (tier 3)There has been improvement in this area, but case rates remain very high at 275 per 100,000, and in those over 60 it is 220 per 100,000. The pressure on the local NHS remains high. Lincolnshire Very high (tier 3) There has been an overall improvement, but case rates remain high throughout the county, at 307 per 100,000 and in the over 60s it is 281 per 100,000. NHS pressures in Lincolnshire remain high and show signs of increasing, particularly for the units treating the more serious cases LincolnshireVery high (tier 3)There has been an overall improvement, but case rates remain high throughout the county, at 307 per 100,000 and in the over 60s it is 281 per 100,000. NHS pressures in Lincolnshire remain high and show signs of increasing, particularly for the units treating the more serious cases Nottingham and Nottinghamshire Very high (tier 3) There has been an improvement, but case rates remain very high in the over 60s at 211 per 100,000. The overall case rate is 244 per 100,000 and positivity is 10%. The proportion of hospital beds taken up by COVID-19 patients is high but appears to be falling. Nottingham and NottinghamshireVery high (tier 3)There has been an improvement, but case rates remain very high in the over 60s at 211 per 100,000. The overall case rate is 244 per 100,000 and positivity is 10%. The proportion of hospital beds taken up by COVID-19 patients is high but appears to be falling. Northamptonshire High (tier 2) Although improvements in the overall case rates have been seen recently, there is a continued rise in rates of COVID-19 in the over 60s. Over 60s case rate is 154 per 100,000. There is some evidence that the local NHS is seeing the proportion of people with COVID-19 being admitted and subsequently occupying beds stabilising, however COVID and non-COVID patients occupying beds in units treating more serious cases is high. NorthamptonshireHigh (tier 2)Although improvements in the overall case rates have been seen recently, there is a continued rise in rates of COVID-19 in the over 60s. Over 60s case rate is 154 per 100,000. There is some evidence that the local NHS is seeing the proportion of people with COVID-19 being admitted and subsequently occupying beds stabilising, however COVID and non-COVID patients occupying beds in units treating more serious cases is high. Rutland High (tier 2) This area is improving with a case rate of 125 per 100,000 and 118 per 100,000 for the over 60s, which while elevated is different from the surrounding areas. Positivity is 6.4%. RutlandHigh (tier 2)This area is improving with a case rate of 125 per 100,000 and 118 per 100,000 for the over 60s, which while elevated is different from the surrounding areas. Positivity is 6.4%. West Midlands Birmingham and Black Country Very high (tier 3) While case rates are improving (down 8.3%) they remain very high (390/100,000). There is a similar trend for positivity. Pressure on the NHS remains high. West MidlandsBirmingham and Black CountryVery high (tier 3)While case rates are improving (down 8.3%) they remain very high (390/100,000). There is a similar trend for positivity. Pressure on the NHS remains high. Staffordshire and Stoke-on-Trent Very high (tier 3) While the situation is improving with case rates down 13.4%, case rates and test positivity are both very high across this area (391/100,000 and 11.1% respectively). The pressure on the local NHS remains very high, including in units treating the more serious cases. Staffordshire and Stoke-on-TrentVery high (tier 3)While the situation is improving with case rates down 13.4%, case rates and test positivity are both very high across this area (391/100,000 and 11.1% respectively). The pressure on the local NHS remains very high, including in units treating the more serious cases. Warwickshire, Coventry and Solihull Very high (tier 3) The case rate remains very high (though falling) across this area at 236/100,000. The case rate in over 60s remains very high at 182/100,000. There is a clear upward trend in case rates in over 60s in 3 of the 7 local authority areas. Positivity is 9.0%. The pressure on the local NHS remains high. Warwickshire, Coventry and SolihullVery high (tier 3)The case rate remains very high (though falling) across this area at 236/100,000. The case rate in over 60s remains very high at 182/100,000. There is a clear upward trend in case rates in over 60s in 3 of the 7 local authority areas. Positivity is 9.0%. The pressure on the local NHS remains high. Shropshire and Telford & Wrekin High (tier 2) The case rate remains high (though falling) at 200/100,000. The case rate in over 60s remains high at 139/100.000 and is falling. Positivity is 7.2%. Shropshire and Telford & WrekinHigh (tier 2)The case rate remains high (though falling) at 200/100,000. The case rate in over 60s remains high at 139/100.000 and is falling. Positivity is 7.2%. Herefordshire High (tier 2) Herefordshire has a high case rate at 160.3/100,000. These rates are too high for allocation to tier 1 but the slight downward trajectory a fall of 1.9% - does currently not warrant inclusion in tier 3. HerefordshireHigh (tier 2)Herefordshire has a high case rate at 160.3/100,000. These rates are too high for allocation to tier 1 but the slight downward trajectory a fall of 1.9% - does currently not warrant inclusion in tier 3. Worcestershire High (tier 2) While there has been a decline in case rates in all lower tier local authorities they do remain high (201/100,000),including in the over 60s (141/100,000), These case rates are too high for allocation to tier 1 but the downward trajectory with a fall of 18.3% - does currently not warrant inclusion in tier 3. Hospital admissions of patients with COVID-19 have started to stabilise WorcestershireHigh (tier 2)While there has been a decline in case rates in all lower tier local authorities they do remain high (201/100,000),including in the over 60s (141/100,000), These case rates are too high for allocation to tier 1 but the downward trajectory with a fall of 18.3% - does currently not warrant inclusion in tier 3. Hospital admissions of patients with COVID-19 have started to stabilise London London High (tier 2) The trajectory of key indicators of COVID-19 in an area (including all age case rates, over 60s case rates and positivity) have been increasing until very recently. The situation in London is not uniform throughout the city. 13 of the 33 boroughs have case rates which are 10% or more higher than a week ago and ten boroughs where case rates for over 60s are above 150 per 100,000. Hospital admissions continue to increase in the East and North London in particular, although they are still well below the spring peak. Taken as a whole, the situation in London has stabilised at a similar case rate and positivity to other parts of the country in tier 2. LondonLondonHigh (tier 2)The trajectory of key indicators of COVID-19 in an area (including all age case rates, over 60s case rates and positivity) have been increasing until very recently. The situation in London is not uniform throughout the city. 13 of the 33 boroughs have case rates which are 10% or more higher than a week ago and ten boroughs where case rates for over 60s are above 150 per 100,000. Hospital admissions continue to increase in the East and North London in particular, although they are still well below the spring peak. Taken as a whole, the situation in London has stabilised at a similar case rate and positivity to other parts of the country in tier 2. East of England Bedfordshire and Milton Keynes High (tier 2) The overall case rate is still increasing in two of the 3 lower tier local authorities. The overall case rate is high at 178/100,000 and it is 113/100,000 in the over 60s although this rises to 185/100,000 in Luton. Positivity 6.9%. There is pressure on the local NHS. East of EnglandBedfordshire and Milton KeynesHigh (tier 2)The overall case rate is still increasing in two of the 3 lower tier local authorities. The overall case rate is high at 178/100,000 and it is 113/100,000 in the over 60s although this rises to 185/100,000 in Luton. Positivity 6.9%. There is pressure on the local NHS. Essex, Thurrock and Southend on Sea High (tier 2) Overall the rate is 159/100,000 and rising. The rate in over 60s is 100/100,000 and falling. Positivity is 6.4%. Essex, Thurrock and Southend on SeaHigh (tier 2)Overall the rate is 159/100,000 and rising. The rate in over 60s is 100/100,000 and falling. Positivity is 6.4%. Norfolk High (tier 2) The majority of Norfolk is improving. Case rates are 123/100,000 and positivity is 5.0%. Case rates for over 60s remain over 100 per 100,000 in Great Yarmouth, Norwich and South Norfolk (with increasing trajectories in the last two areas). NorfolkHigh (tier 2)The majority of Norfolk is improving. Case rates are 123/100,000 and positivity is 5.0%. Case rates for over 60s remain over 100 per 100,000 in Great Yarmouth, Norwich and South Norfolk (with increasing trajectories in the last two areas). Cambridgeshire and Peterborough High (tier 2) An improving picture with decreasing case rates across 5 of the 6 local authorities although the case rate is still high at 123/100,000 overall). Case rates in over 60s are also decreasing (58/100,000). Positivity has dropped to 5.2%. Cambridgeshire and PeterboroughHigh (tier 2)An improving picture with decreasing case rates across 5 of the 6 local authorities although the case rate is still high at 123/100,000 overall). Case rates in over 60s are also decreasing (58/100,000). Positivity has dropped to 5.2%. Hertfordshire High (tier 2) There is an improving picture across the majority of Hertfordshire the case rate has fallen to 147/100,000 overall with drops in rates in 9 of the 10 local authorities. Case rates in over 60s are falling also (102/100,000) but they are greater than 100/100,000 in 6 local authorities. Positivity is 6.3% falling. HertfordshireHigh (tier 2)There is an improving picture across the majority of Hertfordshire the case rate has fallen to 147/100,000 overall with drops in rates in 9 of the 10 local authorities. Case rates in over 60s are falling also (102/100,000) but they are greater than 100/100,000 in 6 local authorities. Positivity is 6.3% falling. Suffolk High (tier 2) There is an improving picture across the majority of Suffolk. The case rate has fallen to 82/100,000 with drops in rate in 4 of the 5 local authorities. There has been a >40% increase in weekly case rate to 128/100,000 in Ipswich compared to the previous week. Across Suffolk, case rates in over 60s are also falling (72/100,000). Positivity is 3.7%. SuffolkHigh (tier 2)There is an improving picture across the majority of Suffolk. The case rate has fallen to 82/100,000 with drops in rate in 4 of the 5 local authorities. There has been a >40% increase in weekly case rate to 128/100,000 in Ipswich compared to the previous week. Across Suffolk, case rates in over 60s are also falling (72/100,000). Positivity is 3.7%. South East Hampshire, Portsmouth and Southampton. High (tier 2) There is a mixed picture across this area although the overall case rate is now 152/100,000 and falling in almost all areas. NHS admissions were increasing rapidly until mid-November and are now stable. South EastHampshire, Portsmouth and Southampton.High (tier 2)There is a mixed picture across this area although the overall case rate is now 152/100,000 and falling in almost all areas. NHS admissions were increasing rapidly until mid-November and are now stable. Isle of Wight Medium (tier 1) The case rate is low and decreasing at 71 per 100,000 and lower in over 60s at 44 per 100,000. COVID-19 pressure on the NHS is low. Isle of WightMedium (tier 1)The case rate is low and decreasing at 71 per 100,000 and lower in over 60s at 44 per 100,000. COVID-19 pressure on the NHS is low. East and West Sussex, and Brighton and Hove High (tier 2) Case rates in Sussex are at 120 per 100,000 with a total positivity of 4.5%. However, the trend is increasing in several areas. NHS admissions have been fairly stable in the last month but there is increasing occupancy in units treating more serious cases. East and West Sussex, and Brighton and HoveHigh (tier 2)Case rates in Sussex are at 120 per 100,000 with a total positivity of 4.5%. However, the trend is increasing in several areas. NHS admissions have been fairly stable in the last month but there is increasing occupancy in units treating more serious cases. Surrey High (tier 2) Case rates are stable or improving in all areas with the overall rate at 139 per 100,000. The most concerning lower tier local authorities are those that neighbour London (Spelthorne and Runnymede) with case rates over 200 per 100,000, and high case rates in the over 60s are observed in neighbouring Surrey Heath and Woking. Surrey Heartlands Health & Care Partnership report admissions to hospital from COVID-19 patients were fairly stable in the last month. SurreyHigh (tier 2)Case rates are stable or improving in all areas with the overall rate at 139 per 100,000. The most concerning lower tier local authorities are those that neighbour London (Spelthorne and Runnymede) with case rates over 200 per 100,000, and high case rates in the over 60s are observed in neighbouring Surrey Heath and Woking. Surrey Heartlands Health & Care Partnership report admissions to hospital from COVID-19 patients were fairly stable in the last month. Reading, Wokingham, Bracknell Forest, Windsor and Maidenhead, West Berkshire High (tier 2) An improving picture across the area with the exception of Slough and Reading. Slough has high case rates (326 per 100,000 overall and 219 per 100,000 for the over 60s) and relatively high positivity of 12%. The case rate and positivity away from Slough do not justify inclusion at tier 3. Reading, Wokingham, Bracknell Forest, Windsor and Maidenhead, West BerkshireHigh (tier 2)An improving picture across the area with the exception of Slough and Reading. Slough has high case rates (326 per 100,000 overall and 219 per 100,000 for the over 60s) and relatively high positivity of 12%. The case rate and positivity away from Slough do not justify inclusion at tier 3. Slough Very high (tier 3) The weekly case rate in Slough is much higher than surrounding areas at over 320 per 100,000 people compared with 155 per 100,000 in the rest of Berkshire and 138 in Buckinghamshire. Test positivity is also much higher at 12%. SloughVery high (tier 3)The weekly case rate in Slough is much higher than surrounding areas at over 320 per 100,000 people compared with 155 per 100,000 in the rest of Berkshire and 138 in Buckinghamshire. Test positivity is also much higher at 12%. Buckinghamshire High (tier 2) A broadly stable or improving picture across Buckinghamshire with a case rate at 138 per 100,000 and positivity at 6.4%. These case rates remain too high for allocation to tier 1. BuckinghamshireHigh (tier 2)A broadly stable or improving picture across Buckinghamshire with a case rate at 138 per 100,000 and positivity at 6.4%. These case rates remain too high for allocation to tier 1. Oxfordshire High (tier 2) Positive improvements across key indicators across all areas in Oxfordshire, but case rates still too high for tier 1. Buckinghamshire, Oxfordshire And Berkshire West STP hospital admissions have been fairly stable in recent months. OxfordshireHigh (tier 2)Positive improvements across key indicators across all areas in Oxfordshire, but case rates still too high for tier 1. Buckinghamshire, Oxfordshire And Berkshire West STP hospital admissions have been fairly stable in recent months. Kent & Medway Very high (tier 3) Case rates are high and continuing to rise with large increases in case rates in almost all areas in the last 7 days. Some of the highest case rates in the country are currently seen in Kent. Rising case rates in people aged over 60 are a particular concern. Positivity is also increasing in 10 of the 13 lower tier local authorities. Kent And Medway STP are reporting hospital admissions are increasing and mutual aid necessary across the county. Kent & MedwayVery high (tier 3)Case rates are high and continuing to rise with large increases in case rates in almost all areas in the last 7 days. Some of the highest case rates in the country are currently seen in Kent. Rising case rates in people aged over 60 are a particular concern. Positivity is also increasing in 10 of the 13 lower tier local authorities. Kent And Medway STP are reporting hospital admissions are increasing and mutual aid necessary across the county. South West Bristol, South Gloucestershire, North Somerset Very high (tier 3) The overall picture remains concerning with very high case rates overall (325/100,000) and in the over 60s (208/100,000). Positivity is 10.4%. Bristol, South Gloucestershire, and North Somerset are part of a wider travel to work area and thus form a natural geographic grouping, separate to the surrounding area. South WestBristol, South Gloucestershire, North SomersetVery high (tier 3)The overall picture remains concerning with very high case rates overall (325/100,000) and in the over 60s (208/100,000). Positivity is 10.4%. Bristol, South Gloucestershire, and North Somerset are part of a wider travel to work area and thus form a natural geographic grouping, separate to the surrounding area. Somerset and Bath and North East Somerset High (tier 2) There are very small increases in the case rates in this area, however overall case rates and those in over 60s remain high (154/100,000 and 102/100,000 respectively). Positivity is stable at 5.5%. Somerset and Bath and North East SomersetHigh (tier 2)There are very small increases in the case rates in this area, however overall case rates and those in over 60s remain high (154/100,000 and 102/100,000 respectively). Positivity is stable at 5.5%. Dorset, Bournemouth, Christchurch and Poole High (tier 2) Case rates are falling across the area (131/100,000 in all cases and 99/100,000 in the over 60s). However the over 60 case rate is still high at 151/100,000 in Bournemouth, Christchurch and Poole. Positivity is 5.2%. In addition, the Dorset STP reports daily admissions to hospitals are increasing. Dorset, Bournemouth, Christchurch and PooleHigh (tier 2)Case rates are falling across the area (131/100,000 in all cases and 99/100,000 in the over 60s). However the over 60 case rate is still high at 151/100,000 in Bournemouth, Christchurch and Poole. Positivity is 5.2%. In addition, the Dorset STP reports daily admissions to hospitals are increasing. Gloucestershire High (tier 2) Case rates in Gloucestershire remain high at 162/100,000. While a decline has been seen in the case rate in the over 60s, this remains at 92/100,000. Positivity is 6.3%. GloucestershireHigh (tier 2)Case rates in Gloucestershire remain high at 162/100,000. While a decline has been seen in the case rate in the over 60s, this remains at 92/100,000. Positivity is 6.3%. Wiltshire and Swindon High (tier 2) Case rates continue to fall in Swindon but are increasing in Wiltshire. Overall case rates are 143/100,000 and 93/100,000 in the over 60s. Positivity is 6.2%. Swindon and Wiltshire STP are reporting increasing admissions to hospital. Wiltshire and SwindonHigh (tier 2)Case rates continue to fall in Swindon but are increasing in Wiltshire. Overall case rates are 143/100,000 and 93/100,000 in the over 60s. Positivity is 6.2%. Swindon and Wiltshire STP are reporting increasing admissions to hospital. Devon High (tier 2) Case rates are 121/100,000 overall though there are higher rates in Plymouth, Torbay and Exeter. The case rate in the over 60s is 85/100,000 though significantly higher in Exeter (155.9/100,000). Positivity is 4.2%. There is pressure at the Royal Devon and Exeter Hospital. DevonHigh (tier 2)Case rates are 121/100,000 overall though there are higher rates in Plymouth, Torbay and Exeter. The case rate in the over 60s is 85/100,000 though significantly higher in Exeter (155.9/100,000). Positivity is 4.2%. There is pressure at the Royal Devon and Exeter Hospital. Cornwall and Isles of Scilly Medium (tier 1) There are low case rates and test positivity in Cornwall and the case rates in all age groups are stable or declining. There have been no cases in the Isles of Scilly in the last 7 days meaning there is strong evidence to make an allocation to tier 1. Cornwall and Isles of ScillyMedium (tier 1)There are low case rates and test positivity in Cornwall and the case rates in all age groups are stable or declining. There have been no cases in the Isles of Scilly in the last 7 days meaning there is strong evidence to make an allocation to tier 1.

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