December 19 2020

The Prime Minister acted swiftly and concisely today having heard from his scientists and then consulting his Cabinet. He is going to move large parts of South East England to a new Tier 4. He acted so swiftly that he has not given it a descriptive name, you remember Tier 3 was called very high. It comes into action at Midnight tonight. I expected this to happen immediately after Christmas, but am very glad he has acted now and not waited too late to do it. My concerns are that we may need a tier 5 now after Christmas. This is because one of the frequent new variants of the Covid virus whose genome has been rapidly worked out by British scientists has been responsible for most of the new cases seen in London and the South East. Remember that mutations or variants are occurring all the time and usually of no particular significance. This mutation has 23 different changes in the viral structure, mostly proteins, which is more than usual. When a new variant is found three questions have to be answered:-

1) Does this variant affect the transmissibility of the virus from person to person? There is evidence that this may be the case. The R number could rise to 1.4 or higher in areas where the new strain is prevalent.

2) Does this variant cause a more virulent illness, causing more hospital admissions and deaths? So far, the evidence with this variant is no, it does not.

3) Will the existing vaccines and treatments used still work? So far. the answer to this seems to be yes as well. The WHO have been informed of the presence of this new variant in Great Britain and the changes of the genome have been shared globally. NERVTAG, the specialist expert group on New and Emerging Respiratory Virus Threats Advisory Group, advised the Government to take immediate action; it could not wait till after the festivities.The Government have taken 3 decisive steps:

1) There will be a new tier 4 with tight restrictions in all of Greater London , Kent and counties in the east of England. It will affect 17.7 million people. It will be a bit like lockdown again. Only essential shops can open. Hair dressers, bars, restaurants, gyms etc are all closed again . You can now only meet one person from another household outside in a public space (not the planned 3 for Christmas).

2) Travel restrictions apply to those living in Tier 4. No travelling abroad excepts in a few specific circumstances and no travel outside your Tier 4 except for work and education with a few other specific exemptions.

3) The planned Christmas relaxations have all been removed. On Christmas day, only if you are in tier 3 or below, you can still meet in a bubble with three different households, but this is not allowed in Tier 4. There are no relaxations for New Year’s Eve anywhere so your Tier rules will apply.

The PM has several times said that he and his Cabinet are guided by the science. If the science changes then the Government must take action to match it. We are not alone, many other European countries have taken action to minimise mixing. In some places it’s much tighter than England with curfews keeping people within their own homes.The devolved nations are expected to make broadly similar steps tonight. I understand the Scots will be banned from entering England. Can any of you budding historians tell me the last time the border was closed like this?Well some good news as well. The route out of this crisis will be vaccines, the Moderna Vaccine has been approved in the USA and the Oxford Pfizer vaccine is reliably said to be approved on 28-29th December.

Sadly a whole pack of the vaccine has been ruined when a deep freezer failed at a doctor’s surgery being used as a hub for the surrounding area. Nine more people have been killed in an oxygen explosion in an ITU in Southern Turkey. I have lost count of the number of times this has happened now. Oxygen can be highly inflammable and explosive if ignited. Never smoke with oxygen running !

In two different styles Mike Pense, the US Vice President, has had his Covid Vaccine live on TV, whereas Prince Charles has not had it as he considers himself well down the queue.

Predictably there have been arrests at today’s demonstrations for wilfully and dangerously ignoring advice not to demonstrate. There were 375,185 tests done in the last 24 hours with 27,052 proving positive, that’s 4.2 per 100k and is very high for a weekend figure.

18,771 were in hospital on 17th December with 1,907 admitted on 15th December and 1,364 are being treated on a ventilator on 18th December.

I am very sorry if your family plans will have been wrecked by the change of policy at this late stage. My plans have had to change as well. Our common sense tells us this was necessary. It must have been a very difficult decision to make, attracting criticism whatever was decided and whenever it was enforced. There’s a lot to discuss again. If you have masses of surplus food now consider freezing it till Easter, or consider local food banks or other local distribution schemes. If there is spare capacity in a freezer help your neighbours out.

Its back to basics still with Hands Face and Space. We should focus over Christmas on the Christmas star that shone over Bethlehem. Look to the South West, low in the sky about an hour after dark where Saturn and Jupiter merge to form a very bright light. You will see it just to the right of the moon. Watch from the safety of your garden or bedrooms.

After Christmas we can focus on protection with vaccine. I am told 350,000 first doses have already been given which includes 4,000 from my old practice area in East London. Well done everyone. Stay safe.

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