NIGHTINGALES across the North are on standby with hospitals just four weeks off levels seen at the coronavirus peak, doctors have warned.
It comes as latest Government maps reveal cases are now spreading from hotspots in the North to the rest of the country.
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Speaking at a Downing Street press briefing today, NHS England's medical director Professor Stephen Powis said Nightingales Manchester, Sunderland and Harrogate have been asked to prepare to take patients.
He also said that all NHS hospital staff in coronavirus hotspots will now be tested regularly regardless of whether they have symptoms.
It comes as Covid cases have soared across areas in the north of England -with Boris Johnson announcing further restrictions later today.
Knowsley and Liverpool, two of the affected areas, are in the top three for infection rates in England - at 669.5 per 100,000 people and 598.5 respectively.
In the seven days to October 8, the areas reported nearly 4,000 new cases.
The North West had 180 hospital admissions for Covid-19 on Friday and, as of Sunday had a total of 1,218 patients in hospital.
Yet the numbers fall far short of the doomsday prediction made by Sir Patrick Vallance and Prof Chris Whitty of 50,000 cases by mid-October.
The Government advisers made the bleak forecast during a press conference on September 22 - where they also warned there would be about 4,000 infections each day by tomorrow.
But the latest Department of Health figures released yesterday show the virus has fallen well short of their predictions with 12,872 positive tests.
There is a lag in the data provided over the weekend, which means the true number is likely to be higher.
The latest numbers also suggest there is no longer a clear North-South divide and Covid-19 is beginning to spread to other parts of the country.
England's deputy chief medical officer, Professor Jonathan Van-Tam, who was heading up today's press briefing at No10, said that cases are "heating up" in more parts of the country compared with a week ago.
Prof Van-Tam said other regions are now following the North West of England pattern where the virus moved through the age bands, having started spiking among young people at first.
Pretty much all areas of the UK are now seeing growths in the infection rate
Prof Jonathan Van-Tam
"There is the spread from those younger age groups into the 60-plus age group in the North West and the North East, and there are rates of change in the same places but also extending a little further south," he said.
"And this is again of significant concern, because of course the elderly suffer a much worse course with Covid-19, they are admitted to hospital for longer periods, and they are more difficult to save."
Addressing a slide shown earlier in the briefing showing rates increasing in the South of England, he said: "The epidemic this time has clearly picked up pace in the North of England earlier than it did in the first wave.
"That almost certainly relates to the fact the disease levels in the North, and certainly in the North West, never dropped as far in the summer as they did in the South.
"But pretty much all areas of the UK are now seeing growths in the infection rate.
"This is a nationwide phenomenon now that rates are changing upwards across the UK."
It comes amid reports that London could be placed into a Tier Two lockdown - meaning a ban on households mixing.
According to the , the capital could be facing tougher restrictions as early as the end of the week.
However, conflicting reports suggest the capital is in fact classified as Tier One - medium risk - and would continue to follow current measures.
'BETTER POSITION'
Prof Powis warned that more people are now in hospital with coronavirus than before restrictions were announced in March.
"Sadly, as the number of those infected increases, then so will the number of people who die," he said.
"And that's why the Government is looking at what other measures could be introduced in the areas where infection is rising the most.
"As the Secretary of State for Health has said, if we do not take measures to control the spread of the virus, the death toll will be too great to bear."
As the number of those infected increases, then so will the number of people who die
Prof Stephen Powis
However, he added that the country was in a better position than in March and April.
"Clearly we have learnt many things from that first wave, we have learnt better treatments for patients, and Dexamethasone… we learnt that that reduces deaths."
But he warned: "R is above one, that means that infections will continue to rise, and as infections continue to rise, then hospital admissions and impact on health services continue to rise."
'TAKE IT SERIOUSLY'
Dr Jane Eddleston, medical lead in Greater Manchester, urged the public to "respect" the virus due to the "extremely serious" consequences it has for some patients.
She told the press briefing: "The North West has about 40 per cent of all Covid cases at the moment and this is proving very challenging for us.
"Within Greater Manchester, we have seen a threefold increase in the number of patients admitted to intensive care in the last five weeks and an eightfold increase in the number of patients admitted to our hospitals.
"The situation at the moment is that 30 per cent of our critical care beds are taken up with patients with Covid and this is starting to impact on the services we provide for other patients."
Dr Eddleston added: "I stress to you the importance of us taking this disease extremely seriously.
"We are still finding that a quarter of patients that are admitted to intensive care are still required to go on mechanical ventilator within 24 hours of admission. This is very serious.
"The condition produces a very profound inflammation of the lungs which does have serious consequences for patients and I would ask you all to respect the virus and follow the advice we're being given."
THREE-TIER LOCKDOWN
It comes as overnight stays in northern virus hotspots are set to be banned for four weeks.
Boris Johnson is also expected to say that residents can only leave the highest risk regions for essential travel such as work, education or health reasons - and must return that day.
Mr Johnson will announce his “tiers for fears” system today — with Tier Three the highest risk.
Tier One — medium risk — will see current social distancing measures, the “rule of six” and a pub curfew of 10pm enforced.
Areas in Tier Two will have the same restrictions plus a ban on households mixing.
Only two households will be able to mix, and then only in gardens. In Tier Three “very high” risk areas overnight stays will be outlawed for residents and visitors.
Pubs and bars will be required to close and no household mixing will be allowed for socialising either indoors or outdoors.
Tier Three gyms and leisure facilities are expected to close. But, after a furious backlash, restaurants are likely to be able to serve until 10pm but without booze.
RED ALERT
It's understood that Liverpool will be placed in Tier Three, although Manchester has been spared the tougher restrictions - for now.
It comes as a senior Tory warned that Britain is back to where we were in March at the peak of the coronavirus outbreak and things may still get “sh**** yet”.
They told Politico: “It’s going to be really hard to stomach, it’s going to go on for some time, and if people don’t follow the rules then we may have to go further still.
“People in all areas of the country should be under no illusion, we are back to where we were in March, this is going to be sh** and it may get sh**** yet.”
Last night the PM told the Cabinet the nation stands at a “critical juncture” and more must be done to avoid triggering full lockdowns.
Tier Three households will not be allowed to mix either indoors or outdoors.
The restrictions are likely to hit Liverpool from Wednesday. They will be reviewed monthly.
The PM sees his clampdown, to be unveiled this evening, as a gamble to avoid a nationwide “circuit breaker” shutdown over half term.
That is still on the table according to one senior minister — although it was publicly denied today.
Mr Johnson, who held a telephone conference with Cabinet colleagues on Sunday, will chair a COBRA emergency committee meeting on Monday "to determine the final interventions" which he will then announce to Parliament.
MPs will be asked to debate and vote on the measures later this week.
The Prime Minister will hold a press conference in Downing Street with Chancellor Rishi Sunak and chief medical officer Professor Chris Whitty later on Monday.
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A Downing Street spokesperson said: "Our primary focus has always been to protect lives and livelihoods while controlling the spread of the virus and these measures will help achieve that aim.
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"We must do everything we can to protect the NHS and make sure it can continue to deliver the essential services that so many people rely on.
"This is a critical juncture and it is absolutely vital that everyone follows the clear guidance we have set out to help contain the virus."