What tier are YOU in and why? Document attempts to explain curbs in each area of England

All but three places will be plunged into Tier Three or Two (shown in red and orange) when England’s national shutdown ends on Wednesday 

Number 10 today published a breakdown of England’s lockdown tiers in a desperate attempt to justify the brutal curbs to the public as Boris Johnson announced all but three places of the country will be plunged into the toughest brackets.  

The document, released as it emerged almost 99 per cent of the population will be living in some form of lockdown when the national intervention finally ends on December 2, vaguely details why different restrictions were allocated to each area but doesn’t reveal the exact thresholds behind making the decisions.  

It seems to be a direct response to fierce criticism levelled at the Government about transparency by scientists and its own MPs, who accused ministers of using ‘finger in the air’ criteria to make the crucial decisions that will put a wrecking ball through already-crippled pubs, restaurants and clubs in swathes of the nation.

In Tier Three Manchester, for example, the Department of Health breakdown said ‘while there has been continued improvement’, weekly infections remain too high, ‘especially in those over 60, at around 260 per 100,000 people.’ Tagged on the end of the explanation is a vague message about the pressure on the local NHS ‘remaining a concern’, especially in ‘Manchester University hospital and Pennine Acute Trust’. 

Improvements have been seen in Tier Three Leicester, according to the breakdown, but Covid-19 infection rates remain ‘very high’ at 355 per 100,000, including in over 60s at 250. The DoH document adds: ‘The pressure on the local NHS remains very high.’ 

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. As a result most of England will be banned from mixing indoors with other households, apart from five days over Christmas. Pubs in Tier 2 will only be able to serve alcohol with ‘substantial’ meals.

Amid shambolic scenes this morning, the government had set an online postcode checker live before the official statement. As residents, journalists and MPs scrambled to gather the news on what decisions had been taken, the website then promptly crashed under the weight of traffic. And the original justification document published on the Government’s website contained a series of question marks against some of the areas listed — but it is not clear why.  

Oxford University’ Carl Heneghan, professor in evidence-based medicine and epidemiologist, told MailOnline without ‘clear, objective criteria’, people are often left confused about why they are being punished and what behaviour they need to adjust to move out of the tougher lockdown brackets. 

Shadow health secretary Jon Ashworth demanded that the government publishes a ‘scorecard’ showing exactly how each area measured against its criteria for deciding Tiers amid complaints they are too vague, and the geographical areas too broad.

The Joint Biosecurity Centre will review the Covid situation in areas every two weeks and sign off on proposals to upgrade or downgrade places, though the final decision remains with the PM. However, there are no specific trigger thresholds for coming in or out of Tiers.

But Professor Heneghan — who yesterday told MailOnline the restrictions would be outdated by the time they come into force next week — said officials ‘need to be much more flexible and reactive’ so regions can be freed from the economically-damaging curbs at the drop of a hat, if the outbreak starts trending in the right direction. 

Adding to confusion, the regional tier breakdown published on Parliament’s website contained a series of question marks alongside some of the areas listed. It was not immediately clear why the question marks were on the document or if was an early draft of the document mistakenly released.

It adds to a catalogue of blunders by UK health officials who in September lost nearly 16,000 Covid test results due to a Microsoft’s Excel glitch and were four months late in launching their ‘world beating’ Test and Trace app. 

The Department of Health today announced the new lockdown tiers that England will be divided into when the national lockdown ends on December 2

The Department of Health today announced the new lockdown tiers that England will be divided into when the national lockdown ends on December 2

The regional tier breakdown published on Parliament's website contained a series of question marks alongside some of the areas listed

It was not immediately clear why the question marks were on the document or if was an early draft of the document mistakenly released

The regional tier breakdown published on Parliament’s website contained a series of question marks alongside some of the areas listed. It was not immediately clear why the question marks were on the document or if was an early draft of the document mistakenly released

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 (STP) 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.
The onerous tiered system will be in place across England from December 3 until the end of March, the Prime Minister said

The onerous tiered system will be in place across England from December 3 until the end of March, the Prime Minister said

Covid-19 cases have fallen across most of the North of England since lockdown was imposed, but they are rising in a corner of the South East. The percentage change is based on comparing data from the week ending November 15 to the week ending November 8. It comes as the Government prepares to unveil its tier system

Covid-19 cases have fallen across most of the North of England since lockdown was imposed, but they are rising in a corner of the South East. The percentage change is based on comparing data from the week ending November 15 to the week ending November 8. It comes as the Government prepares to unveil its tier system

How will government decide what Tiers areas are put into? 

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

  • Case detection rates in all age groups;
  • Case detection rates in the over 60s;
  • The rate at which cases are rising or falling;
  • Positivity rate (the number of positive cases detected as a percentage of tests taken); and
  • Pressure on the NHS, including current and projected occupancy.

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.’ 

For Liverpool – formerly the country’s Covid hotspot –  ‘cases have fallen by 69 pe cent over six weeks’. But the region was placed in Tier Two because ‘case rates in over 60s are very high (over 200 per 100,000) in six lower tier local authorities’, according to the document.

Cornwall and the Isles of Scilly, two of three places to be put in Tier One, there are low case rates and test positivity and the infections in all ages are stable or declining, officials said.

‘There have been no cases in the Isles of Scilly in the last seven days meaning there is strong evidence to make an allocation to Tier One,’ it added.

WHAT IS THE JOINT BIOSECURITY CENTRE?

The Joint Biosecurity Centre is a new, secretive organisation set up by the Government in May this year. 

Little is known about the body, which is run out of the Cabinet Office, where Dominic Cummings’ ally and former boss Michael Gove is the responsible minister. 

Its staff consists of epidemiologists and data analysts but its structure, and whether experts are paid by the government, have not been announced. 

The JBC was originally tasked with monitoring Covid-19 and assisting the nation’s chief medical officers in setting the threat level.     

But it was given boosted responsibilities in July, when Matt Hancock downgraded Number 10’s scientific advisory panel SAGE following criticisms about its response to the first wave.

Data from all of the Government’s health and science bodies are though to be fed into the JBC, which then recommends action to Number 10. 

But to be implemented, measures need to be signed off by the prime minister.

These include lockdown restrictions and the new revamped tiered system. 

The JBC will assess the Covid situation across England every two weeks and decide if places need to be upgraded or downgraded.

Boris Johnson’s winter Covid plan published this week said the criteria being used were: 

Case detection rates in all age groups; 

Case detection rates in the over 60s; The rate at which cases are rising or falling; 

Positivity rate (the number of positive cases detected as a percentage of tests taken); 

and Pressure on the NHS, including current and projected occupancy. 

However, there are no specific trigger thresholds for coming in or out of Tiers. And the document added that there will be ‘flexibility to weight these indicators against each other as the context demands’.

The JBC is headed by Dr Clare Gardiner, a qualified epidemiologist, medical researcher, and cybersecurity director at GCHQ.

She reports to Baroness Dido Harding, the chief of NHS Test and Trace and the entire JBC organisation falls under the control of the Department of Health, which answers to the Health Secretary, Matt Hancock. 

It is currently unclear exactly how the JBC will operate with other bodies like Public Health England.

In Tier One Isle of Wight, the DoH claimed: ‘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.’

Experts have said the Government should be prepared to start moving places up and down tiers next week when the lockdown ends because the country ‘will be in very different position than it is now’.

Professor Heneghan warned the tiers may already be outdated and ‘unjustified’ when the national shutdown lapses next week because Covid infections are plummeting across the country.

He said ‘if the trend continues it will be hard to justify tougher tiered restrictions’ when the lockdown ends on Wednesday. The expert urged ministers to lay out exactly what needs to change for high-risk areas to be downgraded. 

For example, residents in Manchester should be told if they get their case rates in the over-60s then the region should be moved to Tier Two.

At present, the Government is not doing that and it will wait at least two weeks before reassessing the different tiers. 

Tory MPs today accused the Government of ‘authoritarianism’ when it emerged the brutal lockdowns will affect nearly 99 per cent of England.

Although London and Liverpool were spared the harshest Tier 3 in small glimmers of light, just 700,000 people – one per cent of the population – will be subject to the loosest grade of restrictions.

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

Tier Three will be brought in for huge swathes of the country including the bulk of the North, much of the Midlands, all of Kent, and Bristol – putting a wrecking ball through pubs, restaurants and clubs now forced to close except for takeaway.

London escapes Tier 3 and is placed in second bracket – but cases have yet to drop in Newham, Redbridge, Barking and Dagenham 

Coronavirus infections in are trending upwards in at least four London boroughs despite the capital avoiding a Tier 3 lockdown, figures show.

The city was placed under laxer Tier 2 restrictions today in a huge boost for the hospitality and entertainment sectors in London.

Tier 2 means restaurants, gyms, cinemas, theatres, bowling alleys, hotels and leisure centres will be able to open.

The decision was made because the vast majority of London’s 32 boroughs are seeing average infections trend downwards.

But Government data shows four east London boroughs, Newham, Redbridge, Barking and Dagenham and Waltham Forest, are bucking the trend.

Newham was recording 113.4 infections every day on average on November 18, the most recent snapshot.

That’s 6 per cent more than the 101.7 the week beforehand, on November 11, and 20 per cent more than the 94.9 a fortnight prior. 

In Redbridge, also in east London, daily cases were averaging 131.8 on the same date, up from 121.3 the week before and 101.4 on November 4.

The borough of Barking and Dagenham is also recording an upwards trend in cases, though the rate of increase how slowed.

On November 18 cases were 80.3, on average, compared to 75 on November 11 and 70 the week before that. 

Waltham Forest was seeing cases decrease in mid-November but they have started to trend in the opposite direction.

After an October surge in cases, the borough had an average 92 daily infections by November 10. This plunged to 76.9 by November 16, but rebounded up to 84.6 by November 18. 

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.

As a result most of England will be banned from mixing indoors with other households, apart from five days over Christmas. Pubs in Tier 2 will only be able to serve alcohol with ‘substantial’ meals.  

Tory rebel ringleader Steve Baker warned that the government must explain how it is balancing the economic harm with public health.

‘The authoritarianism at work today is truly appalling. But is it necessary and proportionate to the threat from this disease?’ he tweeted.

‘On the economy and on coronavirus, I fear we are now so far down the rabbit hole that we have forgotten we even entered it.’

Health Secretary Matt Hancock formally unveiled the breakdown of areas in the Commons after days of wrangling, saying the country has to stay ‘vigilant’.

He also defended the criteria being used amid complaints that they are too vague and amount to ‘finger in the air’.

And he immediately signalled a retreat on the fortnightly reviews, suggesting that in fact the tiers could be rethought weekly.

Amid shambolic scenes the government had set an online postcode checker live before the statement.

As residents, journalists and MPs scrambled to gather the news on what decisions had been taken, the website then promptly crashed under the weight of traffic.

Tier 3 means that millions of people face a ban on households mixing indoors and outdoors, and pubs will be only be able to provide takeaway service or must close altogether.

The revised Tier 2 restrictions shut pubs unless they serve meals and order people not to meet other households indoors.

Some 23million people will be in that category from next Wednesday, and 32million are in Tier 2.

London was spared after data showed coronavirus falling quickly in more than two-thirds of boroughs – and seemingly stalling in the rest.

Liverpool has also run a successful campaign to control its outbreak after mass testing in the city.

Mr Hancock pointed out that his own Suffolk constituency was going into Tier 2 despite having some of the lowest infection rates.

In a nod to anger on the Tory benches, he said he knew that many other places would prefer to be in the lowest bracket.

And he rejected criticism that there are no specific thresholds for putting areas into the levels.

Mr Hancock told MPs: ‘The indicators have been designed to give the government a picture of what is happening with the virus in any area so that suitable action can be taken.

‘These key indicators need to be viewed in the context of how they interact with each other as well as the wider context but provide an important framework for decision making – assessing the underlying prevalence in addition to how the spread of the disease is changing in areas.

‘Given these sensitivities, it is not possible to set rigid thresholds for these indicators.’

Shadow health secretary Jon Ashworth demanded that the government publishes a ‘scorecard’ showing exactly how each area measured against its criteria for deciding Tiers.

In the Commons, Conservative MP Greg Smith said he was ‘incredibly disappointed’ his Buckingham constituency was placed in Tier 2.

He said: ‘It’s incredibly disappointing news that Buckinghamshire having entered the national lockdown in Tier 1 will emerge from the national lockdown into the more punitive restrictions of Tier 2.

‘A decision that will be hard to understand in the rural communities of north Buckinghamshire that have relatively low infection rates and a decision that will be hard to understand given that there has been zero consultation between central government and Buckinghamshire Council and our local NHS.’

Tory MP for York Outer Julian Sturdy urged the Government to review the situation every week, rather than once a fortnight.

Mr Hancock appeared to concede that should happen.

‘We will review these in a fortnight, and then regularly, by which he can reasonably take weekly,’ he said.

‘And we will have a weekly cycle of meetings with the CMO chairing a meeting typically on a Tuesday, I then chair the meeting on a Wednesday for an announcement on Thursday for any change to the tiers.’

Greater Manchester mayor Andy Burnham criticised the lack of business support available to Tier 3 areas, and said he wanted the region moved down before Christmas if it continued to make progress.

He said: ‘Greater Manchester’s infection rate is reducing faster than any other part of the country but we have to accept that it is still significantly higher than the England average.

‘That said, if the current rate of improvement continues, we will be asking the Government to move our city-region into Tier 2 in two weeks’ time.

‘What we believe is completely wrong is the Government’s decision to provide no additional business support to areas in Tier 3 than those in Tiers 1 and 2.

‘The new Tier 3 will hit the hospitality sector extremely hard. While there are grants for businesses forced to close, there is no extra support for business which supply them like security, catering and cleaning.

‘This will cause real hardship for people whose jobs will be affected and risk the loss of many businesses.’

Conservative mayor of the West Midlands Andy Street tweeted: ‘Tier 3 for the WM is very disappointing, but we must now focus on getting out ASAP.

‘The trajectory is good, and our stay should be short-lived if people stick to the rules.

‘However more support is needed whilst in T3, particularly for the hospitality and live events sectors.’

Sheffield City Region mayor Dan Jarvis warned that ‘lockdown must not become limbo’.

Mr Jarvis, who is also Labour MP for Barnsley Central, said: ‘I welcome Government plans to review our tier arrangements every two weeks, because every extra day we are under restrictions could be the difference between a business surviving the pandemic or going under.

 ‘It is now essential we get a roadmap to get us out of Tier 3 as a matter of urgency.’

He said: ‘We need absolute clarity and consistency from the government about the criteria for areas moving between the Tiers. We need a test and trace system that is fit for purpose and we need clear communications

‘There is light at the end of the tunnel. In South Yorkshire the rate of new infections, and more importantly the number of older people in hospital with the virus, is moving in the right direction.

‘We’ve been under tighter restrictions in South Yorkshire since October 24, and they are slowly suffocating businesses, particularly in the hospitality and events sectors. They are now being hit again just as they enter their busiest time of year.’

Mr Jarvis added: ‘It’s deeply concerning that the government yet again excluded mayors and local leaders from the decision-making process around the new Tiering arrangements.’

Earlier, Chancellor Rishi Sunak insisted people will ‘see a difference’ when England’s national lockdown ends next week. He told Sky News today: ‘Whichever tier you’re in I think people will see a tangible change.

‘That said, things are obviously not normal and I can’t pretend that next week things are going to feel like they were before the spring.’