Covid: England areas most at risk of local restrictions under Plan B - with highest coronavirus cases, positivity rates and hospitalisations

The Government is coming under increasing pressure to act now to stem a rising tide of Covid infections ahead of the winter months, amid warnings about waning immunity.

Doctors from the British Medical Association have accused ministers of being “wilfully negligent” after the Health Secretary Sajid Javid ruled out immediately implementing the Government’s so-called Plan B.

But ministers may be considering introducing some Plan B measures in councils with ‘enduring transmission’, according to the i newspaper, to boost testing capacity and support faster vaccination.

Areas with enduring transmission are those where the case rate has stayed above the national or regional average for a prolonged period. According to the Government’s Winter Plan, such areas could be offered “a menu of support measures”.

A more comprehensive implementation of Plan B could see the return of mandatory face masks, and vaccine passports introduced.

NationalWorld has analysed the latest Covid figures to identify areas with enduring transmission, and to measure other risk factors to see where is bearing the brunt of the virus right now.

You can explore all the data in our interactive map, using the drop down menu to toggle between measures.

Which places have experienced ‘enduring’ transmission?

NationalWorld’s analysis has found there are four areas that have had infection rates higher than the England average for over 100 consecutive days as of 15 October

Leeds is worst affected – it has had an above-average number of cases per 100,000 people for 253 days straight. That is followed by Calderdale (187), Gedling (113) and Doncaster (109).

There are a further 19 councils that have spent more than two months, or 62 days, with above average infection levels.

These are Rotherham, Ashfiled, Mansfield, Kettering, Bolsover, Peterborough, Hinckley and Bosworth, Oadby and Wigston, Derby, East Lindsey, Harborough, Rugby, Tamworth, Tameside, Barrow-in-Furness, Cannock Chase, Nuneaton and Bedworth, Staffordshire Moorlands and Telford and Wrekin.

Where has the highest number of cases?

The highest level of infection in the week to 15 October was in Bath and North East Somerset, with 877 cases per 100,000 people.

Cases have risen rapidly, from 260.7 the week before.

Other councils in the South West also rank highly. Completing the top 10 worst affected areas were Somerset West and Taunton (873.1 cases per 100,000), Ipswich (865.6), Mendip (816.9), Wellingborough (794.2), Stroud (784.1), Cheltenham (775.6), Gosport (771.1), West Lindsey (758.9) and Winchester (757.6).

In total 123 council areas had more than 500 cases for every 100,000 people. The England average for the same period was 447.9.

Where are the most people testing positive?

Earlier in the pandemic the World Health Organisation (WHO) set a benchmark of 5% test positivity for determining if infections are under control.

That means fewer than 5% of unique people tested should return a positive result.

The positivity rate for England in the week to 14 October was 9%. Wellingborough had the highest rate at 16.1%, followed by North East Derbyshire (14.8%), Rotherham (14.6%), and Calderdale, Barnsley and Bath and North East Somerset (all 14.5%).

Of the 315 England councils, only 13 were under the 5% threshold.

Where are cases highest among the over 60s?

The level of infection among people aged 60 and over -- who are classed as high risk – was a key factor in deciding on where to implement local lockdowns last year.

As NationalWorld has previously revealed, a large proportion of positive cases across the UK are currently among school-aged children, who are at lower risk of serious illness.

So where in the country is seeing spikes among older age groups?

In the week to 15 October, there were an average of 199.4 cases per 100,000 60 and overs.

The rate in Copeland was more than twice this, at 415.3. That was followed by Wyre (413.5), Barnsley (372), North East Derbyshire (362.9) and Rotherham (360.7).

Where are hospitalisations the highest?

Hospital figures are broken down by NHS trust, which do not correspond neatly with council boundaries.

There were 6,088 patients in hospitals across England as of 19 October, the latest period with local data, 733 of whom were on ventilators.

The busiest was University Hospitals Birmingham NHS Trust, with 185 patients and 18 on ventilators..

This was followed by Manchester University Trust (151 and 15), Leeds Teaching Hospitals Trust (119 and 18), Barts Health Trust (110 and 18) and Sheffield Teaching Hospitals Trust (105 and 14).

Where is seeing sharp increases in cases?

The Government also said last year that it monitored the increase in Covid cases in a given area to decide if extra measures were needed locally.

Ranking councils by the increase is imperfect – if a council started off with a very low number of cases and sees an increase it could leap up the rankings even though it still has a relatively low number compared to other places.

Many councils that have experienced a big increase now have a far higher rate of cases than the England average. The South West in particular has seen a rapid increase in cases.

In the week to 15 October, cases in Tewkesbury rose by 626%, from 95.2 per 100,000 the previous week to 691.3.

This was followed by Cheltenham (up 459% from 138.7 to 775.6), Stroud (up 448%, from 143.1 to 784.1), Gloucester (up 298%, from 116.4 to 463.3) and North Somerset (up 293%, from 162.8 to 640.2).

The average increase across England over the same period was 22%.

Where is the overall picture worst?

NationalWorld has combined the case rates, test positivity, rate of increase, and infections among 60 and overs data to compile a list of council areas where the overall picture is worst.

Bath and North East Somerset appears to be bearing the worst of the pandemic right now. It ranked fourth for overall infections, eighth for the increase in cases, fourth for test positivity and 19th for infections among the at risk age group.

The rankings are only indicative and should be taken as showing which areas could be cause for concern.

The top 50 worst ranking councils are:

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