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The new UK SARS-CoV-2 variant and lockdown – causes and consequences

Daniel Pan, Nadeesha Lakmal Mudalige, Shirley Sze, David Koeckerling, Oluwatobiloba Oyefeso, Joseph Barker, Caroline ML Williams, Julian W Tang and Manish Pareek
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DOI: https://doi.org/10.7861/clinmed.2021-0019
Clin Med May 2021
Daniel Pan
AUniversity of Leicester, Leicester, UK and University Hospitals of Leicester NHS Trust, UK
Roles: NIHR academic clinical fellow in infectious diseases
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Nadeesha Lakmal Mudalige
BLondon School of Tropical Medicine and Hygiene, London, UK
Roles: Mudalige NIHR academic clinical fellow in paediatrics
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Shirley Sze
CUniversity of Leicester, Leicester, UK
Roles: NIHR academic clinical fellow in cardiology
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David Koeckerling
DUniversity of Oxford, Oxfordshire, UK
Roles: academic foundation doctor
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Oluwatobiloba Oyefeso
ERoyal Free London NHS Foundation Trust, London, UK
Roles: general practitioner
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Joseph Barker
FUniversity of Leicester, Leicester, UK
Roles: NIHR academic clinical fellow in cardiology
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Caroline ML Williams
GUniversity of Leicester, Leicester, UK
Roles: specialist registrar in infectious diseases and microbiology
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Julian W Tang
HUniversity Hospitals of Leicester NHS Trust, UK
Roles: consultant virologist and honorary associate professor
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Manish Pareek
IUniversity of Leicester, Leicester, UK and University Hospitals of Leicester NHS Trust, UK
Roles: associate professor and honorary professor in infectious diseases
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  • For correspondence: manish.pareek@leicester.ac.uk
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    Table 1.

    A summary of the UK ‘tiered’ restrictions that were implemented from October 2020 to early January 2021

    TierMixingBars, pubs and restaurantsRetail, indoor leisure, accommodation, personal care, entertainment, places of worshipEducationTravelWeddings and funeralsExerciseResidential home visitsLarge sporting events, live performance and business meetings
    Tier 1 (Medium alert)Maximum of six indoors or outdoors, apart from with members of a single household or support bubbleBars, pubs and restaurants must be table service only, stop taking orders at 10pm, close by 11pmOpenSchools and universities openTravelling possible but avoid going to Tier 3 areas

    Overnight stays permitted with household, support bubble or up to 6 people
    15 guests for weddings and 30 for funeralsPermitted but maximum of six indoorsIndoor visits limited to two people from a Tier 1 area with social distancing, no physical contact, PPE use and good hand hygieneLimited to 50% capacity of 4,000 people outdoors (whichever is lower) and 50% capacity or 1,000 people indoors (whichever is lower)
    Tier 2 (High alert)No mixing of households indoors, apart from support bubbles. Maximum of six outdoorsPubs and bars must close. Restaurants can only serve alcohol with meals. Venues must stop taking orders at 10pm, close by 11pmOpenSchools and universities openReduce travelling if possible. Avoid entering a Tier 3 area15 guests for weddings and 30 for funeralsClasses and organised sport can take place outdoors, but not indoorsOutdoor/airtight visits onlyLimited to 50% capacity or 2000 people outdoors (whichever is lower) and 40% capacity or 1000 people indoors (whoever is lower)
    Tier 3No mixing of households indoors, apart from support bubbles. Maximum of six outdoorsHospitality is closed, with exception of sales by takeaway, drive-through or deliveryRetail, indoor leisure, personal care and places of worship open. Entertainment venues, accommodation closedSchools and universities openOvernight stays advised to be avoided. Avoid travelling outside own area if possible15 guests for weddings and 30 for funeralsClasses and organised adult sport can date place outdoors onlyOutdoor/airtight visits onlyEvents should not take place; drive-in events permitted
    Tier 4No household mixing, apart from support bubbles. Maximum of two people mixing outdoorsHospitality is closed, with exception of sales by takeaway, drive-through or deliveryEssential shops open only; all other venues closed. Places of worship open for private prayer and communal worshipSchools and universities openOvernight stays must be avoided. Travel is only permitted for work or education. Must not leave a Tier 4 areaSelected funerals of up to 30 people permitted onlyExercise is permitted on an individual basis only, with household or support bubble or with one person from another householdOutdoor/airtight visits only, Clinically extremely vulnerable advised to stay home as much as possible, except to go outdoors for exercise or to attend health appointmentsEvents should not take place
    Lockdown Regulations in March 2020 – July 2020No mixing of household until 13 June 2020, when support bubbles were instigatedAll closedAll closed apart from essential shops. Outdoor non-food markets can reopenAll closedOvernight stays not permittedOnly certain funerals permittedOutdoor exercise alone or with other members of the household permitted onlyNot permitted; 13 June rules were relaxed to allow some to visit care homesEvents should not take place
    Lockdown Regulations in January 2021No mixing of households, apart from support bubblesHospitality is closed, with exception of sales by takeaway, drive-through or deliveryAll closed apart from essential shops. Places of worship open for private prayer and communal worshipSchools open for vulnerable children and children of critical workers. Universities open for students in medicine/dentistry/health/social work/veterinary science/educationOvernight stays must be avoided

    Travel is only permitted for work or education
    Funerals allowed, maximum of 30 people.

    Weddings allowed for 6 people
    Outdoor exercise alone or with other members of the household permitted onlyCare home visits can take place with arrangements such as substantial screens, visiting pods or behind windowsEvents should not take place
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The new UK SARS-CoV-2 variant and lockdown – causes and consequences
Daniel Pan, Nadeesha Lakmal Mudalige, Shirley Sze, David Koeckerling, Oluwatobiloba Oyefeso, Joseph Barker, Caroline ML Williams, Julian W Tang, Manish Pareek
Clinical Medicine May 2021, 21 (3) e295-e299; DOI: 10.7861/clinmed.2021-0019

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The new UK SARS-CoV-2 variant and lockdown – causes and consequences
Daniel Pan, Nadeesha Lakmal Mudalige, Shirley Sze, David Koeckerling, Oluwatobiloba Oyefeso, Joseph Barker, Caroline ML Williams, Julian W Tang, Manish Pareek
Clinical Medicine May 2021, 21 (3) e295-e299; DOI: 10.7861/clinmed.2021-0019
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