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Boris Johnson had no choice but to tighten restrictions

With the R rate above one, hospitals struggling, and a new strain spreading across the South East, the PM's hands were tied

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The Prime Minister may be famed for his boosterism but he was left with no choice other than to act on Saturday and tighten restrictions across the country for Christmas.

Virtually every shred of data was stacked against him. The R rate across the country has again moved above one, meaning the epidemic is growing exponentially. Hospitals in many areas are already struggling. And in London and the South East, where cases are up by over 50 per cent, a new strain of the virus is rapidly carving out a foothold for itself.

The new rules (a full lockdown for the capital and much of the South East of the country, and household mixing limited to just Christmas Day for other areas) aim to stop the virus moving between households and generations. It is also designed to try and stop the new, faster-moving strain of the virus being carried across the country.

“When the virus changes its method of attack, we must change our methods of defence,” said the Prime Minister.

Critics will say the Government should have acted sooner. They point not just to upward trending UK data but the experience in Europe where the epidemic has also been growing rapidly, even without the new mutation for weeks now.

Take Sweden, for example, which until 4pm on Saturday had tougher Christmas guidance than our own. The country’s once laissez-faire approach to Covid mitigation has led to a fearful new spike in deaths in recent weeks, dwarfing those of its Nordic neighbours by a factor of between five and ten. Hospital capacity is so stretched that Finland and Norway have offered help and King Carl XVI Gustaf, Queen Victoria’s great-great-grandson, has publicly declared his country’s response to the virus a failure.

Across Europe, governments have been imposing tighter measures ahead of Christmas. France, Germany, Holland and Italy have already announced hard lockdowns. They all are trying to get ahead of SARS-CoV-2 which – as long predicted – is making the most of cold and the huddling together of its human hosts that the season forces.

UK ministers have been reluctant to spell it out but a traditional British Christmas has always had the potential to become the ultimate super-spreader event – new variant or otherwise. It ticks almost every box: boisterous, close, sustained, intergenerational, multi-household mixing, all held indoors with the central heating turned up.

Even Santa can prove lethal. Last week more than 75 residents and staff were reported to have contracted the virus after a Covid-positive Saint Nicholas handed out gifts at the Hemelrijck care home in Antwerp, for example.

An analysis for The Telegraph by Edge Health, a leading data consultancy used by the NHS, reveals a range of possible scenarios for January, each pivoting on the impact Christmas could have on the reproduction rate (R) of the virus.

If family gatherings lift the R rate by 30 per cent – as happened after Thanksgiving in parts of the US – the projections suggest deaths in England will peak at over 4,000 a week at the end of January.

Only if household mixing was banned completely from Monday and fully complied with do the numbers improve. In this “counterfactual” scenario, the second wave of the epidemic fades over January and we avoid a third major spike.

George Batchellor, a co-founder of Edge Health, said it was impossible to predict the exact impact of Christmas because so much depended on people’s behaviour.

“Our modelling looks at a range of possible scenarios. The lowest risk scenario considers the effect of moving back into a national lockdown from next week. Another is based on what has been seen in America after Thanksgiving, which led to an estimated 20 per cent increase in cases and a 30 per cent increase in deaths”.

Professor Adam Kucharski, an epidemiologist at the London School of Hygiene and Tropical Medicine, said the impact of Christmas on the epidemic would hinge on a trade-off.

“With schools and some workplaces closed, there will be fewer opportunities for outbreaks to spread between households, but larger multi-household gatherings would mean any outbreaks that do occur within bubbles would be bigger,” he said.

“A lot depends on what people do in the week before and after Christmas, because this will influence the chance infection gets into a bubble, and the chance it spreads more widely if an outbreak does occur.

“We know that per-contact risk within households is higher, particularly during multi-day gatherings, and the close-knit nature of a family Christmas could drive this even higher.

“In terms of impact, the most dangerous gatherings will be the ones where attendees with a high chance of recent infection mix with people who have a high risk of severe disease”.

Almost every year British hospitals fill up in the weeks following Christmas threatening a crisis in the NHS. This is caused by a range of factors – including social care staffing issues – but a large part of it is dictated by Christmas itself and the rules of contagion.

A paper published early this month in the Journal of Infection describes how pneumonia in older groups is associated with holiday periods. It suggests that children and young people catch respiratory infections in the run-up to Christmas and pass it to older groups who come down with pneumonia a few weeks later. The same is likely to be true of Covid.

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