Pressure has been mounting on ministers to expand Tier 4 restrictions in the face of increasing strain on hospitals in England where the number of patients has surpassed the April peak of the first wave.
Whitehall sources suggested to The Daily Telegraph that millions more would fall under the harshest rules with “sizeable chunks” of the Midlands and the North expected to enter the highest tier.
The NHS is said to be weeks from collapse in the UK. 
However, Andrew Hayward, professor of infectious diseases epidemiology at University College London, and a member of the government’s new and emerging respiratory virus threats advisory group, said “even higher” tiers would be required to cope with the new mutant strain of the virus.
“I think we are entering a very dangerous new phase of the pandemic and we’re going to need decisive, early, national action to prevent a catastrophe in January and February,” he said.
“A 50 per cent increase in transmissibility means that the previous levels of restrictions that worked before won’t work now, and so Tier 4 restrictions are likely to be necessary or even higher than that.”
A Whitehall source told The Mirror that the Tier 4 rules do not appear to be working. The source even suggested that the government could introduce “another level on to Tier 4, so like a Tier 5”.
Meanwhile, the government’s scientific advisory group for emergencies has urged the Prime Minister to introduce a national lockdown, as they said “the pandemic in England is now at the most threatening stage of the entire year”.
They cited that as of Monday there were more people in hospital with COVID-19 than at any point during the pandemic and called for a “radical rethink of how we deal with COVID-19 going forward”.
“The existing tier system in England is simply not sufficient, even where the new variant is rare,” they added.
Stating that cases have “quadrupled since lockdown” in areas that are currently under Tier 4 restrictions, it warns that if cases in London, Kent and other parts of East England do not plateau and “reduce soon, then we cannot expect Tier 4 to be enough to contain COVID-19 in England”.
Christina Pagel, professor of operational research, University College London, said: “Things are as bad as they have ever been.
“The frightening thing is that they are going to continue to get worse. Action is needed now to avoid the collapse of the NHS in a few weeks. It is that serious.”
The Telegraph London