Phil Day By Superintendent Pharmacist Published:

The latest government update on the 19th December has announced some further changes from those recently announced a few days ago, including a new tier 4, consisting of stricter measures for those in London, the South East and the East of England. The PM has also announced a restriction on the ‘Christmas Bubble’ limiting it to just one day and a new learnings about a new variant of the virus, causing this increase in the spread of COVID-19.

According to the PM and NERVTAG (New and Emerging Respiratory Virus Threats), there is no evidence the new variant of the virus causes more severe illness, but it does appear to be passed on significantly more easily.

The Government review on the 16th December brought in some changes to the tiers that each area of England is in. This review comes 2 weeks after the tier system was reintroduced, following the end of the national lockdown on the 2nd December.

Over the past week, London and some parts of South East of England, moved from tier 2 into tier 3, and now to tier 4 due to continued large increases in confirmed coronavirus cases in those areas. The new rules from the Prime Minister’s most recent update will be in place from the 20th December. Full guidance on tier 4 can be found here.

You can find out if the tier you are in has changed, as well as the most up to date coronavirus restrictions in your area on the Government website. Just enter your postcode to check your tier or you can view the full list of revised tiers.

How will this impact ‘Christmas bubbles’?

The plan from the Government to relax the rules from the 23rd to the 27th December has now changed. People living in tier 4 areas should not mix with anyone outside their own household at Christmas (except for anyone in their support bubble, this is not the ‘Christmas Bubble’). Across the rest of the country, the Christmas Bubble allowing up to three households to meet will now be limited to just Christmas Day, instead of the five days as previously planned.

A small and shorter Christmas is a safer Christmas and we therefore advise people to follow the recommended precautions:

KEEP IT SMALL

KEEP IT SHORT

KEEP IT LOCAL

THINK OF THE VULNERABLE

The guidance is that if possible, keep the number of people you come in contact with as low as you can and even though it is allowed, you should try avoid travelling and overnight stays. If you are planning on seeing an elderly relative you may want to delay seeing them until after they have been vaccinated against Covid-19.

There will also be no relaxation of the rules on 31 December, so people must not break the rules at New Year.

What can and can’t I do in my Christmas Bubble?

People living in a tier 4 area cannot meet with anyone outside of their household or support bubble for Christmas. For those in tiers 1-3 you cannot meet your Christmas bubble in any other indoor setting such as a pub, hotel, shop, theatre or restaurant. In these settings, the rules on who you are allowed to meet depend on the tier you are in. 

You may travel between tiers and other nations of the UK if absolutely necessary, to meet with other households in your Christmas bubble or return home. Once at your destination, you should follow the rules in the tier that your location is now in following the new update. 

If you are vulnerable or clinically extremely vulnerable, forming a bubble carries additional risks. You can take extra precautions which have been set out by the Government and others in your bubble should be extra vigilant in the days prior to getting together, to reduce the risks of catching and spreading the virus.

Patients and their families should continue to stay safe by doing what they can to minimise the risk of catching the virus. The Pharmacy2U NHS repeat prescription service can help make sure you and your family get your medication over the festive period, without having to make unnecessary journeys and avoiding queues.

So far we’ve helped save our patients over 3.5 million trips outside since lockdown, so if you have or know someone with a health condition, find out more about our service today.

Find out more today

How tiers are decided?

The department of health review and decide the tiers based on the below factors

  • 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)
  • local pressure on the NHS, including current and projected occupancy

Rules for all tiers

  • Face coverings – should be worn in most indoor public spaces (unless you’re exempt).
  • Education – all schools, colleges and universities remain open and should be attended as normal, unless you have to self-isolate. 
  • Businesses – all those allowed to remain open can do so but must follow COVID-19 secure guidelines.
  • Commuting – avoid peak times and routes, and try to walk and cycle where possible.
  • Socialising – make sure you follow the restrictions and limits for your tiers, apart from any specific exceptions.

Rules for individual tiers


The restriction in this new tier will be broadly equivalent to the national lockdown restrictions which were in place in England in November.

Socialising
You must not socialise indoors or in most outdoor spaces with anyone outside of your household or support bubble, including private gardens. You can only meet one person from another household in an outdoor public space.
Shops and services
Non-essential retail and personal care services will be closed.
Hospitality
All hospitality venues serving food or drinks must close, but are permitted to open for takeaway services. Accommodation venues must close. Indoor entertainment and tourist venues must close. Such as: casinos, cinemas, theatres, theme parks, indoor play centres and more. Indoor attractions at mostly outdoor entertainment venues must also close.
Public events
Attendance at outdoor and indoor events is not allowed apart from the exception of drive through events.
Sport
Indoor gyms and leisure facilities must close.
Travelling
Residents must stay at home, apart from limited exemptions set out in law. People should not enter or leave a tier 4 area, and tier 4 residents must not stay overnight away from home. Those in tier 4 areas will not be allowed to travel abroad apart from limited exceptions, such as for work purposes.

Socialising
You must not socialise indoors or in most outdoor spaces with anyone outside of your household or support bubble, including private gardens. You can see friends and family outside your household and support bubble in some outdoor public spaces only, such as parks (in a maximum group of 6).
Shops and services
Can remain open unless they’ve been asked to remain closed by law, such as nightclubs.
Hospitality
All hospitality venues serving food or drinks must close, but are permitted to open for takeaway services. Accommodation venues must close.Indoor entertainment and tourist venues must close. Such as: casinos, cinemas, theatres, theme parks, indoor play centres and more. Indoor attractions at mostly outdoor entertainment venues must also close
Public events
Attendance at outdoor and indoor events is not allowed apart from the exception of drive through events.
Sport
Organised outdoor sport can resume, however higher-risk contact activity should not. Indoor sport classes aren’t allowed but leisure and sports facilities may stay open.
Travelling
Avoid travelling outside of your area, including for overnight stays other than where necessary, such as for work.

Socialising
You must not socialise indoors with anyone outside of your household or support bubble. You can still see friends and family outside of your household and support bubble (but in a maximum group of 6) in a private garden or other outdoor space.
Shops and services
Can remain open unless they’ve been asked to remain closed by law, such as nightclubs.
Hospitality
Permitted to open but must close between 11pm and 5am, unless they offer a takeaway service. This early closure also applies to casinos, cinemas, theatres, theme parks and other like activities.
Public events
Attendance at outdoor and indoor events is allowed but with a limited capacity.
Sport
Organised outdoor sport can resume and indoor sport classes will only be permitted if it is possible for people to avoid mixing with those outside their household/support bubble.
Travelling
If you travel to an area in a higher tier you must follow the rules for the area you are visiting. It’s recommended you avoid going to a tier 3 area other than for essential travel.

Socialising
Maximum of 6 people to meet at any one time, indoors or outdoors.
Shops and services
Can remain open unless they’ve been asked to remain closed by law, such as nightclubs.
Hospitality
Permitted to open but must close between 11pm and 5am, unless they offer a takeaway service. This early closure also applies to casinos, cinemas, theatres, theme parks and other similar venues.
Public events
Attendance at outdoor and indoor events is allowed but with a limited capacity.
Sport
Organised outdoor sport can resume and indoor sport classes must follow the ‘rule of 6’.
Travelling
If you travel to an area in a higher tier you must follow the rules for the area you are visiting. It’s recommended you avoid going to a tier 3 area other than for essential travel.

Our Superintendent Pharmacist has written some helpful advice about how you can reduce the risk of catching and spreading Covid-19 over the festive season here, helping to keep you and those in your Christmas bubble safe and healthy.

Please continue to follow NHS and government guidance and remember: hands, face, space.

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