The UK's coronavirus reproduction (R) number has fallen slightly to between 1 and 1.2 across the UK, but deaths will keep rising, say Government scientists.
Analysis from Scientific Advisory Group for Emergencies (Sage) suggests infections are likely to increase again in December if lockdowns are lifted everywhere.
It suggests local restrictions will be needed in certain areas in the weeks before Christmas.
Sage warned that the virus is still spreading and deaths and demand for healthcare will carry on unless R drops below one for an extended period of time.
It said the number of new infections is growing by between 1% to 3% every day.
For the past few weeks, it has put the R at between 1.1 and 1.3.
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If the R value is above one then the Covid-19 epidemic continues to grow, but if it is below one it shows the outbreak is in retreat.
Separate Sage documents released on Friday indicate the national outbreak is still at a “high and controlled” phase.
If this remains the case, or if the outbreak returns to current levels after national lockdown is lifted on December 2, Sage advised that there is “little to no scope for loosening of social distancing rules over Christmas”.
The official R reproductive number is still above 1 because infections are still increasing among the elderly.
For England the R is slightly higher at between 1.1 and 1.2, down from a 1.1-1.3 range the previous week.
These are the R numbers across England:
- South East 1.2 to 1.4 (unchanged from a week ago)
- South West 1.2 to 1.4 (unchanged)
- East of England 1.1 to 1.4 (unchanged)
- Midlands 1.1 to 1.3 (unchanged)
- North East and Yorkshire 1.0 to 1.2 (down from 1.1 to 1.2)
- London 1.0 to 1.2 (down from 1.1 to 1.3)
- North West 0.9 to 1.1 (down from 1.0 to 1.1)
While the publication is focused on England, it suggests R could have dropped below 1 in Wales and Scotland.
The pessimistic outlook came after two independent studies, which feed in to Sage, suggested R could now be below 1 in England.
In its latest weekly R announcement, Sage said: “The estimated growth rate means the number of new infections is growing by between 1% and 3% every day.
"Sage is confident that the epidemic has continued to grow in England over recent weeks.
"Although there is some evidence that the rate of growth in some parts of the country may be slowing, levels of disease are very high in these areas; significant levels of healthcare demand and mortality will persist until R is reduced to and remains well below one for an extended period of time."
The findings suggest Tier 3 and in some areas Tier 2 restrictions were working to get the R value below 1. However, Government scientists believe Tier 1 restrictions were having little impact.
In towns and cities in England which had been under Tier 3 restrictions before national lockdown R is below 1 and new infections are falling.
The only whole region to have an R potentially below 1 was the North West with a range of between 0.9 and 1.1.
It comes as daily confirmed coronavirus cases jumped by 46% to 33,470 on Thursday.
Some officials have suggested the increase - the highest to date - is as a result of people going out and socialising just before the current lockdown period began on November 5.
NHS medical director Stephen Powis played down the impact of the rise at a Downing Street press conference on Thursday.
He said it was "important to look at the number of cases reported over a number of days and not just take one day in isolation".
A further 563 people had died within 28 days of testing positive for coronavirus as of Thursday.
At least 200 UK frontline health and care workers have now died after contracting coronavirus, it was confirmed on Friday.
The list of health and social care workers includes those who were working in roles shortly before their deaths where they were likely to come into contact with patients.
The most recent victim was consultant anaesthetist Dr Krishnan Subramanian, who died on Thursday.
"Quiet and dedicated" Dr Subramanian, who was in his late 40s, worked at the Royal Derby Hospital.
He was being treated at Glenfield Hospital in Leicester before his death.
The figure emerged as England's former chief medical officer claimed the country was ill-prepared for the coronavirus pandemic as officials felt a virus would "never travel this far".
Dame Sally Davies, who left the role in October 2019, said she questioned whether the country should rehearse for a coronavirus outbreak in 2015 but was told it would not "reach us properly" by Public Health England officials.
She told the Daily Telegraph officials focused on the threat of pandemic influenza and was therefore prepared for the "wrong pandemic".
But Public Health England said this is not true, adding: "Dame Sally Davies participated in exercises which planned specifically for a MERS coronavirus scenario in the UK amongst other health threats."
Dame Sally, who left the role last October, told the paper the country was "not as well prepared as we should have been".
She added: "I did ask during a conversation in my office in around 2015, should we do Sars? But I was told no, because it wouldn't reach us properly. They said it would die out and would never travel this far.
"So I did ask, but it was the Public Health England people who said we didn't need to do it, and I'll say that to Parliament.
"That advice meant we never seriously sat down and said: 'Will we have a massive pandemic of something else?"'
Nearly 67,000 deaths involving Covid-19 have now occurred in the UK, the latest figures show, while, as of 9am on Thursday, there had been a further 33,470 lab-confirmed cases of coronavirus in the UK, the highest daily figure recorded since the outbreak began.
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A Government spokesperson said: "This is an unprecedented pandemic and we have taken the right steps at the right time to combat it, guided at all times by the best scientific advice, to protect the NHS and save lives.
"There is a huge amount of work going on behind the scenes, all of which would not be possible without the years of preparation undertaken for a pandemic, including flu and other infectious diseases like MERS, SARS and Ebola."
A spokesman for Public Health England added planning for an influenza pandemic was the focus as it was top of the National Risk Assessment.
They added: "In all of our time working with Dame Sally Davies we agreed that the country should prepare for all health protection threats including infections caused by different organisms such as coronaviruses."
Meanwhile, almost 20% of Liverpool residents have taken part in a mass coronavirus testing pilot in its first week, according to figures from the city's mayor.
Joe Anderson said 90,000 people had been tested for Covid-19 since last Friday, when the city began offering tests to everyone regardless of whether they have symptoms.
The figure is 18% of the city's population of just under half a million.
Mr Anderson told BBC Breakfast 430 people had tested positive, with only about 200 of them showing symptoms before they had a test.