Northerners are twice as likely to get Covid-19 than people in other parts of England, figures show.
A study found coronavirus cases are doubling twice as fast in the North West and Yorkshire, as well as the West Midlands.
But in London, the R value – the disease's reproduction rate – may actually have dropped below one, meaning it will eventually stop spreading.
The React report, the largest study of its kind, suggests one in 100 people in the north currently have the virus, while across the country it is one in 170.
There are an estimated 45,000 new infections each day in England.
Imperial College London experts behind the report suggested the rate of growth has slowed in the last month.
But they warned the country was now at a "critical point in the second wave” and called for further measures to curb the disease.
They said these “should be considered to reduce the infection rate and limit the numbers of hospital admissions and deaths”.
And they warned current measures – such as the rule of six and restrictions in the north – will not be enough to bring the virus under control.
Professor Steven Riley, from Imperial, said there was evidence of "continued growth and possibly rapid growth" in northern regions.
He said the data supported further restrictions in the north "sooner rather than later".
But he added "prevalence is high” across England.
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And he warned parts of the country are not far off reaching the high number of cases seen earlier in the year.
He said: "If things don't change and the patterns that we describe continue, then in a relatively short period of time we will get back to comparable prevalences in some parts of the country."
The report, which looked at Covid-19 swabs, found cases are doubling every 29 days in England.
But the North West it is doubling every 17 days, 13 days in Yorkshire and 14 days in the West Midlands.
The study put the crucial R value – the number of people someone will pass the bug on to – at 1.27 in the North West, 1.37 in Yorkshire and 1.33 in the West Midlands.
But in London, scientists estimated it was 0.97..
They say the high number of cases during the first wave may have had an effect on the capital by building some immunity, although overall it “is quite low”.
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