UK Edition
Boris Johnson was on Thursday night embroiled in a standoff with Labour mayors and his own health advisers over his plans for local lockdowns.
Andy Burnham, the Mayor of Greater Manchester, effectively held the Government to ransom by demanding more money for supporting a move into the top tier of restrictions, while health chiefs warned that a national "circuit-breaker" lockdown may be necessary.
Meanwhile Sadiq Khan, the Mayor of London, was accused of bouncing ministers into imposing draconian new restrictions on the capital that will decimate its economy.
Mr Johnson is expected to impose the highest level of Covid-19 restrictions on Greater Manchester on Friday, with or without Mr Bunham's consent, while Lancashire was close to agreeing to Tier 3 status on Thursday night.
The Prime Minister now faces an intense struggle to salvage the three-tier policy. His own scientific advisers believe the system will ultimately fail and that "circuit breakers" will be necessary, potentially every school holiday.
The deputy chief medical officer, Jonathan Van-Tam, also appeared to have written off the tiers approach by telling Northern leaders a national lockdown was the only policy guaranteed to work.
It led to Mr Burnham accusing the Government of using Northern cities as "canaries in the coalmine" for an experimental strategy "that their own experts tell them might not work".
Hospital leaders have joined those calling for a "circuit-breaker" to ease pressure on ward beds.
Chris Hopson, the NHS Providers chief executive, said the service faced a "perfect storm" of tired staff, the loss of up to 30 per cent of capacity to keep Covid and non-Covid patients separate, and attempts to do "three things at once".
Asked whether he thought a "circuit-breaker" was required, Mr Hopson said: "My sense is what we need to do is err on the side of caution to ensure that the NHS has the capacity that it has got to treat every patient over winter... that is a yes."
Northern Ireland has already introduced a month-long lockdown, and the Welsh Government has indicated that it will announce a "circuit-breaker" over the school half-term in the coming days.
Mr Johnson has not ruled out a two-week national lockdown in England, starting at half-term, but is desperate to avoid countrywide measures.
Ministers believe the Prime Minister will announce a series of regional "circuit-breakers" at the end of next week if the three-tier system fails to halt the rise in coronavirus cases. On Friday, cases in the UK stood at 18,980, with 138 deaths.
Meanwhile, Tory MPs accused Downing Street of imposing restrictions on London in order to appease the North. Conservative backbenchers also suggested the country was being put into "lockdown by stealth" after the latest measures left more than half the UK population living under some form of enhanced restrictions.
On a bruising day for Mr Johnson, a series of meetings with Northern leaders failed to persuade them to accept Tier 3 status for Greater Manchester and Lancashire.
Matt Hancock, the Health Secretary, had been expected to announce third tier status for the North-West at 11.30, but instead brought forward an announcement on London's fate in what was seen as an attempt to take the sting out of the North-South divide row.
In a series of testy meetings, Northern mayors, council leaders and even Tory MPs railed against Tier 3 status, demanding that Mr Johnson restore the furlough scheme to pay 80 per cent of wages if people were unable to work.
The Government refused to budge, meaning the Prime Minister is now expected to impose the tougher lockdown on Greater Manchester with or without its leaders' consent. Whitehall officials were understood to be drawing up regulations for Greater Manchester to be laid in Parliament on Friday.
After talks between ministers and local leaders had ended in acrimony, Mr Burnham called a press conference at which he said the North was "fed up of being pushed around" and was being treated "as canaries in the coalmine" for an experimental regional lockdown strategy.
He said Prof Van-Tam had told him a nationwide lockdown was the "only certain thing to work".
"They are asking us to gamble our residents' jobs, homes and businesses and a large chunk of our economy on a strategy that their own experts tell them might not work," he added. "We would never sign up for that... they are willing to try and sacrifice jobs and businesses here to try and save them elsewhere."
Government sources insisted the restoration of the furlough scheme demanded by Mr Burnham "is not happening", with one saying: "They are using this as an opportunity to leverage some more cash out of us, but it won't work. We are not going to move on this."
Mr Burnham had an ally in the form of Sir Graham Brady, the Conservative MP for Altrincham and Sale West and the chairman of the 1922 Committee of backbench Tories, who said: "The danger is that if you try to do these things without consent, people lose patience very quickly.
"We have a very clear demonstration at the moment that if you have no support amongst members of Parliament, no support from the council leaders and opposition from the Mayor as well, there clearly isn't the broad consent for this measure that would be needed. And I think it would be a very foolish thing to do."
Mr Hancock responded by saying leaders in the North-West should "set aside the party politics".
"The situation in the North-West of England is severe," the Health Secretary said. "The number of cases is rising exponentially, the number of people in hospital has doubled in just the last 12 days... this is a time for people to come together so that we can control this virus."
Mr Khan had actively pushed for London to be moved from Tier 1 to Tier 2, saying the NHS was struggling to cope because of staff shortages as the infection rate rose.
Essex, York, Chesterfield, north-east Derbyshire and Barrow-in-Furness were also moved up to the second tier, but Tory MPs hit out at the restrictions on the capital, saying they had been used as a sop to the North.
The former Conservative leader Sir Iain Duncan Smith said many boroughs in London had low infection rates and blanket measures for the whole city were seen by voters as "a London-wide Tier 2 to stop the North-South divide argument running".
Sir Iain also said that, with 51 per cent of the population now living under enhanced restrictions, "my concern now is that we will reach a national 'circuit-breaker' by piecemeal".
Urging Mr Johnson to think again, Sir Bob Neill, the Conservative MP for Bromley and Chislehurst, told The Telegraph: "I certainly think it's ill-judged, it's politically inept and naive. I don't think it's justified by the evidence. London is much bigger than any of the other cities we are talking about. It shows a poor understanding of London, and it will simply clobber businesses in the suburbs."
The capital's seven-day average for new cases has risen to 97 per 100,000 people. In Ealing, the worst-hit borough, the case rate stands at 145, while in Bexley the level is lowest at just 69.
Bob Blackman, the Tory MP for Harrow East, added: "I've been saying it's ridiculous that we would treat London as a whole. This broad brush approach, when the infection rates are very different between boroughs, is just rubbish."
On Friday, Government scientists suggested "circuit breaker" lockdowns should be planned for every school holiday for the foreseeable future.
Advisers indicated that the "rule of six" is "useless" and in fact increases the risks of transmission. They believe a series of two-week lockdowns for half-terms, Christmas and into next year is the best way to minimise disruption.
Vice-chancellors are preparing for an end of term testing blitz to get university students home for Christmas, saying a fortnight lockdown is "nonsensical". University leaders are opposed to Government proposals to place students in effective lockdown for two weeks before Christmas, keeping them on campus with all teaching online.
The move is designed to deliver on Mr Johnson's pledge to "get students home safely for Christmas" but stop Covid from spreading with the mass movement of students at the end of term.