England’s three-tier system of Covid-19 restrictions will have to be strengthened to get the country through the winter months, a senior health official has said, hinting at a possible new tier 4 of tighter restrictions in December, when the lockdown is due to be lifted. The tier system, introduced last month, put areas into different categories labelled medium, high or very high risk, or tiers 1, 2 and 3 respectively. The health secretary, Matt Hancock, said the government hoped the national lockdown would be replaced on 2 December with a tiered system “similar to what we had before”. But Dr Susan Hopkins, an epidemiologist, told the Downing Street press conference on Monday that tier 1 coronavirus restrictions had “little effect”, while the impact of tier 2 varied in different places. Hopkins, a Public Health England director advising the government’s coronavirus response, said: “We have recognised that the tiering of the country has had a different effect in each area. “Tier 3, and especially tier 3 plus in the north, has had an effect in reducing the numbers of cases in the north-west and we can see the north-west’s declining number of cases now. “Tier 2 seems to hold in some areas and not so well in others, and so really it depends on how fast transmission is occurring and how well the individuals in the population are taking that advice in. “We see very little effect from tier 1 and I think when we look at what tiers may be there in the future, we will have to think about strengthening them in order to get us through the winter months until the vaccine is available for everyone.” Hancock has said it is too early to know the impact of the second lockdown in England, but he hopes measures can be eased on 2 December. He told the press conference: “It is too early for us to know what the number of cases will be as we come to the end of the current lockdown. “At the moment, most of the tests we’re getting back, and most of the positive cases, are from around the time the lockdown came in, so we are yet to see in the data – and it’s too early to expect to see in the data – the impact of the second lockdown. “But we absolutely hope to be able to replace the national lockdown with a tiered system similar to what we had before.” At a briefing on Monday, the prime minister’s official spokesman told reporters: “We are committed to setting out next week what the replacement regime will be and that will be a return to the localised approach, and we’re actively working on those plans at the moment.” The government said a further 213 people had died within 28 days of testing positive for Covid-19 as of Monday, bringing the UK total to 52,147. There had been a further 21,363 lab-confirmed cases of coronavirus in the UK as of 9am on Monday.