Potholes – Britain’s big pothole problem | Britain

LAST DECEMBER, councillors Bob Smytherman and Martin McCabe threw a birthday party—not for a friend, a relation or a celebrity, but for a pothole. Cars in Worthing, West Sussex, had been bumping over it for a full two years, despite pleas that it be mended. The stunt worked. The following day it was filled in, and a second party—a lavish affair, with cake and candles—marked its demise. But plenty of its fellows survive. Mr Smytherman says the town has so many craters, it’s like “walking on the moon”.

Potholes arouse passions in Britain—not surprisingly, since the country’s road quality ranks 37th in the world, between Slovenia and Lithuania. Councils received 700,000 complaints about potholes last year, says the Federation of Small Businesses. The weather, a topic even more popular among the natives than potholes, is mostly to blame. Potholes form when water seeps under the road surface, breaking the tarmac as it expands and contracts. Budget cuts in the wake of the financial crisis did not help. The Local Government Association (LGA) says road maintenance budgets fell from £1.1bn in 2009 to £701m in 2017—the equivalent of 8m potholes. The Asphalt Industry Alliance claims there is a road-repair backlog of £11bn.

But there may be relief in sight for the suspension of the British motor car. Politics is one reason. Traditional Tories—who love cars, particularly fast ones, and tend to live in the countryside, so rely on roads—are particularly infuriated by them. Northern “red wall” seats that the Tories won from Labour in the last election tend to be rural places where the roads are bumpier and the weather worse. Nottinghamshire, home to several of those contested seats, is Britain’s pothole capital, with 253,920 reported in 2017-19. Hence the promise in the Tory manifesto of the “biggest-ever pothole-filling programme”, and a promise of £2.5bn over five years.

Covid is also fuelling the drive against potholes. Rishi Sunak, the chancellor, needs shovel-ready spending opportunities to justify his claim in the spending review on November 25th that “we’re prioritising jobs”. Potholes are ready and waiting for those shovels—hence his commitment that £1.7bn would be spent this year.

Innovation should help get the job done. Rubberised asphalt is spreading across the nation’s roads. Adding shredded tyres to the bitumen used to make asphalt creates an elasticity that helps it mould into the existing road and stops it breaking down as easily. Tarmac, a materials company, is supplying it to several councils. Sheffield council is trying out a simpler version, designed by another company, Roadmender Asphalt. Cumbria is experimenting with recycled plastic as a bitumen substitute, and in Oxfordshire and Kent “Gipave”, a material made from adding a graphene-based additive to asphalt, is being used to resurface entire roads. It is 15-20% more expensive than asphalt but has twice the lifespan.

Repair design may help, too. Potholes are normally repaired by cutting squares out of the asphalt around them, but corners encourage water ingress, so Roadmole, a small road-repairing firm, produces a remotely controlled machine that cuts circular holes instead. The firm claims that none of the potholes they have fixed in the past eight years has needed to be redone.

In order to innovate, councils need cash. David Renard, the LGA’s transport spokesman, says the government’s bung will help fix the backlog. But the supply of candidates for repair never dries up. Back in Worthing, Mr Smytherman says that his celebrated pothole is beginning to reappear. Another party looms.

This article appeared in the Britain section of the print edition under the headline “Revolutionary roads”

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Brighton 1-1 Liverpool FC LIVE! Latest score, goal updates, team news, TV and Premier League match stream

Saturday’s early Premier League kick-off comes at Amex Stadium, where Liverpool will attempt to reclaim top spot and put some early pressure on their title rivals ahead of a big weekend of action.

The Reds currently trail leaders Tottenham – who face third-placed Chelsea in a huge London derby on Sunday – on goal difference only at the top-flight summit after overcoming an injury crisis to easily dispatch of Leicester last weekend.

Jurgen Klopp made the decision to rest a number of his key stars for Wednesday’s Champions League tie against Atalanta – a decision that ultimately proved costly as the Serie A side won 2-0 at Anfield.

The Liverpool boss has registered plenty of displeasure at the scheduling of matches during this most hectic of seasons and will not be pleased to have to contest an early Saturday match straight off the back of a midweek European tie.

Today’s opponents Brighton, meanwhile, currently sit 16th and five points above the bottom three after winning only two of their first nine games in 2020/21.

Solly March’s brilliant strike sealed a dramatic 2-1 win at Aston Villa last weekend, though the Seagulls have lost each of their last nine matches against Liverpool across all competitions and are without the suspended Tariq Lamptey.

Follow all the build-up and match action with Standard Sport’s LIVE blog below…

Brighton: Ryan, White, Dunk, Webster, Veltman, Bissouma, Gross,March, Connolly, Welbeck, Maupay

Subs: Trossard, Lallana, Jahanbakhsh, Alzate, Steele, Burn, Molumby

Liverpool: Alisson, Neco Williams, Phillips, Fabinho, Robertson, Milner, Wijnaldum, Minamino, Firmino, Jota, Salah

Subs: Mane, Adrian, Henderson, Jones, Tsimikas, Origi, Rhys Williams

This weekend get a £10 free bet with Betfair, when you bet £10 on a Same Game Multi on the Premier League.

Terms: Min £10 Same Game Multi bet on any EPL match this Fri- Sun. Free bet valid for 72 hours, awarded at bet settlement. Excludes cashed out bets. T&Cs apply.

Live updates



93min: Gross makes no mistake and Brighton look to have snatched a point!



Robertson fouls Welbeck in injury time!


No goal!

84min: Mane thinks he has headed home a second but he’s offside by a distance.


80min: Into the final 10 minutes and Brighton not showing much threat as they tire.


74min: Curtis Jones is on to replace Milner. Klopp covers his face with a mask, presumably to hide the swearing.


71min: Uh oh. Now James Milner is down and clutching his hamstring.


71min: Uh oh. Now James Milner is down and clutching his hamstring.


Salah subbed off

64min: A surprise from Klopp, who brings on Mane in place of Salah and the Egyptian is fuming.



59min: Jota breaks the deadlock… and what a goal that is!


He skips past one, two, three tackles and squeezes and shot inside his near post.


52min: A similiar start to the second half to what we saw in the first; Liverpool bossing possession but Brighton proving a threat on the counter.

Welbeck just ran through and opted to test Alisson at his near post, saved easily.

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Former youth worker explores reality of child exploitation in debut film County Lines – Channel 4 News

They are children drawn into a dangerous, sometimes deadly world of drugs, crime and violence. County Lines is a new film which explores the reality of child criminal exploitation in all its grimness.

Fiction perhaps, but absolutely rooted in real life, as filmmaker Henry Blake draws on more than a decade’s experience on the frontline of youth work.

County Lines is released in cinemas and digitally on BFI Player and Curzon Home Cinema on 4 December.

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Arsenal’s Dani Ceballos provides transfer advice on Wolves star Adama Traore

Arsenal star Dani Ceballos has given Wolves ace Adama Traore some transfer advice.

It comes as the two sides prepare to go head to head in the Premier League on Sunday night.

The Gunners are desperate for some domestic form after going nearly eight hours without scoring in the league.

It has seen them drop to 12th in the table with one win in five.

They face a Wolves side that have had to contend with a series of transfer rumours surrounding multiple players.

Diogo Jota was the only high-profile departure despite clubs linked to the likes of Raul Jimenez, Ruben Neves and Traore.

Adama Traore has been linked with a move away

Particularly the latter, who has been chased by several elite sides including Manchester United, Liverpool and Barcelona.

And Ceballos has told his countryman that any club would be lucky to have the 24-year-old.

“I think he’s a very special player that any coach in the world would love to have in their team,” Ceballos told the official matchday programme.

It has been a hectic season so far – so make sure you don’t miss a single thing by signing up for the brilliant new Mirror Football newsletter!

All the latest transfer news and big stories will land straight into your inbox. You won’t miss out.

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“Apart from the fact that he’s really intimidating in terms of his physique, I think he’s really improved on a technical level and in terms of cutting inside or going wide, plus he scores goals too.”

One player that looks set to play out his latter years at the Molineux is Joao Moutinho, who works as Nuno Espirito Santo’s midfield metronome.

The 34-year-old is contract to Wolves until 2022 and Ceballos believes he is one of the most important cogs in their machine.

Adama Traore has been linked with a move away

He added: “I think Joao Moutinho is a player we all know about too.

“He’s so important for Wolves because he brings that stability that a team needs and manages the tempo of games.

“He’s a very experienced player and he’ll go down in the history of Portuguese football.

“Nuno has a very well-drilled side that is really recognisable in that 5-3-2 or 5-2-3 formation. They have a really clear style.

“I don’t think there are many other teams in the Premier League that are as well-drilled as they are.

“They’ve started very well this season and last year they only missed out on the Europa League because we won the FA Cup. If we want to get a good result, we’re going to need to be at 100 per cent.”

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what would the rules be, and what UK areas could be affected?

Boris Johnson declined to introduce a fourth tier in his Covid winter plan, instead strengthening the three-tier system which will be introduced on December 2 and stay in place until spring.

The Health Secretary, Matt Hancock, has announced where each region falls in the three-tier system in England, with millions placed under the toughest measures when lockdown ends.

Vast swathes of the country will enter Tier 3, with stricter restrictions meaning pubs and restaurants will close in these areas except for takeaways.

Use our postcode tool to find out which Tier your area is in.

After Scotland introduced a fourth level across 11 of its local authority areas, there was speculation we would see a fourth tier imposed in some high-risk areas in England.

The Prime Minister’s announcement means Christmas is safe from a new Tier, but given the volatile nature of infection rates nothing is off the table, as the Health Secretary Matt Hancock told BBC Breakfast last month. 

Tier allocations will be reviewed every 14 days, with the Government keeping a close eye on infection rates, particularly in the over 60’s.

Here’s what we know about ‘Tier 4’ restrictions if the measure was ever put in place after Christmas.

Why might we need a Tier 4?

In August, the Department for Education published a four-tier structure, in which all educational institutions – including primary schools and early years settings – would be shut. 

On October 26, Health Secretary Matt Hancock told BBC Breakfast: “We’ve always said that we take nothing off the table. Having said that, we have seen the rise in the number of cases has slowed a bit.

“The problem is it’s still going up, and while it’s still going up we’ve got to act to get it under control. We rule nothing out, but at the moment the three-tier system is what we’re working to and it’s effective in slowing the growth of this virus but it hasn’t brought this curve to a halt.”

Government scientists including Prof Chris Whitty (see video below), the chief medical officer, warned that the “base line” Tier 3 restrictions were unlikely to be enough to bring down the R rate alone.  

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Emergency exit – Britain’s vaccine roll-out takes shape | Britain

LOTS OF SPACE and vinyl flooring—that is what local directors of public health want. “The last time you went into an NHS appointment…the floor would have been a certain type of splash-proof vinyl in case you bled all over it or threw up,” says one. It is the sort of floor a mass vaccination centre requires.

The search for suitable venues has just become more urgent. On November 23rd the Oxford/AstraZeneca vaccine team announced positive results (though there are some concerns about the data—see article). A cheap, transportable vaccine would be good news for the world. It would also be good news for Britain, and not just because it would be the product of a British university and an Anglo-Swedish firm.

The government has ordered 40m doses of vaccine from Pfizer and 5m from Moderna, the two other firms to have announced phase-three-trial results. Both require two doses per person. It has ordered 100m from AstraZeneca, which may need just one-and-a-half. If all are approved, the AstraZeneca vaccine would thus accelerate the country’s journey to herd immunity.

That approval is in the hands of Britain’s medicines regulator, the MHRA, which is reviewing data from all three firms. AstraZeneca had planned to have 30m doses ready by September; it missed that target, but is expected to have tens of millions ready when approval is granted. One insider says the hope is to deliver 5m jabs a week by mid-January.

The Joint Committee on Vaccination and Immunisation, which advises the government, has drawn up a prioritisation list, with care-home residents and workers at the top, followed by the over-80s and health-care workers. The MHRA will probably at first offer an emergency-use authorisation, which may restrict vaccination to the most at-risk until more evidence is in.

The British state’s lacklustre response to the covid-19 pandemic provides plenty of reason for trepidation about the roll-out. But unlike the testing programme or track-and-trace, the National Health Service will be running things, removing the need to set up a leadership structure and local organisation from scratch.

It is not an entirely new exercise for the health service. Britain dishes out nearly 15m flu jabs a year. The need to store the Pfizer vaccine at -70°C limits the role of general practitioners (GPs) who deliver much of the flu campaign, since few surgeries have sufficiently icy freezers. But the AstraZeneca vaccine can be kept at 8°C.

Around half of the vaccines will be delivered in the community, the other half in mass vaccination centres. They will spring up in places like hospitals, sports halls and universities. Paramedics, physiotherapists and student medics will be called upon to staff them. So, too, may vets, dentists and trained volunteers, for whom the government has tweaked human medicines regulation to allow them to administer jabs.

All of this is a big ask for the NHS at a time of year when it is normally most stretched. This year’s expanded flu vaccine campaign suffered from distribution problems. GPs are in discussions with NHS leadership about what parts of their job can be put on hold to allow them to focus on vaccination. “We would want to protect patient-facing services,” says Steve Mowle of the Royal College of General Practitioners.

Perhaps the biggest challenge will be the IT system. It will need to contact people at the right time for their first and second jabs, and to integrate information with medical records. This is important, says Penny Ward of the Faculty of Pharmaceutical Medicine, a professional body, so that analysts can trawl the records for unidentified side effects. Not all are optimistic. A scientist advising the government says he cannot think of anything since the start of the pandemic “where we relied on digital support and it happened in a timely way”.

In a programme of this scale, things will almost certainly go wrong. But if enough goes right, there is a glittering prize on offer. By spring, vaccination and increased testing “should reduce the need for economic and social restrictions”, in the words of Boris Johnson. “We should be able to render obsolete the very notion of a covid-19 lockdown.”

Editor’s note: Some of our covid-19 coverage is free for readers of The Economist Today, our daily newsletter. For more stories and our pandemic tracker, see our hub

This article appeared in the Britain section of the print edition under the headline “Emergency exit”

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UK coronavirus LIVE: Covid tiers ‘could change before Christmas’ as London R rate between 1 and 1.1

One source said curbs were not expected to be changed until the new year. But Communities Secretary Robert Jenrick said there was “every reason” to believe some places could see a change when the current tiers are reviewed in mid-December.

Live updates


The New York Post wrote about the UK’s coronavirus plans for Christmas…

… But led with a photo of Paris:


World update: Brazilian president insists, “I will not get vaccinated against coronavirus”

Brazilian president Jair Bolsonaro has said he won’t take any working Covid-19 vaccine himself and called the use of masks “the last taboo to fall”.

Mr Bolsonaro’s comments, broadcast on his social media channels on Thursday night, alarmed health experts who said they could undermine efforts to halt the pandemic.

They warned that his comments might scare off vaccine makers negotiating with local authorities.

However, Mr Bolsonaro said that any vaccine that is certified by Brazil’s health agency will be available for free to the public.

The Brazilian president, who contracted the virus in July, has long resisted the advice of most scientists and health experts to restrict social and economic activity, arguing that damage from a lockdown would be worse than the pandemic.

He also repeatedly promoted an anti-malaria drug as the cure for the disease despite scientific studies finding it ineffective and possibly dangerous.

Mr Bolsonaro also criticised state governors testing a Chinese vaccine at home.

“I tell you – I will not take (any vaccine),” he said.

“It is my right and I am sure that congress will not create difficulties for whoever doesn’t want to take a vaccine.”

He added: “If it is effective, lasting, reliable, whoever doesn’t take it will be doing harm only to himself and whoever takes the vaccine will not be infected.

“There’s nothing to worry about.

A study published on July 15 in the American Journal of Preventive Medicine found that social distancing measures can safely be halted if at least 75 per cent of the population gets a vaccine that is more than 70 per cent effective.

Tests have shown some vaccine candidates have a potential efficacy higher than that.

Miguel Lago, executive director of Brazil’s Institute for Health Policy Studies, said: “Bolsonaro’s statements are a horrible sign.

“If he were a less popular president, this might have little effect. But he is the hero of a lot of people.

“His hardcore supporters might not get a shot and that will generate more political dispute on the right not to get vaccinated.

“That will make it harder for Brazil to get above that minimum level of 70 – 75 per cent of the population vaccinated, which is key for life to go back to some kind of normal.”

( Brazil’s new president Jair Bolsonaro takes office with promises to radically change the path taken by Latin America’s biggest country by trashing decades of centre-left policies. / AFP/Getty Images )

Christmas decoration advice to care homes branded ‘bah humbug’

Advice to care homes warning them to use only artificial trees, wipeable decorations and to have no festive ornaments if there is a coronavirus outbreak this Christmas has been branded “bah humbug”.

The National Care Forum (NCF) said homes had been advised about the “dangers” of Yuletide decorations.

The organisation, labelling it “baublegate”, said it comes at a time when the “hope and joy” of the festive season is needed more than ever.

The NCF said examples of local infection prevention and control (IPC) advice included that there should be no wood, straw or live trees, only laminated single-use decorations should be used, and that there should be no Christmas decorations during an outbreak, or near isolation areas.

It also said advice had been given that cards and decorations should be quarantined for three days before opening, and presents should be brought to homes unwrapped, to be wrapped by staff.

Liz Jones, policy director at the National Care Forum, said “the spectre of infection prevention control overkill lurks”.

She said: “Up and down the country, managers and care workers are digging out the Christmas decorations, untangling the tinsel and dusting off the baubles.

“While Covid has limited so many things in care homes, surely we can still ‘deck the halls’.

“This year, more than any other, the hope and joy of Christmas is needed… But it seems the spectre of infection prevention control overkill lurks.”

She added: “We have yet to find any evidence to underpin this latest flurry of bah humbug advice.

“Quite frankly, IPC advice on Christmas decs is the icing on the (Christmas) cake.

“Christmas decorations can be used safely and sensibly and are a key part of the festive cheer that we all need so badly.

“Baublegate must not happen.”

( Care home residents should still be allowed to enjoy some festive cheer / PA )

Here’s a look at the latest weekly Covid-19 rates for local authority areas in England:

Here are some of the key figures from today’s update on England’s seven-day rate of new cases.

The figures, for the seven days to November 23, are based on tests carried out in laboratories (pillar one of the Government’s testing programme) and in the wider community (pillar two).

The rate is expressed as the number of new cases per 100,000 people.

Data for the most recent four days (November 24-27) has been excluded as it is incomplete and does not reflect the true number of cases.

A majority of areas in England (298 out of 315) have seen a fall in case rates.

Swale in Kent continues to have the highest rate in England, with 841 new cases recorded in the seven days to November 23 – the equivalent of 560.4 cases per 100,000 people.

This is down from 655.0 in the seven days to November 16.

Thanet has the second highest rate, down from 521.4 to 468.6, with 665 new cases.

Boston is in third place, where the rate has dropped from 468.8 to 453.2, with 318 new cases.

The areas with the biggest week-on-week jump in rates are Medway (up from 343.6 to 447.7, with 1,247 new cases); Harlow (up from 151.6 to 225.1, with 196 new cases); and Ipswich (up from 92.0 to 157.8, with 216 new cases).


BREAKING: The latest UK figures are in


Don’t travel to Tier 1 just for a pint, locals plea

A pub owner in Cornwall has asked that people thinking of travelling to the county for a pint “think of others” before doing so amid fears the Tier 1 county could become overwhelmed.

Cornwall is the only area of mainland England that has been placed into the lowest level of measures to reduce the spread of coronavirus.

“I’ve been very restrictive on who can come for a drink and ask that they email/message beforehand so I know who they are and where they have come from,” said Helen Nathan, 36, owner of The Kings Arms in Mevagissey.

“As someone who travels a lot for work outside the pub, I’ve been very responsible and not left Cornwall unless it’s been completely necessary since beginning March. I hoped that others may do the same but Mevagissey has never been so busy during September and October.

“Please think of others as well as your own safety before travelling anywhere outside your region.”

Asked if there was a fear too many people may travel to the county to go to the pub, Ms Nathan said: “Yeah. There was post first lockdown, and the fear seems even more so this time round.”


Tier 2 hospitality businesses say policing the households rule is a challenge

Hotel, restaurant and pub owners operating in Tier 2 say they are grateful to have avoided the highest level of restrictions but say policing the rules can cause problems.

Rebecca Hill, the owner of Galtres Lodge Hotel, in York, said she was relieved the city was in the second tier, which meant she can operate near to normal.

But Ms Hill said the city was on the edge of a huge swathe of Tier 3 territory across West and South Yorkshire which meant many people had cancelled their bookings because they can no longer travel.

She said: “Tier 3 would have been a disaster but Tier 2 means we can welcome guests into the hotel and open the restaurant.” 

Ms Hill said: “We can reopen and we can welcome guests but, obviously, guests from Tier 3 areas cannot travel to us. So that does have a negative affect on bookings and that’s a real shame.

“We’re a small independent, very personable business, so they’ve just called and they’ve just postponed and they’ll just come where they can.”

Mrs Hill said there are still complications dealing with the rules around non-mixing of households.

She said groups suspected of not being from the same household are subtly steered towards the heated outdoor areas.

“You can tell sometimes if people are, maybe, telling you something that’s not quite true,” she said.

“We do have outside seating as a fall back if someone comes and says, ‘oh yes we’re from one household’ and we, maybe, think they’re not.

“We can quite subtly usher them to an outside table so they’re not breaking any rules and we’re not breaking any rules.”

She said: “If anyone’s really adamant they’re from one household, we’re not here to police people.

“We just hope that people do the right thing like we’re trying to do.”

( Pub owners insist they cannot be expected to police customers / Fuller’s )

Boris Johnson discusses coronavirus vaccine effort with Indian PM

Boris Johnson and Indian prime minister Narendra Modi discussed joint work on a coronavirus vaccine, along with trade, security and climate change during a phone call on Friday, Downing Street said.

The Prime Minister told his South Asian counterpart that “2021 would be a year to deepen and strengthen the UK-India relationship”, according to Number 10, as global leaders look to kick-start the recovery after the pandemic.

India’s Covid-19 cases soared past 9.18 million this week, with more than 134,000 deaths.

In the UK, 57,000 people have died within 28 days of a positive test, according to Government data.

A Downing Street spokeswoman said: “The Prime Minister and Prime Minister Modi discussed joint efforts to find treatments and vaccines for coronavirus, and welcomed the collaboration between our countries’ leading scientists.”


UK coronavirus R rate drops below one for first time in nearly three months

Scientists advising the Government on the Covid-19 infection rate estimate that the R number in the UK is currently between 0.9 and one.


Leader of Lancashire County Council Geoff Driver calls for local politicians to have more say in decisions on the tier system

He said he was “extremely disappointed” the area had been placed in Tier 3 despite local leaders asking for the county to be divided into two tiers to reflect different coronavirus rates.

He said: “We know there are still serious pressures on the hospitals and we really want to see that number come down.

“We also know rates have come down significantly since the time when we were placed in the original Tier 3, three weeks before this lockdown began, and in the west and north of the county this is particularly pronounced.

“I am naturally disappointed by the decision to put the whole county into the same tier, and we will be speaking to the Government about what the measures will be for coming out of Tier 3.

“I also think it is important that local leaders have more input on these decisions as we know our areas best.”

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Tier system must be clear and fair, says psychologist – Channel 4 News

The Scottish government has announced that people hoping to form social bubbles over the Christmas holidays will be limited to a maximum of eight people, not including children.

We spoke to the social psychologist Prof Stephen Reicher and asked him whether knowing that the restrictions will be loosened at Christmas will make people more likely to abide by them, in the meantime.

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Tory MP Robert Jenrick admits he’s still undecided on whether he’ll hug relatives at Christmas

Conservative MP Robert Jenrick has admitted that he’s still undecided as to whether he will hug relatives at Christmas.

The Housing Secretary appeared on Good Morning as he was grilled on the government’s new tier system.

On Thursday, the government confirmed 99% of people will be in either Tier 2 or Tier 3 – where all indoor social gatherings are banned.

The new arrangements will apply from December 2 after England’s blanket lockdown ends. Restrictions have been tightened after Government scientific advisers warned that previous measures had not been effective enough.

This comes after it was revealed that three households would be able to meet for Christmas in a five-day relaxing of Covid, which is believed to be between between December 23 and December 27.

During last night’s press conference, Professor Chris Whitty warned against “hug or kiss relatives” during the family Christmas relaxation period.

Questioned whether he would hug his elderly relatives, Jenrick said: “I’m having those conversations with my mum and dad – they’re both older people, they’ve both been shielding at different times.

“I have young kids that would find it very difficult to socially distance when they would love to hug and kiss their grandparents.

“So we’re having those conversations deciding what is the right way-“

Host Kate Garraway interjected, saying: “You’re not sure either, then, because that’s the confusing thing for all of us!”

“Well, we’re going to have a conversation coming to our own conclusion,” Jenrick replied. “It might be, that we choose to do something quite different this Christmas.”

*Good Morning Britain airs weekdays at 6am on ITV

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Trial to investigate use of inhaled steroid as home treatment for coronavirus

An inhaled steroid will be investigated as a possible treatment for coronavirus as part of a national trial.

Budesonide will form part of the UK’s priority platform trial for Covid-19 treatments that can be taken at home.

Led by the University of Oxford, the Principle (Platform Randomised trial of INterventions against Covid-19 In older peoPLE) trial is evaluating treatments that can help people aged over 50 recover more quickly from coronavirus and prevent the need for hospital admission.

Inhaled corticosteroid budesonide is commonly prescribed as part of the long-term management of asthma and chronic obstructive pulmonary disease with no serious side-effects associated with short-term use.

In some patients with Covid-19, the body mounts a significant immune response to fight the virus, causing high levels of inflammation that can damage human cells in the airways and lungs.

Research suggests inhaling budesonide into the airways targets anti-inflammatory treatment where it is needed most and can potentially minimise any lung damage that might otherwise be caused by the virus.

Sars-CoV-2, the virus that causes Covid-19, binds to ACE2 receptors lining cells in the airways, gaining entry to human cells and replicating within.

Laboratory studies suggest inhaled corticosteroids reduce the number of these receptors in the airways and so may block entry of the virus into human cells.

Professor Chris Butler at the University of Oxford, who led the Principle trial, said: “Budesonide is a relatively inexpensive, safe and easy-to-administer drug for respiratory conditions that may have a role to play in treating Covid-19.

“It is only through enrolling volunteers on a randomised controlled trial like Principle that we can assess whether there are clear benefits or harms associated with potential treatments like budesonide.

“We need many more volunteers to join the trial so we can get the answers we really need to keep people with Covid-19 out of hospital.

“Like vaccines and preventative measures, treatments have an important role to play in minimising the burden of this disease on society.”

Trial participants will be randomly assigned to receive an inhaler in the post and the usual standard-of-care from their clinician.

They will be asked to inhale two puffs twice a day for 14 days with each puff providing a 400 microgram dose of budesonide.

They will be followed-up for 28 days and will be compared with participants who have been assigned to receive the usual standard-of-care only.

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