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England and Scotland announce eight more coronavirus deaths in early count

Britain has recorded another eight coronavirus deaths in the preliminary count, as daily fatalities remain in single digits for the fourth day in a row.

NHS England reported seven of the fatalities and Scotland suffered one death, while Wales recorded zero. Northern Ireland is still to publish its figures.

The preliminary total is calculated by adding up fatalities in all of the home nations, but it does not include deaths in care homes and in the community in England. It means the official figure announced later by the Department of Health has the potential to be higher.

Yesterday there were three deaths attributed to Covid-19. On Monday that figure was two and on Sunday there was just one victim. The seven-day rolling average number of deaths is currently eight. By comparison, it was more than 900 at the peak of the pandemic in mid-April.

It comes as another cheap steroid drug was found to reduce mortality in Covid-19 patients.  Hydrocortisone, an anti-inflammatory drug, slashed the risk of death by nearly a third in the most severely ill sufferers.

The £5 steroid becomes the second drug found to be effective in reducing mortality in those with severe symptoms, following the success of another cheap anti-inflammatory, dexamethasone.

Meanwhile, the Northamptonshire town of Corby and South Tyneside could be next to be hit with lockdowns amid an uptick in Covid-19 cases in the last week, analysis shows.

Corby, in the East Midlands, now has the third highest coronavirus infection rate in the country after 41 people tested positive in the last seven days. The town of about 62,000 people now has a case rate of 56.8 per 100,000 people, according to analysis of official data by the PA news agency.

It puts Corby behind only Bolton, which has a rate of 59.1 per 100,000, and Pendle, 71.7 per 100,000 – where tough Covid-19 restrictions are already in place. Meanwhile, South Tyneside in the North East has had 62 new cases in the last seven days, pushing its infection rate up from 11.9 to 41.1 cases per 100,000. The metropolitan borough in Tyne and Wear, home to 150,000 people, is now the ninth worst-hit region in England. 

There are growing fears Covid is making a resurgence across the UK amid the rising infections and yesterday Health Secretary Matt Hancock warned a surge in hospitalisations was coming.

But the increasing cases are yet to spill over into admissions or deaths. British experts tell MailOnline such comments were ‘alarmist’ and that rising infections are simply a byproduct of young asymptomatic people finally being tested.

In other coronavirus developments today: 

  • Widely-used and cheap steroid hydrocortisone can cut coronavirus deaths by a THIRD in sickest patients, study finds;
  • Keir Starmer blasted Boris Johnson’s latest change of heart as No10 U-turned AGAIN by putting Bolton and Trafford BACK into Covid lockdown after revolt from council leaders;
  • Weekly coronavirus deaths dropped below 100 for the first time in five months, according to the Office for National Statistics, which includes all deaths suspected of being caused by the virus;
  • Glasgow woke up to new lockdown measures today as Nicola Sturgeon enforced restrictions on city’s 800,000 people and nearby regions after spike in Covid cases – with measures to last at least 14 days;
  • Greece hit back at Scotland’s ‘harsh’ quarantine, with its tourism minister claiming cases are ‘well below’ 20 per 100,000 people threshold as Sturgeon’s 11th hour announcement sparks scramble to get back by 4am tomorrow;
  • The impact of the Covid pandemic on businesses in UK is worse than in Belgium, France and Germany, study claims; 
  • Experts have rubbished Matt Hancock’s warning a surge in Covid-19 hospitalisations is coming – as they put UK’s rise in cases down to better testing finding ‘young, healthy, symptomless people’ who are unlikely to die.

It means South Tyneside and Corby are the only regions in the top 10 infection hotspots where restrictions have not been introduced. 

The rise in Corby comes after a bar worker in Wetherspoons tested positive for the disease.

The worker had taken a Covid-19 test and was waiting for results but turned up for work at the Samuel Lloyd pub at Rockingham Leisure Park anyway.

No10 U-turns AGAIN by putting Bolton and Trafford BACK into Covid lockdown 

Boris Johnson was roasted for ‘mess after mess’ in the coronavirus crisis today after the government performed another embarrassing U-turn on lockdowns. 

Bolton and Trafford were among a series of areas in the North West due to see restrictions eased today.

But the move was abandoned at the 11th hour after a furious backlash from local politicians including Manchester mayor Andy Burnham, who said infection levels were still far too high. 

As the dramatic volte face emerged, Mr Johnson was lashed by Keir Starmer at PMQs for ‘making it up as he goes along’.

‘It’s mess after mess… U-turn after U-turn, it’s a fundamental issue of competence,’ the Labour leader raged.

‘God knows what’s going on, there’s no grip.’

But a clearly stung PM retorted by branding Sir Keir ‘Captain Hindsight’. 

Announcing the latest abrupt change of heart this afternoon, Health Secretary Matt Hancock said: ‘Following a significant change in the level of infection rates over the last few days, a decision has been taken that Bolton and Trafford will now remain under existing restrictions.

‘This decision has been made in collaboration with local leaders after reviewing the latest data. We continually monitor outbreaks across the country, and have seen infection rates increase more than three times in Bolton in under a week, and double in Trafford since the last review.’ 

They were sent home after it emerged they had the disease and colleagues were told to self isolate, the Northampton Telegraph reported

It’s unclear if they infected others or whether the case is to blame for the overall spike in Corby. 

Other areas where there has been a significant week-on-week rise include Rossendale, where 35 people got infected in the last week. 

The Lancashire borough, home to 70,000 people, went from a case rate of 12.6 per 100,000 to 49 in seven days. 

In Greater Manchester, where swathes have been subject to tougher lockdowns – Trafford has seen a jump in cases. 

Trafford’s infection rate rose from 19.4 to 35.4 cases per 100,000, with 84 new cases in the past seven days.

Meanwhile, Leeds in West Yorkshire has also seen a steep rise – up from 18.9 to 31.4 cases per 100,000, with 249 new infections.

It comes as Boris Johnson was roasted for ‘mess after mess’ in the coronavirus crisis today after the government performed another embarrassing U-turn on lockdowns.

Bolton and Trafford were among a series of areas in the North West due to see restrictions eased today.

But the move was abandoned at the 11th hour after a furious backlash from local politicians including Manchester mayor Andy Burnham, who said infection levels were still far too high.

As the dramatic volte face emerged, Mr Johnson was lashed by Keir Starmer at PMQs for ‘making it up as he goes along’.

‘It’s mess after mess… U-turn after U-turn, it’s a fundamental issue of competence,’ the Labour leader raged.

‘God knows what’s going on, there’s no grip.’

But a clearly stung PM retorted by branding Sir Keir ‘Captain Hindsight’.

Announcing the latest abrupt change of heart this afternoon, Health Secretary Matt Hancock said: ‘Following a significant change in the level of infection rates over the last few days, a decision has been taken that Bolton and Trafford will now remain under existing restrictions.

‘This decision has been made in collaboration with local leaders after reviewing the latest data. We continually monitor outbreaks across the country, and have seen infection rates increase more than three times in Bolton in under a week, and double in Trafford since the last review.’

It means hundreds of thousands of people in both areas will remain banned from mixing with people from other households, while businesses that were due to open – such as casinos – will need to remain closed.

Several areas in the North West will still come out of lockdown. They are Stockport, Burnley, Hyndburn and parts of Bradford, Calderdale and Kirklees.

Lockdowns are being lifted in some parts of the North West - but will now be kept in place in Bolton and Trafford

Lockdowns are being lifted in some parts of the North West – but will now be kept in place in Bolton and Trafford

Boris Johnson at PMQs today

Keir Starmer accused the PM of 'mess after mess'

Boris Johnson (left) branded Keir Starmer (right) ‘Captain Hindsight’ after the Labour leader accused him of overseeing ‘mess after mess’ at PMQs today

Where are local lockdowns being lifted in the North West? 

  • Stockport 
  • Burnley
  • Hyndburn 
  • Bradford (some areas)
  • Calderdale and Kirklees

Earlier, Greater Manchester Mayor Mr Burnham told BBC Radio 4’s Today programme that people in Bolton and Trafford should ‘continue to follow the guidance’ not to have social gatherings in their home.

‘We find ourselves at a completely unsustainable position this morning – that’s the politest way I can put it,’ he said.

‘Overnight we’ve had restrictions released in two boroughs where we’ve got a rising number of cases – in one case in the red zone.

‘And neighbouring boroughs are still under restrictions but with much lower numbers of cases.

‘These restrictions were always hard to explain to the public but they are completely illogical now.’

His comments echo those of Trafford Council leader Andrew Western, who blasted the ‘chaotic’ way local lockdowns had been handled and accused ministers of making a ‘purely political calculation’ to lift the restrictions even as cases rose.

It came after his counterpart in Bolton, the Tory councillor David Greenhalgh, insisted an ‘unforeseeable’ rise in infections meant it was necessary to keep the lockdown in place.

While the ban on mixing households has been lifted in many areas, they remain in others including Oldham, Pendle and Leicester.

Businesses opened elsewhere on August 15, such as casinos, bowling alleys and indoor concert venues, will also be allowed to reopen.

BOLTON'S INFECTION RATE: 18.2 per 100,000 people in week ending July 31; 31.2 per 100,000 people in week ending August 7; 25.6 per 100,000 people in week ending August 14; 18.4 per 100,000 people in week ending August 21; 44.9 per 100,000 people in week ending August 28; 56.4 per 100,000 people on September 1

BOLTON’S INFECTION RATE: 18.2 per 100,000 people in week ending July 31; 31.2 per 100,000 people in week ending August 7; 25.6 per 100,000 people in week ending August 14; 18.4 per 100,000 people in week ending August 21; 44.9 per 100,000 people in week ending August 28; 56.4 per 100,000 people on September 1

Meanwhile, a rise in cases in Scotland has seen new lockdowns introduced in Glasgow as well as in East Renfrewshire and West Dunbartonshire.

Restrictions have been in place across much of the North West since July 15.

The request to maintain restrictions in Bolton was made following an emergency meeting between officials as the rate of new Covid-19 cases in Bolton surged over the weekend from 44.9 per 100,000 on Friday, to 56.4 per 100,000 yesterday.

Analysis showed that new cases in Bolton were spread across the borough and not limited to a single area, community, or place of work, said the council.

Critically ill patients who received hydrocortisone (pictured) intravenously for seven days had a 93 per cent better recovery odds - measured by either a greater chance or survival or less need for organ support

Critically ill patients who received hydrocortisone (pictured) intravenously for seven days had a 93 per cent better recovery odds – measured by either a greater chance or survival or less need for organ support

WHAT IS DEXAMETHASONE?

Dexamethasone is a type of corticosteroid medication which is used as an anti-inflammatory to treat a wide-rang of conditions.  

It was first made in 1957 by US physician Philip Showalter Hench and was approved for medical use in 1961. 

The drug, which is sold under the brand names Ozurdez and Baycadron, is on the World Health Organization’s List of Essential Medicines. 

It is given via an injection or a once-a-day tablet and is used to treat a variety of afflictions. 

It is even used to help reduce the side effects of chemotherapy in cancer patients.  

The steroid is also used to treat  conditions that cause inflammation, conditions related to immune system activity, and hormone deficiency.

These include:

  • allergic reactions
  • rheumatoid arthritis 
  • psoriasis 
  • lupus
  • eczema  
  • flare-ups of intestinal disease, such as ulcerative colitis 
  • multiple sclerosis
  • pre-treatment for chemotherapy to reduce inflammation and side effects from cancer medications
  • adrenal insufficiency (a condition where the adrenal glands don’t produce enough hormones)

Dexamethasone is known to cause a number of mild to moderate side effects, including vomiting, heartburn, anxiety, high blood pressure, muscle weakness and insomnia. 

 What did the RECOVERY trial show?

On June 16, 2020, a trial to test possible treatments for coronavirus patients was started by the Nuffield Departments of Public Health and of Medicine at the University of Oxford.

While the trial is expected to continue until June 2021, a preliminary report on its findings was published on July 18. 

Some 11,800 Covid-19 patients had enrolled in the trial as of June. 

The trial, Randomised Evaluation of Covid-19 therapy (RECOVERY) trial, found dexamethasone improves survival rates of hospitalised patients with Covid-19 receiving oxygen or on a ventilator. 

However, this was only the case in patients who were struggling to breathe and needed respiratory support.  

People who didn’t require breathing support saw a worse survival rate if they were treated with the drug, although this may have been coincidence.  

The World Health Organisation (WHO) states that dexamethasone should be reserved for seriously ill and critical patients receiving Covid-19 treatment in a hospital setting.

The WHO Director-General said: ‘WHO emphasizes that dexamethasone should only be used for patients with severe or critical disease, under close clinical supervision. There is no evidence this drug works for patients with mild disease or as a preventative measure, and it could cause harm.’ 

Based on those preliminary results, dexamethasone treatment has been recommended by the National Institutes of Health in the US, and by the NHS in the UK.

It’s only for patients with Covid-19 who are mechanically ventilated or who require supplemental oxygen but are not mechanically ventilated.

Dexamethasone has not been recommended in patients with COVID-19 who do not require supplemental oxygen or hospitalisation. 

How does it help Covid-19 patients?    

In coronavirus patients, the steroid reduces inflammation in the lungs triggered by an overreaction by the immune system.

One in 10 symptomatic Covid-19 patients are thought to suffer from the nasty symptom, known as acute respiratory distress syndrome (ARDS). 

ARDS causes the immune system to become overactive and attack healthy cells in the lungs.

This makes breathing difficult and the body eventually struggles to get enough oxygen to vital organs.  

Infections between different households appear to be the main cause of the spike with people aged 18-49 representing the overwhelming majority of new cases, it added.

The government also faced calls from fellow Tories to keep restrictions in place in Trafford and Bolton before deciding to do so.

Conservative leader of Bolton Council, Councillor David Greenhalgh, said: ‘It is with a heavy heart that the cabinet and officer team have come to this decision and this will be incredibly disappointing for both residents and business owners.

‘We urged the Government to lift Bolton out of the additional restrictions at a time when infection rates were low.

‘This was the right decision at the time.

‘However, there has been a sudden and unforeseeable rise in the number of coronavirus cases in Bolton.

‘We have always been led by the data, which means we have no choice but to act quickly to keep everyone safe.’

Meanwhile, a British study has found the steroid hydrocortisone can cut Covid-19 deaths by almost a third in the sickest patients. The NHS has promised to start using the widely-used steroid with ‘immediate action’.

An analysis co-ordinated by the World Health Organisation (WHO) of seven different studies found three steroids – hydrocortisone, methylprednisolone and dexamethasone – reduce the risk of death in critically ill coronavirus patients by 20 per cent.

It bumped up to 31 per cent for hydrocortisone, a drug widely used to treat allergic disorders, skin conditions, ulcerative colitis, arthritis, lupus, multiple sclerosis, or lung disorders.

The study, from the University of Bristol, is one of three published today in The Journal of the American Medical Association (JAMA), that suggests steroids improve survival of the sickest Covid-19 patients. 

Another found hydrocortisone can improve outcomes by up to 93 per cent in critically ill patients – measured by either a greater chance or survival or less need for organ support. 

The findings come from the REMAP-CAP trial, involving more than 50 research teams around the world in around 13 countries, including 88 patients treated at Imperial College Healthcare NHS Trust Hospitals. 

Dexamethasone has already been approved by NHS officials for use on critically ill patients after results of the world’s biggest Covid-19 drug trial found it could cut their risk of death.

Oxford University scientists claimed it may save up to 35 per cent of patients relying on ventilators — the most dangerously ill — and reduce the odds of death by a fifth for all patients needing oxygen at any point. 

NHS chief executive Sir Simon Stevens said today: ‘Just as we did with dexamethasone, the NHS will now take immediate action to ensure that patients who could benefit from treatment with hydrocortisone do so, adding a further weapon in the armoury in the worldwide fight against Covid-19.’

The World Health Organisation will be issuing new guidelines to include the use of steroids to treat critically ill Covid-19 patients today. 

The REMAP-CAP trial is led in the UK by Professor Anthony Gordon from Imperial College London with collaborators from the Intensive Care National Audit & Research Centre. 

Professor Gordon, Chair in Anaesthesia and Critical Care at Imperial and a Consultant in Intensive Care Medicine at Imperial College Healthcare NHS Trust, said: ‘At the beginning of the year at times it felt almost hopeless, knowing that we had no specific treatments. It was a very worrying time. 

‘Yet less than six months later, we’ve found clear, reliable evidence in high quality clinical trials of how we can tackle this devastating disease.’

The work was funded by the National Institute for Health Research and supported by the NIHR Imperial Biomedical Research Centre.

Professor Gordon added: ‘The studies published today show that we now have more than one choice of treatment for those who need it most. 

‘Steroids are not a cure, but they help improve outcomes. Having a choice of different types of steroids, all of which seem to improve patient recovery, is great as it helps ease the problem of drug supply issues.’      

Steroids are anti-inflammatory drugs, and evidence strongly suggests that they reduce the lung inflammation in patients with Covid-19 who are seriously ill and require oxygen support for their breathing difficulties.

In the latest study, 403 patients with suspected or confirmed Covid-19 were enrolled between March and June 2020.

They each required respiratory or cardiovascular organ support, such as mechanical ventilation or drugs to support their blood pressure.

The cohort included patients of mixed ethnicities in the UK, Ireland, Australia, the US, the Netherlands, New Zealand, Canada and France.

Patients were randomly assigned to different treatment regimes. One group were treated with a fixed dose of 50mg hydrocortisone four times a day for seven days, while another group were treated with hydrocortisone only if their blood pressure dropped, known as the ‘shock-dependant group’. 

A third group received no hydrocortisone known as the ‘control group’.

The trial showed that using the fixed dose of hydrocortisone led to a 93 per cent chance of a better outcome, measured by a greater chance of survival and less need for organ support, than not using hydrocortisone. 

If the hydrocortisone was given only when the blood pressure was low, the chance of a better outcome was 80 per cent.

Confirming the NHS would fast track hydrocortisone into hospitals, Sir Stevens said: ‘One of the distinctive benefits of having our NHS is that we’ve been able to mobilise quickly and at scale to help researchers test and develop proven coronavirus treatments.’

The findings follow the groundbreaking results of the RECOVERY trial in June, which revealed that another steroid, called dexamethasone, helped improve recovery of patients with Covid-19.

Dexamethasone reduced deaths by up to a third among patients on ventilators, and by a fifth for those on oxygen, leading to its use in the NHS ever since.

Scientists from Brazil, Canada, China, France, Spain, the UK and the USA were involved in the study.  

Martin Landray, professor of medicine and epidemiology at the University of Oxford, who leads on the Recovery trial, said: ‘These drugs have been around for decades, they are the sort of drugs that every medical student learns almost as soon as they open a clinical pharmacology text book.’

He said dexamethasone and hydrocortisone, which can be taken orally or intravenously, were ‘widely available, cheap, well understood drugs’.

As an example, he said treating 12 people with dexamethasone costs around £60.

But he warned that the ‘impressive’ results ‘are not sufficient to lead to a complete resumption … of life as we knew it’.

He said that social distancing and wearing face masks ‘remain as important as ever’.  

Professor Gordon, an intensive care consultant, said hydrocortisone could be used ‘straight away’, with it being available in intensive care units in the UK.

But Professor Landray said data showed hydrocortisone was not effective in patients with milder cases of disease.

He said: ‘This is not a treatment for prevention, this is not a treatment for early out patients, general practice type cases, this is a treatment for people who are sick.

‘This is a treatment for people who are in hospital who need oxygen, who’ve got complications from Covid.’ 

The findings of the RECOVERY trial and REMAP-CAP are published in JAMA alongside two further clinical trials which have also evidenced the benefits of steroids as a treatment for the severely ill Covid-19 patients.   

The journal edition concluded that a range of steroids – all safe, cheap and readily available – can improve the outcomes of patients receiving intensive care.

Professor Gordon, from the Department of Surgery and Cancer at Imperial, added: ‘This been an incredible international effort. We were all aware of the other studies and were happy to share our raw data before it was published. Only by collaborating were we going to make real advances and make them fast.’

One of the other studies, which was co-ordinated by the World Health Organisation (WHO) and analysed by the National Institute for Health Research (NIHR) at the University of Bristol, found cheap and readily available steroids reduced the risk of death in critically ill coronavirus patients by 20 per cent.

An international team of researchers analysed seven trials involving three different types of anti-inflammatory corticosteroids.

It looked at patient mortality over a 28-day period after treatment with one of three types of corticosteroids – dexamethasone, hydrocortisone and methylprednisolone.

Researchers said the estimated 20 per cent reduction in death was equivalent to about 68 per cent of critically ill patients surviving after treatment with the steroids, compared to approximately 60 per cent surviving without them. 

Jonathan Sterne, professor of medical statistics and epidemiology at the University of Bristol, said: ‘Steroids are a cheap and readily available medication, and our analysis has confirmed that they are effective in reducing deaths amongst the people most severely affected by Covid-19.

‘The results were consistent across the trials and show benefit regardless of age or sex.’

He explained that the findings pointed to ‘eight fewer deaths for every a hundred critically ill patients assigned to corticosteroids’.

The seven control trials recruited 1,703 critically ill coronavirus patients from 12 countries from February to June. The study included patients who were taking part in the Oxford University-based RECOVERY trial.

Patients were randomised to either receive one of the three drugs or a placebo.

Researchers said the mortality results were consistent across the seven trials, with dexamethasone and hydrocortisone giving ‘similar effects’.

But there were too few patients involved in tests of methylprednisolone to enable researchers to estimate its impact with precision.

The study found that the steroids benefited patients regardless of whether they were on a ventilator.

But researchers said it appeared to have a greater effect on those who did not require medication to support their blood pressure. 

Updated WHO guidance is due to be published on its website on Wednesday, Professor Sterne said.

Professor Jonathan Van-Tam, deputy chief medical officer, hailed the work of UK researchers and trial participants.

He said: ‘It is impressive to see so many UK participants willing to take part in studies, and able to volunteer due to the rapid recruitment response of the NIHR’s Clinical Research Network.

‘Research such as this will make the difference in controlling this virus.

‘These findings offer further evidence that corticosteroids can be an important part of COVID-19 treatment for severe patients.’ 

REVEALED: COVID-19 INFECTION RATES IN EVERY AREA OF ENGLAND 

Below is Tuesday’s update of the rolling seven-day rate of new cases of Covid-19 for every local authority area in England.

The figures, for the seven days to August 29, are based on tests carried out in laboratories (known as pillar one tests) and in the wider community (pillar two).

The list has been calculated by the PA news agency and is based on Public Health England data published on September 1 on the Government’s coronavirus online dashboard.

From left to right, it reads: name of local authority; rate of new cases in the seven days to August 29; number (in brackets) of new cases recorded in the seven days to August 29; rate of new cases in the seven days to August 22; number (in brackets) of new cases recorded in the seven days to August 22.

Pendle 71.7 (66), 68.4 (63)
Bolton 59.1 (170), 18.4 (53)
Corby 56.8 (41), 22.2 (16)
Oldham 56.5 (134), 60.3 (143)
Rossendale 49.0 (35), 12.6 (9)
Blackburn with Darwen 48.8 (73), 57.4 (86)
Bradford 48.5 (262), 43.2 (233)
Rochdale 44.1 (98), 36.9 (82)
South Tyneside 41.1 (62), 11.9 (18)
Manchester 39.3 (217), 45.9 (254)
Tameside 37.1 (84), 30.5 (69)
Salford 36.3 (94), 27.8 (72)
Trafford 35.4 (84), 19.4 (46)
Kettering 35.4 (36), 25.5 (26)
Preston 32.8 (47), 25.8 (37)
Great Yarmouth 32.2 (32), 3.0 (3)
Leeds 31.4 (249), 18.9 (150)
Breckland 30.0 (42), 5.7 (8)
Birmingham 29.4 (336), 24.3 (278)
Kirklees 28.2 (124), 26.4 (116)
Burnley 28.1 (25), 24.7 (22)
Sandwell 27.7 (91), 21.0 (69)
Bury 25.7 (49), 38.2 (73)
Leicester 25.1 (89), 46.3 (164)
Wirral 24.7 (80), 8.6 (28)
Hyndburn 24.7 (20), 21.0 (17)
Watford 23.8 (23), 8.3 (8)
Kensington and Chelsea 23.1 (36), 16.0 (25)
Northampton 22.7 (51), 39.6 (89)
Middlesbrough 22.7 (32), 16.3 (23)
Newcastle-under-Lyme 21.6 (28), 18.5 (24)
Tamworth 20.9 (16), 0.0 (0)
Hackney and City of London 20.3 (59), 22.7 (66)
Peterborough 20.3 (41), 16.8 (34)
Swindon 19.8 (44), 42.8 (95)
Ribble Valley 19.7 (12), 13.1 (8)
Welwyn Hatfield 19.5 (24), 10.6 (13)
Redcar and Cleveland 19.0 (26), 5.8 (8)
Wycombe 18.3 (32), 6.3 (11)
Epping Forest 18.2 (24), 6.8 (9)
Dacorum 18.1 (28), 22.6 (35)
Wandsworth 17.9 (59), 18.5 (61)
Coventry 17.8 (66), 11.0 (41)
Cambridge 17.6 (22), 4.0 (5)
Harrow 17.5 (44), 13.5 (34)
Hammersmith and Fulham 17.3 (32), 16.7 (31)
Windsor and Maidenhead 17.2 (26), 23.1 (35)
Hertsmere 17.2 (18), 9.5 (10)
Calderdale 17.0 (36), 30.7 (65)
Brentwood 16.9 (13), 10.4 (8)
Winchester 16.8 (21), 7.2 (9)
Stoke-on-Trent 16.8 (43), 23.0 (59)
Blaby 16.7 (17), 20.7 (21)
Havering 16.6 (43), 9.6 (25)
Mole Valley 16.0 (14), 6.9 (6)
Spelthorne 16.0 (16), 6.0 (6)
Harborough 16.0 (15), 7.5 (7)
East Staffordshire 15.9 (19), 9.2 (11)
East Hertfordshire 15.4 (23), 6.0 (9)
Elmbridge 15.4 (21), 16.1 (22)
Barnet 15.2 (60), 13.4 (53)
Lambeth 15.0 (49), 12.6 (41)
Rutland 15.0 (6), 12.5 (5)
Westminster 14.5 (38), 13.0 (34)
Tower Hamlets 14.5 (47), 11.7 (38)
Liverpool 14.3 (71), 18.9 (94)
Norwich 14.2 (20), 2.8 (4)
Newcastle upon Tyne 14.2 (43), 15.2 (46)
Sheffield 14.2 (83), 11.6 (68)
Redditch 14.1 (12), 29.3 (25)
Oadby and Wigston 14.0 (8), 31.6 (18)
Richmond upon Thames 13.6 (27), 9.1 (18)
Waverley 13.5 (17), 15.8 (20)
Sefton 13.4 (37), 11.9 (33)
Gateshead 13.4 (27), 7.4 (15)
Hambleton 13.1 (12), 2.2 (2)
Plymouth 13.0 (34), 5.7 (15)
High Peak 12.9 (12), 10.8 (10)
South Bucks 12.8 (9), 22.8 (16)
Camden 12.6 (34), 11.5 (31)
Enfield 12.6 (42), 12.6 (42)
Ealing 12.6 (43), 18.7 (64)
Wolverhampton 12.5 (33), 16.7 (44)
Vale of White Horse 12.5 (17), 10.3 (14)
Oxford 12.5 (19), 26.2 (40)
Lichfield 12.4 (13), 2.9 (3)
Epsom and Ewell 12.4 (10), 2.5 (2)
Reading 12.4 (20), 11.1 (18)
Barking and Dagenham 12.2 (26), 14.1 (30)
Bedford 12.1 (21), 12.1 (21)
Southend-on-Sea 12.0 (22), 4.9 (9)
Mid Sussex 11.9 (18), 9.3 (14)
Waltham Forest 11.9 (33), 10.8 (30)
Three Rivers 11.8 (11), 12.9 (12)
Rushcliffe 11.7 (14), 5.9 (7)
Hartlepool 11.7 (11), 7.5 (7)
Stockton-on-Tees 11.7 (23), 2.5 (5)
Wigan 11.6 (38), 12.2 (40)
Brent 11.5 (38), 9.1 (30)
South Hams 11.5 (10), 2.3 (2)
Wakefield 11.5 (40), 19.8 (69)
Chiltern 11.5 (11), 10.4 (10)
East Hampshire 11.4 (14), 5.7 (7)
Hillingdon 11.4 (35), 15.6 (48)
Newham 11.3 (40), 9.3 (33)
Wellingborough 11.3 (9), 21.3 (17)
Southwark 11.3 (36), 17.3 (55)
Derbyshire Dales 11.1 (8), 5.5 (4)
Hastings 10.8 (10), 8.6 (8)
Greenwich 10.8 (31), 4.2 (12)
Kingston upon Thames 10.7 (19), 9.0 (16)
County Durham 10.6 (56), 9.8 (52)
Redbridge 10.5 (32), 6.9 (21)
Bexley 10.5 (26), 8.1 (20)
Haringey 10.4 (28), 13.0 (35)
Cheltenham 10.3 (12), 8.6 (10)
Darlington 10.3 (11), 1.9 (2)
Stevenage 10.2 (9), 1.1 (1)
Allerdale 10.2 (10), 4.1 (4)
Rotherham 10.2 (27), 6.4 (17)
Carlisle 10.1 (11), 14.7 (16)
North Tyneside 10.1 (21), 5.3 (11)
Harrogate 9.9 (16), 8.1 (13)
Knowsley 9.9 (15), 5.3 (8)
Dartford 9.8 (11), 4.4 (5)
Chelmsford 9.5 (17), 8.4 (15)
East Northamptonshire 9.5 (9), 8.5 (8)
Bristol 9.5 (44), 11.0 (51)
St Albans 9.4 (14), 7.4 (11)
Guildford 9.4 (14), 12.8 (19)
Gedling 9.3 (11), 10.2 (12)
Blackpool 9.3 (13), 5.7 (8)
Solihull 9.2 (20), 7.9 (17)
South Norfolk 9.2 (13), 2.8 (4)
Hounslow 9.2 (25), 13.3 (36)
South Gloucestershire 9.1 (26), 10.5 (30)
Southampton 9.1 (23), 4.0 (10)
Islington 9.1 (22), 9.9 (24)
Warrington 9.0 (19), 2.9 (6)
Brighton and Hove 8.9 (26), 5.8 (17)
West Berkshire 8.8 (14), 6.3 (10)
Lewisham 8.8 (27), 10.5 (32)
Selby 8.8 (8), 3.3 (3)
Broxtowe 8.8 (10), 10.5 (12)
Uttlesford 8.8 (8), 6.6 (6)
Walsall 8.8 (25), 14.0 (40)
Babergh 8.7 (8), 0.0 (0)
Cheshire East 8.6 (33), 8.1 (31)
Stockport 8.5 (25), 12.6 (37)
South Northamptonshire 8.5 (8), 5.3 (5)
Luton 8.4 (18), 14.6 (31)
Bromley 8.4 (28), 11.1 (37)
Nottingham 8.4 (28), 12.9 (43)
Dudley 8.4 (27), 6.5 (21)
Sunderland 8.3 (23), 6.1 (17)
Broxbourne 8.2 (8), 12.3 (12)
Staffordshire Moorlands 8.1 (8), 9.1 (9)
Sedgemoor 8.1 (10), 1.6 (2)
Lincoln 8.1 (8), 9.1 (9)
Wyre Forest 7.9 (8), 4.9 (5)
Mendip 7.8 (9), 6.1 (7)
New Forest 7.8 (14), 7.2 (13)
Croydon 7.8 (30), 8.5 (33)
Thanet 7.8 (11), 0.7 (1)
Castle Point 7.7 (7), 2.2 (2)
Gloucester 7.7 (10), 5.4 (7)
Shropshire 7.7 (25), 7.1 (23)
Nuneaton and Bedworth 7.7 (10), 5.4 (7)
Barnsley 7.7 (19), 10.1 (25)
Sevenoaks 7.5 (9), 7.5 (9)
Bolsover 7.4 (6), 3.7 (3)
Derby 7.4 (19), 7.8 (20)
Slough 7.4 (11), 12.7 (19)
Newark and Sherwood 7.4 (9), 18.8 (23)
Mansfield 7.3 (8), 7.3 (8)
Central Bedfordshire 7.3 (21), 6.6 (19)
Bath and North East Somerset 7.2 (14), 15.5 (30)
Hart 7.2 (7), 2.1 (2)
St. Helens 7.2 (13), 11.1 (20)
Northumberland 7.1 (23), 11.8 (38)
Hinckley and Bosworth 7.1 (8), 5.3 (6)
Wokingham 7.0 (12), 5.8 (10)
Cheshire West and Chester 7.0 (24), 8.2 (28)
Portsmouth 7.0 (15), 4.7 (10)
Basildon 6.9 (13), 3.7 (7)
Erewash 6.9 (8), 6.9 (8)
Rochford 6.9 (6), 5.7 (5)
Sutton 6.8 (14), 11.1 (23)
Chorley 6.8 (8), 8.5 (10)
Eastbourne 6.7 (7), 5.8 (6)
Surrey Heath 6.7 (6), 4.5 (4)
Runnymede 6.7 (6), 8.9 (8)
Gravesham 6.5 (7), 7.5 (8)
Bracknell Forest 6.5 (8), 4.9 (6)
North Somerset 6.5 (14), 2.3 (5)
Rugby 6.4 (7), 7.3 (8)
West Oxfordshire 6.3 (7), 5.4 (6)
Bournemouth, Christchurch and Poole 6.3 (25), 4.0 (16)
South Ribble 6.3 (7), 6.3 (7)
Milton Keynes 6.3 (17), 9.6 (26)
Maldon 6.2 (4), 1.5 (1)
East Devon 6.2 (9), 8.9 (13)
Exeter 6.1 (8), 7.6 (10)
Reigate and Banstead 6.1 (9), 6.7 (10)
Bassetlaw 6.0 (7), 11.1 (13)
Worcester 5.9 (6), 4.0 (4)
Tunbridge Wells 5.9 (7), 5.1 (6)
Copeland 5.9 (4), 7.3 (5)
North West Leicestershire 5.8 (6), 3.9 (4)
Boston 5.7 (4), 1.4 (1)
York 5.7 (12), 7.1 (15)
Tandridge 5.7 (5), 5.7 (5)
South Cambridgeshire 5.7 (9), 3.1 (5)
South Kesteven 5.6 (8), 2.8 (4)
South Derbyshire 5.6 (6), 0.9 (1)
West Suffolk 5.6 (10), 5.6 (10)
Wealden 5.6 (9), 1.9 (3)
Warwick 5.6 (8), 4.9 (7)
Horsham 5.6 (8), 6.3 (9)
Worthing 5.4 (6), 4.5 (5)
South Somerset 5.3 (9), 1.8 (3)
Crawley 5.3 (6), 8.0 (9)
Merton 5.3 (11), 9.2 (19)
Folkestone and Hythe 5.3 (6), 14.2 (16)
Tewkesbury 5.3 (5), 4.2 (4)
West Lancashire 5.2 (6), 5.2 (6)
North Hertfordshire 5.2 (7), 9.0 (12)
North Lincolnshire 5.2 (9), 6.4 (11)
Fareham 5.2 (6), 2.6 (3)
Colchester 5.1 (10), 2.1 (4)
Stafford 5.1 (7), 5.1 (7)
Fylde 5.0 (4), 6.2 (5)
South Oxfordshire 4.9 (7), 10.6 (15)
Mid Devon 4.9 (4), 12.1 (10)
Charnwood 4.8 (9), 8.6 (16)
Test Valley 4.8 (6), 4.8 (6)
Adur 4.7 (3), 7.8 (5)
Halton 4.6 (6), 3.9 (5)
King’s Lynn and West Norfolk 4.6 (7), 1.3 (2)
Stratford-on-Avon 4.6 (6), 5.4 (7)
Basingstoke and Deane 4.5 (8), 4.0 (7)
Huntingdonshire 4.5 (8), 5.6 (10)
Wyre 4.5 (5), 5.4 (6)
Cotswold 4.5 (4), 5.6 (5)
Torbay 4.4 (6), 8.1 (11)
North Kesteven 4.3 (5), 1.7 (2)
Rushmoor 4.2 (4), 9.5 (9)
North Devon 4.1 (4), 5.1 (5)
East Riding of Yorkshire 4.1 (14), 5.9 (20)
Thurrock 4.0 (7), 4.6 (8)
Aylesbury Vale 4.0 (8), 7.0 (14)
Bromsgrove 4.0 (4), 6.0 (6)
Swale 4.0 (6), 2.7 (4)
Cherwell 4.0 (6), 9.3 (14)
Woking 4.0 (4), 9.9 (10)
Medway 3.9 (11), 3.2 (9)
Wychavon 3.9 (5), 10.0 (13)
Eden 3.8 (2), 3.8 (2)
Teignbridge 3.7 (5), 3.7 (5)
Richmondshire 3.7 (2), 13.0 (7)
Doncaster 3.5 (11), 2.9 (9)
Daventry 3.5 (3), 7.0 (6)
Forest of Dean 3.5 (3), 1.2 (1)
Harlow 3.4 (3), 6.9 (6)
Wiltshire 3.4 (17), 4.2 (21)
East Cambridgeshire 3.3 (3), 6.7 (6)
Telford and Wrekin 3.3 (6), 11.7 (21)
Stroud 3.3 (4), 7.5 (9)
East Suffolk 3.2 (8), 2.0 (5)
Havant 3.2 (4), 4.0 (5)
North East Lincolnshire 3.1 (5), 3.8 (6)
Ashfield 3.1 (4), 2.3 (3)
Rother 3.1 (3), 3.1 (3)
Hull 3.1 (8), 3.1 (8)
North Warwickshire 3.1 (2), 6.1 (4)
Broadland 3.1 (4), 2.3 (3)
North East Derbyshire 3.0 (3), 3.9 (4)
Fenland 2.9 (3), 2.9 (3)
Dorset 2.9 (11), 3.2 (12)
Lewes 2.9 (3), 1.0 (1)
Mid Suffolk 2.9 (3), 3.9 (4)
Lancaster 2.7 (4), 7.5 (11)
Malvern Hills 2.5 (2), 3.8 (3)
Canterbury 2.4 (4), 4.2 (7)
Gosport 2.4 (2), 5.9 (5)
Tonbridge and Malling 2.3 (3), 5.3 (7)
Eastleigh 2.2 (3), 3.7 (5)
East Lindsey 2.1 (3), 4.9 (7)
Isle of Wight 2.1 (3), 1.4 (2)
Cornwall and Isles of Scilly 2.1 (12), 2.4 (14)
Braintree 2.0 (3), 3.9 (6)
South Lakeland 1.9 (2), 2.9 (3)
Arun 1.9 (3), 3.1 (5)
Scarborough 1.8 (2), 2.8 (3)
Ryedale 1.8 (1), 3.6 (2)
South Staffordshire 1.8 (2), 5.3 (6)
Craven 1.8 (1), 12.3 (7)
Maidstone 1.7 (3), 6.4 (11)
Chichester 1.7 (2), 7.4 (9)
Herefordshire 1.6 (3), 5.7 (11)
Ashford 1.5 (2), 1.5 (2)
Tendring 1.4 (2), 5.5 (8)
South Holland 1.1 (1), 1.1 (1)
West Lindsey 1.0 (1), 1.0 (1)
Cannock Chase 1.0 (1), 7.9 (8)
North Norfolk 1.0 (1), 1.9 (2)
Chesterfield 1.0 (1), 2.9 (3)
Amber Valley 0.8 (1), 5.5 (7)
Ipswich 0.7 (1), 5.1 (7)
Somerset West and Taunton 0.6 (1), 4.5 (7)
Melton 0.0 (0), 13.7 (7)
Dover 0.0 (0), 5.9 (7)
Barrow-in-Furness 0.0 (0), 3.0 (2)
Torridge 0.0 (0), 1.5 (1)West Devon 0.0 (0), 0.0 (0)

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