Across the North West there are now a total of 157,193 confirmed coronavirus cases.

New figures released by Public Health England show a further 1,278 cases across Lancashire, 92 in Cumbria, 460 in Manchester, 478 in Liverpool and 225 in Cheshire.

Matt Hancock said the Government is "working hard" to secure a Tier 3 deal with Greater Manchester while talks are continuing with five other parts of the UK over moving them into the highest tier, joining Lancashire and the Liverpool city region.

The Health Secretary has also come under pressure today from Tory MPs in the region to review the restrictions relating to the closure of gyms in Tier 3 areas.

The latest data shows that Liverpool has overtaken Manchester with the number of confirmed cases since the start of the pandemic.

The North West now accounts for nine of the top 10 highest weekly infection rates of Covid-19 in England and 18 of the top 20.

However analysis of the figures shows the numbers are falling in cities with high seven-day rate of new case.

Knowsley continues to have the second highest rate in England behind Nottingham, but this is down from 729.1 to 673.5, with 1,016 new cases.

Third placed Liverpool has seen their rate drop from 684.7 to 606.6, with 3,021 new cases while the rate in fourth placed Burnley has decreased from over 600 last week to 536.4.

Case rates have also fallen in the cities of Manchester, Leeds Newcastle and Sheffield.

The data below includes the total number of cases and overall infection rate for each area since the pandemic began. Many of these cases will no longer be active.

These are the number of confirmed cases of coronavirus by North West borough as of today (October 19):

There are 30,648 cases in Lancashire, 7,650 in Bolton, 4,637 in Bury, 4,661 in Cheshire East, 4,422 in Cheshire West and Chester, 5,163 in Cumbria, 2,746 in Halton, 4,947 in Knowsley, 15,063 in Liverpool, 15,541 in Manchester, 6,790 in Oldham, 6,006 in Rochdale, 5,994 in Salford, 6,243 in Sefton, 4,326 in St Helens, 5,009 in Stockport, 5,064 in Tameside, 4,501 in Trafford, 4,333 in Warrington, 7,006 in Wigan and 6,443 in Wirral.

Mr Hancock told the House of Commons that large parts of the North of England are headed towards the 'very high' Covid Alert Level.

He also said he is "very worried" about the rising number of cases among the over-60s in the Liverpool city region, Lancashire and Greater Manchester.

He said: "Following the successful introduction of measures in Liverpool and Lancashire, talks are continuing this afternoon led by the Communities Secretary with Greater Manchester, and this week further discussions are planned with South Yorkshire, West Yorkshire, Nottinghamshire, the North East and Teesside.

"Cases continue to rise among the over-60s, who are the most likely to end up in hospital or worse.

"I’m very worried that the cases per 100,000 among the over-60s is 401 in the Liverpool City Region, 241 in Lancashire and in Greater Manchester has risen over the past week from 171 to 283."

Projections produced by the Government suggested Manchester’s hospitals risked being overwhelmed by November 12.

The Prime Minister’s official spokesman told a Westminster briefing: “Cases in Greater Manchester continue to rise.

“In the over-60 age group, cases have tripled in the most recent 15 days of full data – there were 89 cases per 100,000 on September 27 compared to 282 per 100,000 on October 12.

“Hospital admissions in Greater Manchester are doubling every nine days.”

Asked if that meant hospitals being overwhelmed, the spokesman said: “Yes, that’s the entire surge ICU capacity.”

Currently the number of Covid-19 patients in intensive care is around 40% of that seen at the peak of the first wave.

Talks between Whitehall figures and Greater Manchester continued on Monday and ministers are now “carefully considering next steps” after failing to strike a deal.

Local figures including Mayor Andy Burnham have resisted moving into the higher bracket, which would result in pubs and bars being ordered to close as part of a package of strict measures.

Mr Burnham has written to Boris Johnson to express “disappointment” at the outcome of the meeting with the Government.

Senior Conservative Sir Graham Brady, MP for Altrincham and Sale West, said many are “sceptical” that closing pubs, bingo halls and gyms will make a “significant difference” to the spread of Covid-19.

While fellow Tory and Southport MP Damien Moore called on Mr Hancock to “get our gyms open”, adding “they part of the solutions, not part of the problem.

Labour’s Angela Eagle (Wallasey) called for the Government to “be consistent across tiers” in relation to gym and soft play closures.

She asked: “Why in Merseyside which is currently in Tier 3 were all the gyms forced to close, but soft play was left open and in Lancashire all the gyms were left open and soft was closed.

“Surely this doesn’t make any sense at all and will he publish the evidence that he’s got and be consistent across tiers. Either all the gyms are open or they should all close, which is it to be?”

Mr Hancock said: “The baseline for Tier 3 is set across the board, and then further measures are set out in consultation with an agreement with the local area.”

Tory Damien Moore (Southport) said: “The gyms in Lancashire are open, the gyms in Merseyside are closed. The deal that was struck for us wasn’t a good deal for my constituents in Southport.

“Will the Secretary of State review these restrictions as soon as possible and get our gyms open, they part of the solutions, not part of the problem.”

Mr Hancock replied: “Nobody has stood up for the gyms of this country more than (him) and he’s made this argument endlessly to me….I will take this point away….

“The reason that these decisions were taken was in agreement with the local area and we want to, as much as possible, make agreements with local areas so that we can all give over the same public health messages, which is if everybody follows the rules, then we are more likely to get this under control and get the Liverpool City region out of tier 3 altogether.”

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