Thanks for joining our live coverage of the coronavirus pandemic, we'll be back tomorrow morning. Here's a reminder of some of the day's headlines:

• England's chief medical officer, Prof Chris Whitty, has warned this winter will be "exceptionally difficult" for the NHS "irrespective" of Covid cases, due to pressures from flu and falls
• Ministers have set up a £250m emergency winter rescue package so GP surgeries can take on more temporary staff to see more patients

• Health Secretary Sajid Javid says the plan will provide financial support and remove "red tape"
• But former health secretary Jeremy Hunt says the measures won't "turn the tide" and says a "sticking plaster will no longer cut it"
• And doctors' union the British Medical Association has been highly critical of the plan
• Meanwhile, six out of every seven coronavirus cases are not being detected in Africa, the World Health Organization says

• And finally, the UK has recorded another 45,066 coronavirus cases - the highest number of new infections since 20 July

This live page was written by Becky Morton, Jennifer Meierhans, Lauren Turner and Malu Cursino. It was edited by Hamish Mackay and James Clarke.

From all of us, have a good evening.

Nick Triggle
Health Correspondent

Since July, infection rates have been bobbling around – with periods of increases followed by drops.

That is a sign we have reached an equilibrium whereby the amount of immunity in the population keeps the virus in check.

However, it is now clear we are seeing the most sustained rise since July, with more than 45,000 new cases reported in the UK today.

There was always a concern the autumn could prompt a significant rise.

A combination of an increase in mixing with waning immunity could unbalance that equilibrium.

What is noticeable about the latest figures is that there are signs infection rates are going up in older age groups and not just in teenagers, certainly in England. That is a worry because of the impact it will have on hospital cases.

But what remains to be seen is how long this rise lasts – and what the consequences will be.

The roll-out of boosters will offer more protection to those at highest risk of serious illness.

The vaccination of children may help drive down overall infection levels.

With flu just beginning to take-off and a virus called RSV, the leading cause of hospitalisation for respiratory illness among the under fives, at high levels, it is easy to see why there is such concern about what the coming months will bring.

Image source, Getty Images

Members of the British Medical Association are calling for the health secretary to explain where extra locum doctors - otherwise known as temporary, freelance doctors - will come from to fulfil his winter plan.

Sajid Javid says £250m will be given to GP surgeries in England to pay for temporary staff to boost face-to-face appointments.

but Dr Ben Molyneux, BMA sessional GPs committee chair, says: “It’s not as if there is a large group of locums on standby, waiting for a call from their local practice to go in and help out.

"Those locums who can and want to be in work, are already doing so."

Dr Richard Vautrey, BMA GP committee chairman, adds that it is unclear how practices will access the new funding and how many hoops they will have to jump through to get it.

“Most worrying is that the funding is being linked to current performance, so it will penalise practices most in need of support," he says

“GP morale is already at rock bottom and being asked to ‘prove themselves’ in order to secure desperately needed extra investment will be an insult too far. Rather than taking away unnecessary bureaucracy as we needed, the government has just added more."

Tuberculosis is on the rise internationally for the first time in a decade, the World Health Organization says - linked to problems accessing healthcare during the pandemic.

WHO director-general Dr Tedros Adhanom Ghebreyesus says it is "alarming news" and "must serve as a global wake-up call" to the need to close gaps in diagnosis, treatment and care for those affected, the AFP agency reports.

In its annual TB report for 2020, the WHO had said progress towards eradicating TB entirely had been made worse, because of cases going undiagnosed and untreated.

It estimates about 4.1 million people have TB that has not been diagnosed or officially declared - up from 2.9 million in 2019.

Dr Tedros says: "This report confirms our fears that the disruption of essential health services due to the pandemic could start to unravel years of progress against tuberculosis."

Image source, Getty Images

Last month, Transport Secretary Grant Shapps said that "day two" PCR tests would be replaced with cheaper lateral flow tests for fully vaccinated travellers from "the end of October". Tour operators and airlines are now calling on the government to publish a date.

No firm details have been issued yet. Travel chiefs, and travellers going overseas, are frustrated by this delay.

Jet2 - UK’s second-largest tour operator - says it is experiencing an increase in demand following a difficult 18 months. The travel business says “half-term will be incredibly busy” and it will be “operating up to 2,500 weekly flights”. Steve Heapy, boss of Jet2, says: "It is time for the UK government to confirm exactly when these changes will come into force."

Half-term holidays begin this Friday in some areas of England, while other schools in England and Wales follow in the last week of October. Northern Ireland's schools have a short break in October and Scotland's half-term has already happened.

The government is encourageing travellers to hold off from booking tests for half-term.

At the moment, fully vaccinated travellers need to do a PCR test on day two of arrival in the UK. Under the new rules, lateral flow tests will replace PCR tests for those that are fully jabbed, but the date of the change remains unknown.

There are no changes if you are not fully vaccinated.

The UK has recorded another 45,066 coronavirus cases, according to the government's daily figures., external

It is the highest number of new infections since 20 July, when the number was 46,558.

Another 157 deaths within 28 days of a positive Covid test have also been reported.

Image source, Getty Images

Earlier we heard from England's chief medical officer Prof Chris Whitty, who warned this winter will be "exceptionally difficult" for the NHS.

While the vaccination programme has weakened the link between Covid cases and hospital admissions, the health service also faces other challenges, including the return of normal winter illnesses and a backlog of other patients waiting for treatment delayed by the pandemic.

Last year saw much lower levels of flu than normal due to lockdown measures and social distancing.

But this means immunity to flu and other respiratory viruses will have waned, while very young children will not have been able to develop any at all.

Alongside Covid patients, this could put significant pressure on NHS services.

Hospitals are also dealing with a huge backlog, with record numbers waiting for operations and other routine treatments.

Image source, Getty Images

Basketball star Kyrie Irving says he is "doing what's best for me" in refusing the Covid-19 vaccine, a move that will see him sidelined from the NBA.

His team the Brooklyn Netts says Irving will not play until he is eligible to become "a full participant" under New York City Covid-19 vaccine rules.

Regulations state that all athletes, external who play or train in the city have to be vaccinated and the 29-year-old says he will not bow to pressure.

Speaking about the issue on Instagram, Irving says: "Do what's best for you, but I am not an advocate for either side. I am doing what's best for me."

As we've been reporting, ministers have set up a £250m emergency winter rescue package so GP surgeries can take on more temporary staff. So how far will that money go?

There are around 7,500 GP surgeries in England, according to NHS data.

The Shadow Health Secretary Jonathan Ashworth says that the proposal works out at £33,000 per GP surgery which "is not enough money to recruit an extra doctor".

The government says the money is to help surgeries take on more temporary staff.

Royal College of Practitioners, external is advertising some locum GP roles at around £700 a day and on that basis the money would pay for a temporary GP at one surgery for 47 days.

Image source, AFP

Six out of every seven coronavirus cases are not being detected in Africa, the World Health Organization (WHO) says.

It has made the calculation based on a formula that looks at recorded deaths and case fatality rates.

So far only eight million Covid cases have been recorded but the WHO now estimates the real figure could be 59 million.

In the main, the only people who are tested are those who turn up at health centres with symptoms and those intending to travel out of their country. This means a huge number of asymptomatic cases are not being spotted, resulting in more transmission.

To deal with this, the WHO is boosting community screening in eight countries aiming to reach seven million people with rapid testing in the next year.

“With limited testing, we’re still flying blind in far too many communities in Africa... More testing means rapid isolation, less transmission and more lives saved through targeted action,” says WHO's Africa director Dr Matshidiso Moeti.

Burundi, Ivory Coast, the Democratic Republic of the Congo, Guinea Bissau, Mozambique, Congo-Brazzaville, Senegal and Zambia will be taking part.

There has been a decline in recorded new cases recently, the WHO says, but there is concern that with low vaccination rates Covid remains a threat for many.

Case rates in England are continuing to rise in all age groups, according to the UK Health Security Agency.

The highest rate is among 10 to 19-year-olds, with 1,120.8 cases per 100,000 people in the seven days to 10 October, up week-on-week from 1,061.8.

This is followed by five to nine-year-olds, for whom rates are up from 484.2 to 574.2.

For both age groups this is the highest weekly rate since this data was first collected in October 2020.

The lowest rate is among people aged 80 and over, at 110.8, up from 90.2.

Vaccination rates are lower in under-18s, as healthy 16 and 17-year-olds were only offered a Covid jab from early August, while first doses have been offered to 12 to 15-year-olds since 20 September.

Meanwhile, cases are also rising in all regions of England, the data shows.

The East Midlands has the highest rate, with 488.7 cases per 100,000 people, up from 450. London has the lowest rate at 214.2, up from 204.6.

You can check the number of cases in your area here.

Image source, JAMES PAGET HOSPITAL

A nurse has received an award from the Royal College of Nursing for her outstanding efforts to create a Covid-19 vaccine clinic for people with learning disabilities and autism.

Rebecca Crossley developed a sensory-friendly clinic with patients who find syringes, PPE and a noisy clinic daunting at the heart of her planning. Due to her efforts to make the environment as sensory-friendly as possible, the clinic has a 99.9% vaccine take-up rate.

Rebecca pitched the idea to the clinical commissioning group and James Paget Hospital following her own experience having the Covid jab earlier this year.

The clinic is ongoing and based in the Waveney area of Norfolk and north Suffolk.

The Royal College of Nursing says its awards showcase the diversity of nursing and recognise commitment, compassion and clinical excellence.

Rebecca says patients "come through a sensory garden to enter the clinic, where all the equipment is hidden behind a screen".

She adds that it is important "to get it right the first time because people have to come back, and if you get it wrong, they won't come back".

Image source, Getty Images

We've been telling you about a new winter plan that's being set up in England. As part of it, GPs are being told to see more patients face-to-face, with funding being given for more temporary staff.

Health Secretary Sajid Javid says the new GP rescue package will help relieve pressure on the whole system.

But what do GPs themselves think about it?

Dr Rob Barnett, who works at Greenbank Road Surgery in Liverpool, says: "I would ask the health secretary to come here to our surgery and see for himself how it works and how we’ve had to change to support patients.

“More face-to-face appointments isn’t the answer - if we were to make all our interactions face-to-face we would end up with huge waiting lists."

Dr Barnett, a British Medical Association representative in the North West, says GPs are "having more contact than ever with patients" online and on the phone - and that "just throwing money at the issue" is not going to solve their problems.

And Dr Nigel de Kare-Silver of Gladstone Medical Centre in north-west London says the fund is "a long-awaited recognition of the impossible strains on our services".

But he stresses there are "massive workforce issues which cannot be ignored with an undersupply of trained competent GPs across the UK".

"Even with this boost on funding", he says, "the historic decline in GP numbers" would not be alleviated.

But, he says recognition of the problem by government could help "alleviate the pressures from patients who have health concerns - increasingly expressed as abuse to our front-line reception and clinical teams".

Image source, Getty Images

The government has set up a £250m emergency winter rescue package so GP surgeries can take on more locums - but what does this mean?

What is a locum GP? They are doctors who are employed on a temporary basis to help surgeries fulfil appointments. They may be self-employed or work for an agency. They might work solely as a locum, be employed by another surgery or have retired from full-time practice.

How much do they earn? Locum GP roles advertised by the Royal College of General Practitioners, external are about £700 a day.

Richard Fieldhouse, chairman of the National Association of Sessional GPs (NASGP) says an agency locum can cost upwards of £1,000 a day with 30% going to the agency.

But he says some locums charge £200 per half day to work at a surgery where they feel part of a team.

"Money has never been the problem in getting locums, it's how you treat them," he says.

How many locums are there? NASGP says there are about 20,000 locum GPs across the UK and they make up 25% of the workforce.

Image source, Getty Images

British actress Letitia Wright has denied a report that she shared anti-vaccination views on the set of Black Panther 2.

Wright, who plays Shuri in the Marvel films, says the story in The Hollywood Reporter is "completely untrue".

It comes after she was criticised in December for sharing a video making unsubstantiated claims about the safety of coronavirus vaccines.

Wright, 27, has responded on Instagram, saying: "Anyone who knows me or has worked with me, knows that I work incredibly hard at my craft & my main focus is always to do work that's impactful and inspiring. That has been & will continue to be my only focus."

Late last year, she become embroiled in a controversy after posting a link to a video whose host said people taking the vaccines would have to "hope it doesn't make extra limbs grow".

After being criticised on Twitter, Wright said she wasn't against vaccines but it was important to "ask questions".

Read more here.

Image source, PA Media

England's chief medical officer Prof Chris Whitty has been speaking at a GPs' conference and says this winter will be "exceptionally difficult" for the NHS.

He says this will be the case "irrespective" of whether the country experiences relatively low Covid cases or a further surge, alongside other winter pressures such as flu and falls.

Prof Whitty also praises GPs for their "outstanding" hard work during the pandemic, after some said they felt they were being attacked by sections of the media and some politicians over the issue of face-to-face appointments.

On the lessons to be learned from the pandemic, he tells the annual conference of the Royal College of GPs "there are certainly some quite significant things we got wrong at the beginning of Covid".

However, he says it would be a mistake to assume the lessons from the current pandemic would necessarily be applicable to the next one.

Image source, EPA

Former health secretary Jeremy Hunt says unless the government addresses long term planning for the GP workforce the number of face-to-face appointments will go down and not up.

In a long thread of tweets, external the Conservative MP, who chairs the Commons Health and Social Care Committee, says: "As someone who tried and failed to get 5,000 more GPs into the system, I don’t think this package will turn the tide."

He says he got thousands more graduates into GP surgeries but found experienced GPs were retiring or going part time faster than new trainees arrived.

Hunt says the only way to stop this is "a clear plan to end the unsustainable pressure they face".

He suggests a big recruitment drive and incentives to persuade retired GPs who stepped up temporarily during the pandemic to extend their service.

"But sticking plaster after sticking plaster will no longer cut it. Unless we fix workforce planning in the NHS for the long term, the future will be bleak and the number of face-to-face GP appointments will go down not up," he says.

Image source, PA Media

The new justice secretary says he can't promise when court backlogs in England and Wales will return to pre-pandemic levels.

Funding cuts and delays caused by Covid restrictions have contributed to the unprecedented delays in prosecuting and jailing criminals.

More than 60,000 crown court trials are waiting to be heard with many serious cases now being listed in late 2023.

Dominic Raab, who moved to the role last month, tells the BBC he hopes backlogs will fall within 12 months but could not give a precise figure.

Read more.

Russia’s surging outbreak hits a population with only 31% fully jabbed, according to the Gogov website, which tallies data from around the country.

The Kremlin has refrained from re-introducing major restrictions, despite calling the country's vaccination rate "unacceptably" low. It says authorities have to ensure "the economy continues working."

Today, Kremlin spokesman Dmitry Peskov has ruled out a lockdown and says authorities have to "continue to explain to people that it is necessary to be vaccinated.”

"It's irresponsible not to get the vaccine," Peskov says.

He adds "the entire medical infrastructure is mobilised” for the surge in coronavirus patients, and says it is not "overwhelmed".

Russia's Health Minister Mikhail Murashko blames the growing spread on the "behaviour" of Russians and is urging them to get vaccinated.

Although several Russian-developed jabs have been available for months, authorities are struggling to inoculate a vaccine-sceptic population.

Moscow - the epicentre of Russia's outbreak - has so far withheld from bringing back restrictions. However, it announced on Monday that two dozen sites would open in the capital for residents to get free rapid tests.

Independent experts have accused authorities of downplaying the severity of Russia's epidemic.

Russia’s Federal State Statistics Service, also known as the Rosstat statistics agency, said last week an estimate of 400,000 Russians that contracted coronavirus had died by the end of August.

Covid infections rose exponentially among five to 17-year-olds in England in September, as children returned for the autumn school term, research suggests.

Across the general population, the React-1 study, conducted by Imperial College London and Ipsos Mori between 9 and 27 September, found one in 120 people were infected and prevalence appears to be remaining stable overall.

The data shows the infection rate is growing most among those aged under 18, and falling among those aged 18 to 54.

Prof Paul Elliott, director of the React programme, says the trends "reinforce how important it is for children aged 12 and above to get vaccinated and help curb the spread of infection, and minimise disruption to education".

Relatively few under-18s have been vaccinated in the UK, as healthy 16 and 17-year-olds were only offered the jab from early August, while first doses have been offered to 12 to 15-year-olds since 20 September.

The study's findings also support the arguments for booster jabs for adults, with a higher prevalence of fully vaccinated people testing positive within three to six months of their vaccination.