Nationwide restrictions cannot be ruled out should England see a spike in coronavirus cases this winter, the health secretary has warned.

Matt Hancock has also hinted that restrictions may not be eased over Christmas in order to avoid an “uptick” in the number of Covid-19 cases.

Speaking to The Times, Hancock said countries in others parts of the world were already experiencing a second wave, adding it was “a very serious threat”.

But he said the UK was managing to keep the number of new cases “flat” through the test and trace system and local lockdowns.

Describing the worst-case scenario, he said the UK could be battling bad flu and a growth in coronavirus as people spend more time indoors.

He continued: “Cases go up again, and we have to use very extensive local lockdowns or take further national action.

“We don’t rule that out, but we don’t want to see it.”

BBC’s Newsnight reported on Friday that a ‘reasonable worst-case planning assumption’ presented to the government warned there could be up to 81,000 excess deaths directly attributed to Covid-19 between July and next March.

The broadcaster said the scenario was laid out in a document signed off by the Scientific Advisory Group for Emergencies (SAGE) for the Cabinet Office at the end of July.

Hancock’s comments come as local Covid-19 restrictions were eased in northern England, which will allow social gatherings between two homes from Wednesday in Bolton, Stockport, Trafford, Burnley, Hyndburn and parts of Bradford, Calderdale and Kirklees.

Hancock told The Times that a second wave could be “avoidable but it’s not easy”, with schools reopening next week presenting new challenges in stopping the spread of the virus.

In an interview with ITV News, Hancock said: “We’re doing a huge amount of planning to make sure that the NHS is prepared and can cope to make sure that people can have as much freedom to enjoy Christmas, to enjoy winter, as possible.”

But when asked whether there will be special rules to allow more people to visit one another over Christmas, Hancock suggested it could lead to a rise in the number of people catching the virus.

“The danger of a rule like that is that it increases the spread of the disease,” he said.

“I mean, there are an awful lot of things I’d love to be able to do, but the risk of them is that we see an uptick in the disease.

“Hence, we’ve had to take decisions that you wouldn’t ever want to.”

Tory former minister Tobias Ellwood said “draconian action” could be needed if the public do not stick to social distancing rules, hinting the government could take stronger action than local lockdowns.

He told Times Radio: “It’s an enduring emergency and until a vaccine turns up there is a national resolve, there is a responsibility, a duty of every individual… also the Government needs to keep the nation safe and that’s where Matt Hancock’s work comes in and then Rishi Sunak needs to make sure the economy is working.

“If the nation, if individuals aren’t following the rules then ultimately… we cannot break the chain of spread and therefore draconian action is required to take place.”

On vaccines, the health secretary said there is potential for it to be available this year, but that it is more likely next year.

He continued: “It’s a very difficult science, it’s thankfully one that our scientists are up to, and each sign at the moment is going well and going in the right direction.

“But we don’t want to raise people’s hopes too much.”

The government is responding to “an increase in anti-vax messages and anti-test messages”, he said, with a programme under way to tackle “these sorts of conspiracy theories” which he branded as “wrong”.

When asked about the government’s U-turns on a number of policies recently, Hancock said he believed people would have been “really cross” if they did not happen.

“We’re dealing with a crisis that is entirely unprecedented,” he responded.

“We’re dealing with a disease that didn’t even exist, as far as we know, before December last year.

“And so, we’re taking decisions guided by the science on it.

“I think people would, what people would get really cross about, is if a government refuse to change even if evidence came up that there was a better option.”

Prime minister Boris Johnson said on Friday that schools were safe to attend as he encouraged every pupil to return to the classroom.

“The evidence is overwhelming that it is in the interest of the wellbeing and the health of children, young people, pupils, to be back in school rather than missing out any more,” he said.

“So, it is the healthy, safe thing to do.”