Nightingale hospitals have been asked to mobilise to deal with a rise in coronavirus patients, the medical director for the NHS in England has announced.

Stephen Powis told a televised briefing on Monday morning there are more coronavirus patients in hospital now than there was when Boris Johnson imposed the first national lockdown in March.

“If we do not take measures to control the spread of the virus, the death toll will be too great to bear,” he said.

Powis said it was “wishful thinking” to believe the elderly could be “fenced off from risk”.

“It is clear that hospital admissions are rising fastest in those areas of the country where infection rates are highest, particularly the North West,” he said.

“Sadly, as the number of those infected increases, then so will the number of people who die.”

Powis said the specialised Nightingale facilities in Manchester, Sunderland and Harrogate had been told to be ready to accept patients.

England’s deputy chief medical officer Jonathan Van-Tam told the No.10 briefing there had clearly been a “marked pick-up” in coronavirus cases, which would result in more deaths.

He said more deaths were now “baked in” as the infection rate was “creeping” from those aged 16-29 to older more vulnerable groups.

Van-Tam said the virus spread in closed spaces, crowded spaces and areas where people were in close contact.

“We do know the virus thrives on the thing we like most which is human contact,” he said.

It comes as Johnson prepares to set out his three-tier strategy in a Commons statement on Monday afternoon, with areas in England labelled as medium, high or very high risk, which will inform the “appropriate interventions” needed in each area.

In Merseyside, which is expected to be subject to the most stringent Tier 3 controls, local leaders were battling for an enhanced package of financial support for businesses hit by the new measures.

Manchester meanwhile was resisting moves to require it to close pubs and bars, arguing that it should be placed in the less restrictive Tier 2 category.

The prime minister will hold a press conference with chancellor Rishi Sunak and chief medical officer professor Chris Whitty on Monday evening. MPs are expected to vote on the new controls on Tuesday.