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Jonathan Van-Tam has become one of the break-out stars of the pandemic thanks to his direct, no-nonsense style. When the nation was coming out of lockdown last summer, the deputy chief medical officer (known affectionately as JVT) was the one who famously told us not to “tear the pants out of it”.

Tonight, he was as blunt as ever as he delivered a fresh warning at a No.10 press conference that felt deliberately designed to startle the public and jolt them out of any complacency. His “do not wreck this now” message was accompanied by some worrying charts showing virus case rates going up, not down, in one in five areas of the UK. This, on the day the R number stayed stubbornly unchanged.

Van-Tam certainly guaranteed headline and front page newspaper coverage with his warnings, not least because he neatly captured fears that the prospect of warm weather this weekend would prompt people to drop their guard. It’s not the rising temperatures outdoors that worry him, it’s the Covid hotspots. “There are still quite a few areas of the UK that are burning quite hot,” as he put it.

The message once again was that even apparently small infractions of the rules, all those “it’s only a one night stay” or “my mum was only in my garden for a few minutes”, add up to a public health risk if replicated across the country. And Van-Tam explicitly warned that the milestones on the PM’s roadmap were in jeopardy. In a nutshell: behave or you’ll have to wait even longer for the pub or hairdresser.

Now it’s worth saying that it’s not entirely clear that the levelling off or the rise in cases in some areas is due to people breaking the rules. There may be other factors such as bosses insisting on people coming into work, or, perish the thought, it may be that new variants are spreading undetected in greater numbers than expected. Maybe the recent freezing cold snap prompted more indoor spread. Another reason may be uneven distribution of vaccination.

Speaking of which, the good news today was that we are back above half a million first doses a day in the vaccine programme. Matt Hancock added that “We’re going to have a bumper March” thanks to new supplies coming on stream (and given the need for all those second doses within 12 weeks of the first, that’s a relief).

The other good news were yet more tentative signs of the “vaccine effect” on hospitalisation and death, with numbers among the older population falling rapidly. Hospitalisations are the lowest for over 4 months, easing pressure on the NHS for all those crucial non-Covid treatments.

But Van-Tam is right that if the cases continue to tick up, then Boris Johnson’s timetable looks less secure. Will April 12 become April 26? Will the promised June 21 now become July 5? After all, the government’s five-week pause between stages allows for exactly that kind of extra delay.

The real problem for the PM is just how variegated the UK map now looks. Hancock again insisted tonight that “the goal is for us all to come out together” yet what if case levels continue to diverge across the nation, and hotspots become hotter while coldspots become colder? Pressure from Tory MPs to have a tiered response (as in Scotland don’t forget) will intensify.

Still, the PM has been pretty firm that tiers are not coming back. Yet if he holds his nerve on that, then his problems could be more difficult than he thinks. If it turns out that more deprived, overcrowded areas are the ones with stubbornly high case rates (and lower vaccination rates), and if the whole country’s unlockdown is dictated by the worst cases, he’s going to have to tackle the thorny issue of income and isolation levels.

With the Budget due next week, normally a chancellor will have signed off all the measures needed by the weekend before. But maybe, just maybe, Rishi Sunak will have to finally agree to a simple salary replacement scheme for people too scared to lose wages. With cases lower overall than a month ago, it may not be as expensive as some in the Treasury suggested.

So, if his roadmap is to stay on track, the PM may have to pay for it in pounds and pence. And that “don’t wreck it now” message from Van-Tam could be as much a message for Sunak and Johnson as it is for the public.