Some 44 million people, 78% of England’s population, will be under Tier 4, the highest level of coronavirus restrictions, from Thursday, U.K. Health Secretary Matt Hancock announced in the House of Commons on Wednesday.

Greater London and its surrounding areas are already in Tier 4. Cities joining London from Thursday include Birmingham, Manchester, Nottingham and Leicester.

Under Tier 4 restrictions, businesses deemed non-essential must close. These include entertainment venues such as theaters, concert halls, cinemas, museums and galleries, casinos, amusement arcades, bingo halls, bowling alleys, skating rinks, go-karting venues, indoor play and soft play centers and areas, circuses, fairgrounds, funfairs, zoos and other animal attractions, water parks and theme parks. Hospitality businesses like pubs, cafes, bars and restaurants are allowed to operate only as take-away venues.

Businesses that are permitted to operate include film and television productions and training and rehearsals without an audience in theaters and concert halls.

Scotland, Northern Ireland and Wales are already in the highest restriction tier.

The expansion of Tier 4 is a response to surging pandemic numbers in the U.K. A further 981 people have died, it was announced Wednesday, bringing the total to 72,548. Daily infection cases totaled 50,023.

“We must all stick at it during the difficult weeks ahead,” Hancock said. “We end 2020 still with great challenges but also with hope and confidence that in 2021 we have a brighter future ahead.”

Earlier on Wednesday, the U.K. approved the Oxford-AstraZeneca vaccine.

“It brings forward the day on which we can lift the restrictions that no one in this House wants to see any longer than are absolutely necessary,” Hancock said about the vaccine. “But we must act to suppress the virus now, not least because the new variant makes the time between now and then even more difficult.”

“And so whilst we have the good news of the vaccine today, we also have to take some difficult decisions,” Hancock added.