England’s hospitals are facing an ominous start to winter after flu activity climbed earlier than expected and Covid-19 admissions increased fivefold in a month, raising fears of a renewed squeeze on already overstretched NHS services.
September recorded higher influenza activity than the same period in each of the previous four winter seasons, according to surveillance data from the UK Health Security Agency (UKHSA). Although overall infection levels remain relatively modest, multiple indicators suggest the season began gathering pace as early as August.
Flu test positivity rose from 5 per cent to 6.5 per cent between September 28 and October 4, while hospital admissions reached 1.97 per 100,000 people.
Professor Frankie Swords, the NHS national medical director, described the figures as “slightly ominous early signs of winter pressure”, adding that flu admissions were at the highest level she could recall seeing at this point in the year.
The timing presents a fresh challenge for hospitals already operating close to capacity. Emergency departments experienced their busiest summer on record, while average hospital occupancy stood at 95 per cent throughout September, according to Professor Swords.
The rise in flu cases is also coinciding with an increase in Covid-19 infections and hospital admissions, creating the prospect of mounting pressure from multiple respiratory viruses as colder weather drives more people indoors.
Covid cases more than tripled between August and September, rising from 1,374 to 4,589. Hospital admissions associated with the virus increased fivefold over the past month, with infections climbing by nearly 30 per cent during the final week of September alone.
Dr Alex Allen, a consultant epidemiologist at UKHSA, said Covid activity had increased over the previous month or two, both in terms of infections and hospital admissions.
“As we enter winter, changes in weather and people spending more time indoors contribute to the spread of respiratory viruses,” he said. He added that immunity from previous infections and vaccinations could weaken over time.
Scientists have warned that the early flu season could translate into a longer period of transmission, although the timing alone cannot establish how severe the winter will become.
Professor Antonia Ho of the University of Glasgow’s Centre for Virus Research said an early rise in infections could indicate a more intense season, while cautioning that “onset timing alone doesn’t determine severity”.
Two influenza A subtypes, H1N1 and H3N2, are circulating in England alongside influenza B. UKHSA has identified minor genetic changes in H1N1 compared with the strain used in vaccine production, but experts say it is too early to determine whether this will affect vaccine effectiveness.
Health authorities are urging eligible people to get vaccinated promptly. Some 3.9 million people in England had received flu jabs since the campaign began last month.
Last winter’s vaccination programme was estimated by UKHSA to have prevented around 100,000 hospital admissions and 7,000 deaths.
Professor Sir Andrew Pollard, director of the Oxford Vaccine Group, urged people at greater risk because of their age or underlying health conditions to get vaccinated before infections peak.
The warning is stark: with hospitals already under pressure, an early flu season and rising Covid admissions leave the NHS facing another winter in which demand could intensify before services have had a chance to recover.
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