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Covid, flu, RSV ‘triple threat’ risks pushing NHS overboard


By Jess Hacker
15 July 2021

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The mix of Covid-19, influenza and Respiratory Syncytial Virus (RSV) could add unmanageable pressure to an already depleted NHS this winter, a report has warned.

Commissioned by the Government’s chief scientific adviser and published by the Academy of Medical Sciences (15 July), the report suggested that influenza and RSV hospital admissions could be double that of a normal year, coinciding with an anticipated Covid-19 spike.

Given the very low levels of influenza activity over winter 2020-21 and the mild influenza season in 2019-20, it is likely that population immunity to influenza will have diminished, it warned.

It added that there will also be a larger number of children who will have never been exposed to the virus.

Similarly, the report noted the recent easing of social contact rules has led to a summer surge of infections that are ‘typically seen in the winter’, including RSV, bronchiolitis, parainfluenza and rhinovirus.

Its ‘reasonable worst-case scenario modelling’ suggested RSV levels could peak at two times the normal level in early autumn, and 2.2 times for influenza.

This model would mean between 15,000 and 60,000 people could die from influenza this winter.

For RSV, this could result in ‘between a 25% and 65% increase in cases in children under 5 years old, and between 30%-100% increase in the youngest infants’, it said.

It warned that the NHS is already dealing with a current third wave of Covid-19 – with subsequent outbreaks expected up to spring 2022 – which will impact its ability to catch up with the care backlog.

The report also highlighted that the NHS is short of nearly 84,000 staff, and a shortage of 2,500 GPs.

Flu vaccine strategy

The Government should prioritise increasing the uptake of the influenza vaccine for high-risk groups including the elderly, health and social care staff, and children who can amplify spread, it said.

Just as the influenza vaccination programme was extended last winter, public health authorities should ‘consider whether the influenza vaccination programme for this winter should be extended in a similar fashion’.

NHS England yesterday published its Covid-19 booster jab plan, which will see flu and Covid jabs co-administered.

Meanwhile, the NHS should develop plans to increase paediatric ICU capacity to manage an RSV outbreak, with the introduction of multiplex testing for children and vulnerable adults, it said.

Resourcing primary care ‘immediate’ priority

The report added that adequately resourcing primary care, reducing the backlog of non-Covid-19 care, and increasing vaccine uptake are among the immediate priorities.

To achieve this, the Government must commit to bolstering local public health capacity, it said.

‘As we see greater variability in Covid-19 transmission and outbreaks at a local level, there needs to be a collaborative partnership between central government – who provide standards and consistency – and local authorities who should lead outbreak investigation and control,’ it said.

Local responses should be co-designed with local communities and delivered through local public health teams and primary care.

Professor Dame Anne Johnson, president of the Academy of Medical Sciences and Expert Advisory Group member, said: ‘The NHS must keep on delivering vaccines on a very large scale now, as well as preparing for a possible Covid-19 booster campaign and widespread programme of flu vaccination for those eligible this autumn.’

Last week, the NHS Confederation said the health service was facing a winter surge ‘in the middle of summer’, calling on the Government to make the public more aware of the ‘unprecedented situation’.

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