Hospital flu cases have quadrupled in one month, however GPs have reported ‘as expected’ levels of respiratory virus in the community.
NHS England warned last week that flu cases have ‘continued to skyrocket’ with over 5,000 patients hospitalised with the virus at the end of last week.
This comes as the UK Health Security Agency (UKHSA) issued an ‘amber’ cold health alerts this week, and after data in December showed a lag in flu vaccination rates. At the latest count, only 37.6% of those under 65 years in a clinical risk group had taken up their vaccine offer; 33.1% of all pregnant women; and 73% of over-65s.
The national booking system for flu vaccination closed in December, but NHSE has encouraged eligible patients to visit Covid-19 walk-in sites or participating pharmacies.
Since the seasonal influenza enhanced service for practices runs until 31 March 2025, GPs told our sister title Pulse they are continuing to push for vaccination among eligible groups while their stocks last.
However, they also indicated that the number of respiratory virus cases they are seeing in the community is in line with previous years, despite reports of increased hospital cases.
NHSE said there were 4,102 patients in hospital with flu on Christmas day, which ‘rose sharply’ to 5,074 by 29 December, meaning cases have quadrupled in just a month, from 1,190 on 29 November.
The number of patients with flu in hospital each day last week – at an average of 4,469 – is almost 3.5 times higher than the same week last year, according to NHSE.
The UKHSA has said its latest data ‘shows the anticipated increase in flu activity over the festive season’, with the influenza positivity rate increasing from 26.4% in the penultimate week of the year to 29.5% last week.
Nottingham GP partner Dr Irfan Malik said that ‘obviously’ his practice is seeing ‘respiratory infections more than other times of the year’, but that the level for this time of year has been ‘the same as average’.
‘I think the hospitals are seeing a different cohort of patients, the more severe ones affected by the flu,’ he said.
Dr Malik also suggested that the high level of cases may be a result of the timing of flu vaccinations this year.
He said: ‘Normally, the flu vaccinations restart in September, but this year, the guidance was to start in October, and I wonder whether that’s had a bit of an effect on this as well.’
Dr Pipin Singh, a GP partner in North Tyneside, said his practice is seeing ‘lots and lots of respiratory viruses’ and this is ‘not uncommon in November, December and January’, but he could not say with certainty whether they are seeing ‘more than usual’.
He said: ‘It’s difficult to know for us whether something’s flu or Covid or RSV or human metapneumovirus or something, just because we don’t do swabs and testing for flu.’
On vaccination, Dr Singh said his practice is continuing to send texts to eligible patients to boost uptake, and is ‘actively encouraging’ those they come across who have not already been vaccinated.
In East London, GP partner Dr Selvaseelan Selvarajah said of respiratory viruses that his practice is ‘seeing in line with what [they] expect to see in flu season’.
He added: ‘We tend to reserve more on the day appointments, because we know during the winter season there’ll be many more patients consulting with us with respiratory conditions.
‘So we’ve seen lots and lots of kids, adults, elderly people with flu-like symptoms, with RSV, and there’s also Covid around as well.’
Dr Selvarajah said they have sent ‘a handful’ of such patients to hospital over the last week, but ‘not in increased numbers’.
He also said flu vaccine uptake in his area ‘hasn’t been great’ with less than half of eligible patients coming forward.
Despite the national booking system coming to an end, Dr Selvarajah said his practice ‘will be continuing to push’ for vaccine uptake, with patients being offered it ‘opportunistically’.
Health secretary Wes Streeting said there has been a ‘tidal wave of flu this winter’ which is ‘putting huge pressures on the NHS’.
He continued: ‘This government has ended the strikes so staff are on the frontline this winter rather than the picket line, introduced the new RSV vaccine, and put immediate extra investment into the NHS.
‘But we have been honest from day one that the status quo isn’t good enough. We are investing in and reforming our NHS, and grasping the nettle of social care reform, to finally break out of the cycle of annual winter crises, because there is no solution to the crisis in the NHS that doesn’t involve a solution to the social care crisis.’
Dr Lindsay Broadbent, a lecturer in virology at the University of Surrey, said the number of people with flu is ‘increasing rapidly’ and that the ‘higher than usual levels of flu hospitalisation’ are partly due to lower vaccination rates in some groups.
She said: ‘There are many strains of influenza, each year the vaccine is designed to target the strains that are most likely to be circulating.
‘This is based on flu data that emerges from around the world. Meaning the efficacy of the flu vaccine can change from year to year.
‘However, even if the vaccine isn’t a perfect match to the circulating strains, it does still provide good protection against severe disease. But even a small drop in efficacy can result in increased hospitalisation numbers.’
A version of this story was first published on our sister title Pulse.
