THE 'AGGRESSIVE' NEW SUPER-FLU STRAIN THAT COULD RUIN CHRISTMAS
Christmas is fast approaching, but the customary festive cheer has been dampened by doctors and health bodies warning that England is on the precipice of a tidal wave of flu cases. Some 8,000 patients in England could be in hospital with flu by this Sunday – a figure of such magnitude that, when statisticians began to sound the first warning bells last week, the UK Health Security Agency (UKHSA) went so far as to urge anyone with symptoms to “consider wearing a mask”.
The stark warning came amid fears for a health service in crisis, with flu season landing a month earlier than usual. The peak of the virus is yet to hit, and A&E departments are already “under siege”, according to NHS England. This grim outlook prompted the UKHSA to remind the public that “face coverings continue to be a useful tool in limiting the spread of respiratory viruses in some situations”.
Officials said: “Wearing a well-fitting mask when unwell can reduce the number of particles containing viruses that are released from the mouth and nose of someone who is infected with a respiratory infection.”
An average of 2,660 patients per day were in a hospital bed with flu last week – the highest ever for this time of year and up 55 per cent on the previous week. This is in part due to a particularly virulent strain of the circulating H3N2 virus. Last week, 21.4 per cent of flu tests carried out came back positive, which highlights how prevalent the virus is across the community. For comparison, in the middle of November, just 10.8 per cent of tests were positive.
More troubling for health officials is the hospitalisation rate, which jumped by almost a quarter week-on-week to 10 per 100,000 population – the highest in data going back to 2011-12. The extra squeeze on the health service is not helping. The latest hospital figures show that 999 calls and A&E demand have already reached New Year’s Eve levels; add to that the upcoming doctors’ strike and a festive period in which it is customary for many non-emergency departments to close or have reduced hours, and the pressure is building up.
“We should be able to handle a surge [like this],” says Dr Fiona Hunter, the vice president (Scotland) for the Royal College of Emergency Medicine, “but because the system is so broken, and we already have our corridors full of patients awaiting admission to the hospital, we simply don’t have room to handle the extra pressure.”
Patients turning up to emergency departments seeking care are increasingly finding themselves “waiting in the back of ambulances and, even worse, they’re waiting in the community, waiting for an ambulance to come and get them, or they’re waiting in a corridor attached to oxygen; they’re being toileted in the corridor,” Hunter adds. “It is not dignified care and not safe care, and it is obviously a huge risk to other patients.”
These close quarters are not just leading to higher patient infection levels, but also high levels of infection among staff. “We’ve got quite a high sickness rate... we’re putting ourselves at risk on a daily basis,” says Hunter. “Staff morale is incredibly low.”
Sir Jim Mackey, the chief executive of NHS England, warned last month that the health service was bracing for the worst flu season since records began. In recent months, Australia – often seen as an accurate indicator for the UK’s annual flu outbreak – confirmed 425,000 cases. The virus arrived earlier than usual and spread more widely, “and all the signs suggest the NHS will face similar challenges in the months ahead,” he said at the time. In Japan too, thousands of people have been hospitalised and classes have been cancelled at more than 6,000 education institutions.
There are four types of the flu virus, with “A” strains responsible for annual epidemics. Between June and July – the start of the Australian winter – most cases were caused by a variant of the H1N1 virus, but from September, H3N2 – which causes more severe illness in older adults – “became predominant,” explains Patrick Reading, the director of the Collaborating Centre for Reference and Research on Influenza at the World Health Organisation. “Specifically, a genetic subgroup of A(H3N2), called ‘subclade K’, has been rapidly spreading worldwide.”
Thanks to repeated mutations, the virus has now clobbered both hemispheres “The A(H3N2) K subclade has several changes in one of its outer spike proteins, known as the haemagglutinin spike, which is a key part of the virus targeted by the immune system after vaccination or previous infection,” says Reading. “These changes may help the virus spread more easily and partially evade immunity.”
Vaccine uptake currently stands at more than 70 per cent for over-65s, as per UKHSA figures, with early data showing 70-75 per cent efficacy at preventing hospital attendance in children, and 30-40 per cent efficacy in adults. Problematically, the form of the virus included in the vaccine is now somewhat different to the form wreaking havoc in Britain, making transmission control yet more challenging.
Despite this, doctors warn that some immunity is better than none. “Vaccination is our best defence against severe illness and hospitalisation,” says Dr Jamie Lopez Bernal, a consultant epidemiologist at the UKHSA. “But time is running out to get vaccinated ahead of Christmas. It can take up to two weeks from vaccination for your body to build maximum protection.”
Does that mean December 25 – and this month’s requisite festive socialising – is as good as cancelled? “I hope not,” says Chris Smith, a consultant virologist at Addenbrooke’s Hospital and presenter of the Naked Scientists podcast. But “the thing that Christmas does do is to bring multiple generations together. And in some respects that’s wonderful, because we know that being friendly and getting together and good wellbeing and all that is good for our health.”
Like Covid, however, “you don’t want one person to catch something which is trivial for one, but which could be really, really bad for another.” All health agencies advise that eligible groups (such as those aged 65 and over, and pregnant women) get the vaccine, which can both prevent contracting flu and reduce the severity of the illness for those affected.
For those that do catch the virus and end up in hospital, where almost two per cent of beds are currently occupied by flu patients, things become more complicated, says Smith. “Trying to do infection control and prevention – that’s the big headache.”
It is not only flu surging at this time of year, but other highly contagious viruses such as norovirus, respiratory syncytial virus (RSV) and paraflu. Handling outbreaks as they happen is hard; harder still when hospitals don’t yet know what is to come. “We don’t know how big the peak’s going to be; we don’t know if it’ll do everything it’s going to do in the next week or so, and then nothing after that, or if we’re going to have a slower burn, a lower peak but for longer so, overall, more people get affected,” Smith says.
He adds that the primary goal is that the fewest number of people get it and that they don’t all get it at the same time, because if they do there is a higher likelihood that they will all need to be in hospital simultaneously, making it harder to manage. And finding a spare bed isn’t the only challenge in packed NHS wards, but also where that spare bed is located. Patients with respiratory illnesses can’t simply take the next vacant space, because they will infect the people around them. “So you then need to have isolation facilities, or you’ve got to cohort patients together who’ve all got the same infection, and it makes it a much more tricky marshalling problem than if you’ve just got people coming in with broken legs.”
All of this is playing out with an ageing population in an increasingly frail system. To quote Smith, it is starting to feel like “one more thing is enough to bring the whole house of cards down”.
2025-12-12T12:25:29Z
