Intended for healthcare professionals


Sixty seconds on . . . the “twindemic”

BMJ 2022; 379 doi: (Published 03 October 2022) Cite this as: BMJ 2022;379:o2370
  1. Zosia Kmietowicz
  1. The BMJ

An epidemic of twins?

Although the rate of multiple births in the UK has been rising over the past 20 years, it’s starting to slow down, in line with singleton births.1 But this isn’t about twins. We’re talking about the dual epidemics of flu and covid-19 which will be in circulation this winter.

Oh, brother!

Indeed. Public health officials are certainly getting worried. Last week the UK Health Security Agency urged parents to vaccinate their 2 and 3 year old children against flu this year, because of fears over a lack of natural immunity caused by reduced exposure during the pandemic.2 All those eligible for a flu vaccine should also book their jab, it said.

The deadly twins?

Possibly. An analysis by health analytics company Airfinity has estimated that hospitals in England could see more than 7500 people admitted to hospital every week in January 2023 with covid-19 or flu (under different scenarios, such as vaccination status). This surpasses the previous threshold of 4000 weekly admissions for covid-19 which triggered lockdowns.3

What are hospital admissions for covid-19 now?

Going up. In England admissions to hospital of people with confirmed covid-19 increased to 7.62 per 100 000 people in the week ending 25 September, up from 4.91 per 100 000 the previous week (18 September).4 The Office for National Statistics said this was the first increase seen in hospital admissions since July 2022.

What do we know about flu from down under?

Australia has had a difficult flu season with flu notifications reaching 27 500 a day in June this year, much higher than the peak of 17 500 in 2019 and the five year average peak of 7500.5


I should say so. The message from trust leaders and health officials is to get double jabbed to prevent serious illness and ease pressure on health services. Louise Blair, head of vaccines and variants at Airfinity, said, “Vaccine fatigue could exacerbate the problem.” Uptake of covid boosters is currently about 45% in the US to 70% in the UK, compared with over 90% in previous rollouts. “Higher uptake could protect healthcare systems this winter,” said Blair.