Intended for healthcare professionals


England and Scotland see sharp rise in covid and flu cases as hospitals struggle

BMJ 2023; 383 doi: (Published 21 December 2023) Cite this as: BMJ 2023;383:p2977
  1. Elisabeth Mahase
  1. The BMJ

Just over 4% of people in England and Scotland—around one in 24—may have had covid-19 last week, says the latest release from the Winter Coronavirus Infection Study.1

Data released by the UK Health Security Agency (UKHSA) showed that on 13 December the prevalence of SARS-CoV-2 was estimated to be 4.3% (95% credible interval 3.3% to 5.4%) in England and 4.1% (3.0% to 5.6%) in Scotland. This is a sharp rise from the estimated 1.8% prevalence seen at the end of November.

The highest rates were seen in people aged 18 to 44, and London was the region worst affected. The study collects as many as 30 000 self-reported lateral flow test results every week, as well as questionnaire responses, from around 150 000 participants in England and Scotland.

Steven Riley, UKHSA director general for data and surveillance, said, “At this time of year the cold weather, shorter days, and increased socialising mean that the potential for transmission of respiratory viruses like covid-19 is particularly high. This, as well as the possible impact of new variants, means it’s not unexpected to see cases increasing.”

This week the World Health Organization highlighted a new covid variant of interest: JN.1, an offshoot of the omicron subvariant BA.2.86. While the new variant was described by WHO as “low” risk, UKHSA said that it now made up around 7% of positive tests for SARS-CoV-2.2

“Chock-a-block” wards

The infection update came as NHS England warned that the number of people in hospital with flu had also increased by almost two thirds in just a week, from an average of 402 patients a day to 648 a day. This is four times higher than the average of 160 seen at the end of November.

Hospital admissions with covid have also risen by 12% in a week—from 3024 on 10 December to 3390 on 17 December—and norovirus cases in hospital have increased by 10%, from an average of 506 patients a day to 566 a day. Meanwhile, last week saw almost 50 000 NHS staff absences each day.

Saffron Cordery, deputy chief executive of NHS Providers, which represents NHS trusts, commented, “There’s pressure right through the system, from chock-a-block hospital wards to a rising number of staff off work sick, on top of more than 121 000 vacancies across England in hospital, ambulance, mental health and community trusts—at a time when many staff are off on planned leave.”

Cordery added that the three day strike by junior doctors this week and the upcoming, record long strike action planned for January would add to this “significant pressure.”3 She said, “We urge the government and unions to get back round the negotiating table now to hammer out a deal that will end the junior doctors’ strikes and take the extra strain off staff, services, and patients.”

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