UK hospitals bracing for once-in-a-decade flu surge this winter | Health

Hospitals are bracing for a once-in-a-decade flu season, with a mutated version of the virus spreading widely among young people and expected to lead to a wave of admissions when it reaches the elderly.

The threat has prompted NHS officials to step up efforts to vaccinate staff and communities, expand same-day emergency care and treat more patients in the community to reduce the need for hospitalization.

As resident doctors in England continue a five-day strike for pay, hospitals are turning to contingency plans to call on consultants and other staff for extra shifts and reschedule appointments if necessary.

“Last flu season was particularly horrible and we fear this year will be even worse,” said Elaine Clancy, group chief nurse at St George’s, Epsom and St Helier University Hospitals. “We are preparing for an outbreak of flu in our services.”

Scientists first spotted the mutated version of the flu virus in June. Genetic analysis shows it is a descendant of a strain that fueled Australia’s worst flu season on record this year. The country has recorded more than 400,000 laboratory-confirmed cases, with low vaccination rates compounding the problem.

The mutated virus, which changed in a natural process called antigenic drift, quickly became the dominant strain in the UK, triggering the start of the flu season more than a month earlier than usual.

Dr Claire Beynon, executive director of public health at Cardiff and Vale University Health Board, said: “We are seeing a rapid and early rise in flu this winter and we expect an increase in hospital admissions. »

A spokesperson for NHS Greater Glasgow and Clyde said the number of flu cases on its sites was normal for the time of year, but it was implementing efforts to relieve pressure on hospitals “at a steady pace”.

Flu cases increase every winter, but health officials fear this season could be particularly bad if new mutations in the dominant strain help it evade the population’s immune defenses.

The virus is a subtype of influenza called H3N2, which tends to cause more severe illness than other circulating subtypes, especially in older people. Mutations could increase the transmissibility of the virus. It is too early to know if they make infections worse.

During a normal flu season, the R value, which is the average number of people an infected person passes the virus to, is about 1.1 to 1.2. This season it is estimated to be 1.4, meaning 100 people with flu are expected to infect 140 others.

“Whenever the season starts early, the peak tends to be larger,” said Antonia Ho, professor of infectious diseases at the MRC-University of Glasgow Center for Virus Research. One reason is that fewer people have been vaccinated when they come into contact with the virus.

On Thursday, the UK Health Safety Agency (UKHSA) said flu cases continued to rise overall, despite a temporary slowdown due to school holidays. Infections are highest among children but are increasing among the elderly. Health officials expect those numbers to rise further as colder weather leads to more mixing indoors.

“The new strain of flu is a worry in relation to what was already predicted to be a major flu season,” said Age UK charity director Caroline Abrahams. “It is more important than ever that everyone eligible – including older adults – get their flu vaccine and also take precautions to stay healthy this winter. »

Early data from the UKHSA suggests that current vaccines are less effective at blocking infections caused by the mutated flu virus, but still provide good protection against severe disease. In England, vaccine effectiveness against hospital attendance and admissions has so far been within the normal range, 70-75% in children and 30-40% in adults.

Although H3N2 can cause serious flu seasons, it is not inevitable. In 2003-2024, the season started early with a derived H3N2 strain. This resulted in 12,000 flu deaths in England and Wales, which is at the lower end of the usual range.

Ho urged everyone who is eligible to take advantage of the vaccine offer and encouraged others to consider paying for the vaccine and using lateral flow tests to check for flu infections. According to the UKHSA, less than a third of people with one or more long-term health conditions have come forward to be vaccinated.

Ed Hutchinson, professor of molecular and cellular virology at the MRC-University of Glasgow Virus Research Centre, said it was “entirely plausible” that the UK was on track for its most severe flu season in a decade.

“This could mean that a large number of people need hospital treatment, particularly people in at-risk groups, including the elderly, but also people with underlying illnesses, pregnant women and very young children,” he said.