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<\/a><\/p>\nI\u2019m sure most people now know someone in bed with Covid. If someone says they are in bed with flu, it\u2019s almost certainly Covid<\/strong>, given that the number of people admitted to hospital for Covid last week was 50 times higher than the number admitted for flu<\/strong>! Flu is seasonal – last year we had a massive flu spike, concentrated within a few weeks around New Year, and this year\u2019s season has barely started. <\/p>\n Covid simply is not seasonal yet<\/strong> (although winter behaviours such as mixing indoors help it spread). Even the low and stable Covid hospitalisation levels we saw between November 2024 and last month are substantially higher than the effectively zero flu and RSV hospital admissions, as is clear from the chart of hospitalisations for all three diseases below.<\/p>\n England (stupidly) isn\u2019t doing Covid wasterwater analysis. The good thing about wastewater testing is that measured virus amounts are not reliant on people getting tested or having symptoms, so it gives a pretty good idea of levels of infection in the community. That said, it\u2019s not a precise estimate of number of people infected because there\u2019s variation between individuals, and between variants, on how much virus is excreted.<\/p>\n Scotland is<\/strong> still measuring wastwater and interestingly it is not showing much at the moment (a modest increase compared to a few months ago). <\/p>\n BUT Scotland also isn\u2019t experiencing<\/a> a as big a spike in Covid hospital admissions as England, so it\u2019s possible that the wave England is experiencing will hit Scotland a bit later (it has hit Wales already). Many countries in Europe are however seeing Covid waves reflected in their wastewater measurements as shown in this chart by Bob Hawkins<\/a>.<\/p>\n We are not having a wave because there\u2019s a new Covid variant. The latest variant picture from UKHSA shows that Omicron variant XFG is firmly dominant here and has been since July. I did think it would cause a summer wave as it took over quite rapidly in May and June, but it didn\u2019t. This suggests that the current wave is driven more by people\u2019s waning immunity (especially given no big waves for almost a year) and more indoor mixing, from changing weather and return to work and education after summer.<\/p>\n The autumn vaccine booster campaign has only just started and so far about 14% of over-75s and 8% of eligible clinically vulnerable people have had it<\/a>. The eligibilty criteria keep narrowing – this round the following groups can get a free NHS vaccine.<\/p>\n I urge anyone eligible to get boosted<\/a>! If you can afford the vaccine (currently almost \u00a3100 at Boots!!<\/a>), then it might be worth doing. Personally, I am planning to buy a booster in November, to get maximum protection in December and over Christmas and New Year. Sandy Laping pointed me to a recent peer-reviewed paper<\/a> looking at timing of booster vaccinations. It suggested a booster is most effective from 6 months since your last Covid infection (i.e. when immunity from your last infection has started to wane), so that\u2019s also worth bearing in mind.<\/p>\n Share<\/a><\/p>\n As we head into another winter, let\u2019s take stock of how the NHS is doing. Has it has recovered after the last few winters? No. <\/p>\n Ambulance response times are at their \u2018summer\u2019 baseline, but that baseline is notably higher than its pre-pandemic baseline. Before 2020, even the winter peak ambulance response time was below the current summer baseline. <\/p>\n Long waits in A&E tell an even worse story. Before 2021, it was almost unheard of to wait more than 12 hours on a trolley before being admitted. Now, tens of thousands of people do every month. The number falls every summer, but year on year that summer baseline has grown higher and we are already seeing a sharp increase in September. <\/p>\n<\/a><\/p>\n<\/a><\/p>\n<\/a><\/p>\n<\/a><\/p>\n<\/a><\/p>\n