Flu Activity Reaches Unseasonal Highs Across England
Flu cases in England are rising earlier than usual, with health officials reporting above-average activity for September and warning of potential winter pressures on the NHS. According to the UK Health Security Agency (UKHSA), flu indicators—including positive test rates and GP consultations for influenza-like illness—have been climbing since August, and emergency department attendances for influenza-like illness are above seasonally expected levels.
“Flu activity throughout September has been higher than in the same period during all past four winter seasons,” UKHSA reported. Nationally, during the week of September 28 to October 4, flu swab positivity increased from 5.0% to 6.5%, while hospital admissions for the virus reached 1.97 per 100,000 people. In London, test positivity rose from 2.5% at the end of August to 5.6% by the end of September, driven largely by cases among young people.
Professor Frankie Swords, NHS national medical director, described the situation as “slightly ominous,” noting that flu admissions are the highest she can recall for this point in the year. “From an NHS perspective, it is very early in the season, but the number of admissions for flu are the highest that I can remember seeing at this time of year,” she said. The rise coincides with an expected increase in Covid-19 cases, adding to concerns about a dual respiratory virus season.
Experts Point to Multiple Factors Behind Early Surge
The early flu surge has puzzled experts, though several factors are believed to contribute. Prof Sir Andrew Pollard, director of the Oxford Vaccine Group, suggested a combination of weather, the circulating strain’s transmissibility, population immunity, and behavioural factors such as the number of close contacts people have. “We don’t know for certain why the timing varies each year,” he said. “An early rise does not necessarily mean a worse flu season.”
However, Antonia Ho, professor of infectious diseases at the University of Glasgow’s Centre for Virus Research, warned that an early start could signal a more intense season. “An early rise in influenza cases may indicate a more intense influenza season overall, because earlier onset is associated with a longer period of community transmission and higher cumulative case numbers,” she said. This underscores the importance of timely vaccination, as it takes a few weeks for the vaccine to provide full protection.
Vaccination Urged for At-Risk Groups as NHS Faces Pressure
Health officials are urging eligible individuals to get vaccinated as soon as possible. Free flu vaccines are available on the NHS for children and those in higher-risk groups, including older adults and people with underlying health conditions. For those not eligible, private vaccinations cost about £20 at most high street pharmacies, with some retailers offering them for under £10 as part of membership schemes. Some employers also provide free vaccines.
Dr Jamie Lopez Bernal, consultant epidemiologist at UKHSA, emphasised the need for prompt action: “Flu levels are increasing with the possibility of an early flu season so now is the time for those eligible to get vaccinated. The vaccine contains components to help protect against all three types of flu virus.” The NHS is also preparing for a potential rise in Covid-19 cases, with the autumn vaccine designed to protect against the dominant XFG strain, also known as “American Covid.”
Covid-19 Cases Add to Winter Pressures
While flu dominates headlines, Covid-19 cases have also risen sharply. UKHSA data shows that Covid cases more than doubled in September, with hospital admissions up five-fold compared to August. The XFG variant, first identified in January 2025, now accounts for almost half of sequenced samples. Despite the increase, Dr Alex Allen, consultant epidemiologist at UKHSA, noted that cases remain at low levels and there is no evidence the strain causes more severe illness. “It’s completely normal for viruses to change over time,” he said. “This year’s autumn vaccine has been specifically designed to protect against them.”
The simultaneous rise in flu and Covid-19 cases could strain NHS resources. London already saw around 433,000 A&E attendances in September, a rise of almost 24,500 on August, and 129,900 ambulance incidents. The capital’s health chiefs are urging Londoners to get their jabs to avoid overwhelming hospitals.
Broader Implications: A Warning Sign for Winter
The early flu season serves as a warning sign for the months ahead. With flu and Covid-19 circulating simultaneously, the NHS faces a potential “twindemic” that could test its capacity. The UKHSA’s surveillance data indicates that flu trends have been rising since August, and the proportion of positive tests and GP consultations are above seasonal norms. This pattern mirrors concerns raised in other countries, where early flu seasons have led to longer periods of community transmission and higher cumulative case numbers.
Vaccination remains the best defence. Pollard stressed that everyone can benefit from vaccination, but free vaccines are limited to children and higher-risk groups. He also noted that those not eligible might access free vaccines through their workplace. “There is one simple action for all those who are at risk because of age or their underlying health conditions, which is to get vaccinated as soon as possible and before we reach the peak of transmission,” he said.
As the UK enters autumn, health officials are closely monitoring flu and Covid-19 trends. The coming weeks will be crucial in determining whether the early surge translates into a severe winter season. For now, the message is clear: get vaccinated, and do it soon.
What This Means for the Public
For the general public, the early flu surge means taking precautions earlier than usual. Frequent handwashing, avoiding close contact with sick individuals, and staying home when unwell can help reduce transmission. Those eligible for free vaccines should book appointments promptly, while others may consider private vaccination. Employers can also play a role by offering workplace vaccination programmes.
The UKHSA continues to publish regular surveillance reports, and the situation is evolving. While it is too early to predict the severity of the season, the early indicators suggest that this winter could be challenging. The NHS is bracing for pressure, and public cooperation will be essential in mitigating the impact.
In summary, flu cases are rising earlier than usual in England, with hospital admissions already at high levels. Experts attribute the rise to a mix of factors and warn that an early season could be more intense. Vaccination is the best protection, and eligible individuals are urged to get their jabs without delay. With Covid-19 also circulating, the coming months will test the resilience of the health service.
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