January 3, 2025

expert reaction to high numbers of flu hospitalisations

Scientists comment on high numbers of hospitalisations from flu, as reported by NHS England. 

Dr Leon Peto, Consultant in Infectious Diseases and Microbiology, Clinical Coordinator for the RECOVERY trial, University of Oxford, said:

“These figures for influenza hospitalisations demonstrate the severe impact of seasonal influenza and the pressures it causes on the NHS. The number of hospitalisations in England is significantly worse than at this stage last year but it is not unprecedented. Currently the number of hospitalisations is similar to the winter 2022-23 flu season, which at its height caused around 5,000 deaths per week in England. Identifying the best way to treat people hospitalised with influenza could reduce the burden on patients and the health service, but in contrast to COVID-19 we do not have good evidence to guide treatment. This is currently being addressed by the RECOVERY and REMAP-CAP clinical trials, which are evaluating flu treatments at NHS hospitals across the UK this winter”

Dr Lindsay Broadbent, Lecturer in Virology, University of Surrey, said:

“The number of people with flu, and being admitted to hospital with flu, is increasing rapidly. This is putting pressure on hospitals that are also dealing with other seasonal bugs such as RSV and norovirus (the winter vomiting bug).

“There are probably several factors contributing to the higher than usual levels of flu hospitalisation.

“Vaccination rates in some groups are lower than this time last year, particularly in health care workers and the over 65s. Last year 73% of over 65s were vaccinated, this year it is 70%.

“Getting together with friends and family over Christmas and New Year’s will also contribute to the spread of the virus.

“There are many strains of influenza, each year the vaccine is designed to target the strains that are most likely to be circulating. This is based on flu data that emerges from around the world. Meaning the efficacy of the flu vaccine can change from year to year. However, even if the vaccine isn’t a perfect match to the circulating strains, it does still provide good protection against severe disease. But even a small drop in efficacy can result in increased hospitalisation numbers.

“The best way to protect yourself from flu is to get vaccinated to reduce the risk of serious disease. If you are sick, it is advised to reduce the contact with you have with others. Particularly people that are at higher risk of severe flu such as the very young, older individuals and those that have other health conditions.”

Prof Penny Ward, Visiting Professor in Pharmaceutical Medicine, King’s College London, said:

“Hospital admissions for complications of winter viral disorders vary from year to year and are more frequent in high risk patients – pre-school age children or older (>65 year old) adults or adults and children of any age with a range of underlying conditions, including diabetes, renal disorders, heart disease, asthma or other chronic lung diseases.

“A range of viruses circulate in the winter and hospitalisations can occur following infection with any of these viruses, particularly among the higher risk population. The severity of the infection depends on the virulence of the circulating strain of the virus causing the epidemic and whether or not an individual has been vaccinated. While we have been hearing about flu admissions for quite a while, the influenza epidemic this year started in the second week of December and has not yet reached its peak. It appears to be a mix of two influenza A virus strains representatives of both of which were included in the vaccine recommended for use this year. 

“However, the uptake of vaccine this year has been lower than last year. Around 73% of older adults have been vaccinated but fewer than 35% of higher risk adults of any age have been vaccinated so far. This uptake rate is lower than is needed (90%) to limit the extent of flu outbreaks. Another possible factor is whether the circulating strains are a good or a poor ‘match’ to the strains used in the vaccine- the HSA might have some information on that but has not yet commented.

“We do have access to effective antiviral treatment for influenza but to be effective these treatments must be given within 2 days of first symptom onset. Antiviral treatment can also be used to prevent the spread of infection in hospitals/care homes, but regrettably, it seems that GPs may not use these treatments as effectively as they can to protect care home residents and prevent hospitalisations. If these treatments were used more widely this annual burden of illness could be considerably reduced.”

Hospital patients with flu quadrupled to over 5,000 ahead of New Year –https://www.england.nhs.uk/2025/01/hospital-patients-with-flu-quadrupled-to-over-5000-ahead-of-new-year/

Declared interests

Dr Leon Peto: I coordinate the RECOVERY clinical trial. This is evaluating treatments for patients hospitalised with influenza and pneumonia (and previously COVID-19). The trial was initially funded by the UK government and is currently funded by Flu Lab (a charity).

Dr Lindsay Broadbent: Receive funding from MSD.

Prof Penny Ward: “I am semi retired but am owner and director of PWG Consulting (Biopharma) Ltd, advising companies on drug and device development.”