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Major infectious diseases – England (and Scotland) update, week 10

TL&DR: Good news last week did not last long. Covid and scarlet fever indicators are all up this weeks, while influenza and RSV are mostly stable.


The current wave is different to all the previous ones, with numbers (positivity and hospitalisation) going up, but not as fast as in previous waves. While appreciating the slower-than-before increase, it is worrying on two counts.

Firstly, we are talking about high numbers. The hospitalisation rate is almost as high as it was at the previous peaks. With 50 million population in England, there are 5,000 people needing hospital care every week because of Covid (700 per day). It is 5,000 beds needed, use of doctors’ and nurses’ time, and – above all – huge worry for patients and their families.

Secondly, it means the transmission mechanism is changing. Either it is a decoupling of age groups, or new variants behaving differently, or changes in the immunity landscape. It makes the predictions more difficult.

Daily England’s data is not yet online, so just looking at Scotland, where we see an increase in case notifications in almost every age group, with the largest increases in 65+ years olds.

Scarlet fever

Last week I was hoping for the Scarlet fever numbers to buck the pre-pandemic trends and continue declining. It remains to be seen whether this week’s increase will continue – as in 2017-18 and 2019-20 (before the lockdown) – or turn down again. Regardless, we are now in the “normal” range of weekly cases.

Influenza and RSV

The two “most seasonal” infectious diseases that I look at in this report, flu and RSV, seem to follow the pre-pandemic trends, with a slow decline in numbers continuing. Some other countries have seen large flu outbreaks in recent weeks, but England seems to be following the “usual” seasonal pattern.

England’s daily data has just been released, so here is a quick update.

Increase in the number of cases across almost all age groups, possibly except the 0-14-year-olds. Not as rapid increase as in Scotland, but certainly moving up.

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