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Major infectious diseases – England (and Scotland) update, week 12

New week, new data, but the old story. TL&DR: Covid is still a problem in England (and elsewhere), although the increase in cases and hospitalisation might be slowing down.

Other diseases I routinely monitor here follow their seasonal, pre-pandemic patterns, although Rhinoviruses remain high.


I have not looked at Rhinoviruses for a while. The UKHSA does not provide readily-available electronic data so I need to resort to scanning and digitizing.

Rhinoviruses are the primary cause of the common cold. They prefer temperatures 33-35C, typically found in human noses. Their spread is seasonal, but unlike flu or RSV they tend to peak twice a year, in Spring and in Autumn.

Initially suppressed in March/April 2020, they came back later in 2020 and were largely unaffected by subsequent lockdowns. In the 2022/23 season, the Autumn peak was followed by a drop in positivity but a large increase in the number of positive samples.

The positivity stays high, so there is indeed a lot of sniffing and sneezing around. It will be interesting to see how the Spring wave will develop, but we will likely continue with a lot of rhinoviruses around.


The hospitalisation numbers are slightly down, but there is probably no reason to celebrate yet. A high number of cases and positivity are sadly bound to be translated into a jump in hospital admission next week.

As mentioned in my earlier posts, this wave is different to the previous ones, and so it is difficult to make any predictions. I am worried about the rapid growth in India, as what affects the largest country in the world is bound to make its way here.

Similar increases have been seen elsewhere, for example, in Denmark, as excellent reporting by @BarclayBenedict shows:

Flu, RSV and Scarlet fever

I am lumping these three together, as they now follow a similar, pre-pandemic, seasonal pattern.

Pre-pandemic, both influenza and RSV peaked in late Autumn and Winter. Flu is a bit more complicated due to different Influenza A and B behaviours, but it was always strongly seasonal.

Both flu and RSV epidemics are now generally over, although flu seems to be lingering at low levels.

Scarlet fever is also seasonal, but the before the pandemic, the peaks were later and more spread out. This season was, of course, different due to the unprecedented outbreak levels in November and December.

But, when the top values are ignored, the current levels of Scarlet fever are within the pre-pandemic range – which encompassed such different epidemics as 2017-18 (peaking at over 2000 cases per week) and 2018-19 (peaking at 500 cases per week).

I expect the Scarlet fever numbers to linger near the current level for a few more weeks before slowly disappearing over Summer.

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