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Major infectious diseases – England and Scotland update, week 14

TL&DR: All indicators are down this week, Covid cases, hospitalisation and deaths are sharply down, as are Scarlet fever cases. Time will tell whether this is a lasting drop or it is a result of inefficient reporting. Flu and RSV are also down, although already at low numbers.


While the cases are slowly going down, hospital admissions and Pillar 1 positivity experienced a sharp decline. I was originally sceptical about associating this with changes in reporting, but this is now an increasingly likely reason for such a rapid change.

To be clear, I believe that there is a decline, but I suspect there are other factors driving the reported numbers down.

Cases are clearly down in both England and in Scotland. How much of it is driven by the Easter school and work break, will be seen in the next few weeks, but there is no doubt we are over the wave crest.

Flu and RSV

Both flu and RSV continue following their seasonal pre-pandemic pattern, with numbers low and slowly declining.

Scarlet fever

Something rather strange happened to Scarlet fever notifications this week, with a huge drop in reported cases. While such declines are not completely unusual and indeed happened in pre-pandemic years (see 2017-18 season data), but I will believe it when I see the notifications next week.

I would not be surprised if this week’s numbers were revised upwards, but still expect the general trend to be a decline.


Apologies for still “poaching” the graph from the UKHSA report. The numbers are also down and it appears we are now in a “sweet spot” – a seasonal break before the summer months (from week 20) when the numbers will be picking up again.

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