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Major infectious diseases – England’s update, week 4

TL&DR: We are approaching a new Covid wave, driven by XBB.1.5. Not very good news for flu and RSV either, and Scarlet fever still at exceptionally high levels. So, a rather gloomy update, hence a nice picture above (Sunset over river Tay from Dundee Law, Scotland).


Covid cases are picking up again; both notifications and hospitalisations have gone up in the last week of January.

The daily notifications – more up to date than the above UKHSA data – also show the numbers picking up in the youngest (0-14yo) and in their parents (25-44yo) and grandparents (75+).

I am concerned about the Scottish data, with the drop suggesting lack of testing rather than low numbers.

This wave seems to be coming quicker than I expected, possibly because of the new variant(s). The XBB.1.5 one is fast growing is now a dominating one (not seen yet in the picture below).


The flu season is not over yet and the positivity seems to be levelling off. As usual, I expect the last point to be revised upwards and so we might see an increase again.


To complete a set of bad news, RSV admissions have picked up again. Hopefully, the seasonal pattern will be restored soon and we will see drop again, the epidemic might be still a problem for some time.

Scarlet fever

Following a Twitter exchange recently, here is a graph of Scarlet fever cases without a logarithmic scale. This shows the real scale of this year’s outbreak which dwarves the previous years.

And, it is possibly not over yet, with the last 2-3 data points likely to be updated upwards next week.


I still have not managed to digitise the UKHSA data, so here is a figure from the most recent report. It is a mixed picture, with some increase where we should be seeing a decline, but probably no reason to panic (yet).

Major infectious diseases in England – Week 3 update

TL&DR Major infectious diseases, RSV, flu, Strep A, and even Norovirus are back to their “normal” seasonal pattern, although numbers remain higher than pre-pandemic. COVID is going down, but I expect another wave to start in a couple of weeks’ time.


The rate at which COVID cases and hospitalisation numbers are declining is slowing down and the virus is not disappearing. I expect that this is a precursor of another wave.

As discussed in the previous posts, overlaying the number of deaths in each omicron wave (with some additional scaling for the two early ones) shows a remarkable similarity of each wave. The most recent data seem to follow the same pattern:

As always the last 203 data points should be ignored. If the same pattern follows again, I expect the current wave ending in about 3 weeks (day 70 on the plot above) when the deaths will start climbing up again, with a peak about a month afterwards.

So, expect a peak in deaths around April-May, with cases peaking a couple of weeks earlier.


Flu cases are dropping down very fast an indeed the proportion positive is lower than in a similar 2019-20 season. Expect the last point to be revised upwards, with a possible tailing off, but the flu season is largely past.


Very similar pattern to flu, RSV cases are decreasing and the overall pattern is very similar to the pre-pandemic years. Expect further decline and the effective end of the epidemic.

Scarlet fever

The scarlet fever infections are significantly higher this year than in previous ones, but again they seem to follow a similar seasonal pattern.

After an usually end-of-the-year peak, the numbers dropped over Christmas and New Year, but appear to be peaking up again. Expect a further increase, perhaps not the same levels as recently, with a peak in week 11, end of March, beginning of April.

Why are we not completely back to “normal”? – COVID in China, and Norovirus in Scotland

TL&DR: My China COVID article is out in The Conversation, and I am quoted on Norovirus in The Times. COVID numbers are down, but expect a new wave starting soon.

Post-pandemic, RSV, flu, Strep A, and even Norovirus are back to their “normal” seasonal pattern, although numbers remain higher than pre-pandemic.


My article on China’s COVID outbreak and herd immunity was published on Monday and generated a lot of comments. It was a rather difficult piece to write but I am happy to with the end results.

For the sake of people in China, I hope the prediction of another massive wave in March/April is wrong, but there is a huge gap between the current immunity levels and those required for herd immunity.


More recently, I was asked to comment on the increased risk of Norovirus, following a report from Public Health Scotland. A screenshot from The Times article (behind the pay wall):


As I told Helen Puttick, the infectious diseases that do show a regular seasonal pattern – including Norovirus – are back to their “normal” behaviour, following a suppression during the lockdown and a period of abnormal behaviour when the restrictions were removed.

However, the number of cases is often higher this winter – RSV and Strep A hospitalisations are up, as are reported Norovirus cases. Why?


A detailed update on the major infectious diseases is in a separate post.