Fears of a potential “quad-demic” are rising, with a 350% increase in flu cases and an 86% rise in norovirus cases in hospitals compared to the same week last year, the NHS England has said.
The health service has said it is “busier than it has ever been before” this winter, with cases of Covid-19 and RSV (respiratory syncytial virus) also increasing in hospital wards.
Those who are eligible, and NHS staff, are being urged to get their vaccinations without delay as virus levels rise, with pressure on hospitals expected to increase further over the coming weeks.
So, how bad are the difficulties faced by the NHS this winter? Here, ITV News takes a look at the latest figures.
What is a quad-demic?
A quad-demic is a way of describing the co-circulation of four “very common viruses” at this time of year – influenza virus, RSV, coronavirus and norovirus.
“The first three are respiratory viruses – they cause colds and more severe diseases of the lung; norovirus causes diarrhoea and vomiting,” John Tregoning, a professor in vaccine immunology at Imperial College London, told ITV News.
“They are what are known as endemic viruses – there is low level circulation of them most of the time, as opposed to pandemics which are the massive outbreaks.”
“Viral infections are more common in winter. They tend to peak in the last four weeks of one year and the first four weeks of the following one,” he added.
How much are cases rising this winter?
New weekly figures, published for the first time this year, show a 350% increase in flu cases, and an 89% rise in norovirus cases in hospitals compared to the same week last year.
Rising Covid-19 and RSV levels are also a concern, with an average of 1,390 patients with Covid in hospital beds each day last week, and 142 children in hospital each day with RSV.
The NHS says the latest data shows it is going into winter under more pressure than ever before, with an average of 1,099 people in hospital with flu every day last week compared to 243 in the same week last year – the highest number of cases heading into winter for at least three years.
“We are still only at the start of December, so we expect pressure to increase and there is a long winter ahead of us,” said NHS national medical director, Professor Sir Stephen Powis.
“For a while there have been warnings of a ‘tripledemic’ of Covid, flu and RSV this winter, but with rising cases of norovirus this could fast become a ‘quad-demic’ so it’s important that if you haven’t had your Covid or flu jab to follow the lead of millions of others and come forward and get protected as soon as possible,” he added.
New figures from the UK Health Security Agency (UKHSA) also show tuberculosis (TB) levels in England increased by 11% last year, with 4,855 notifications of the disease in 2023, up from 4,380 in 2022.
How much pressure are ambulance services under?
Pressure on ambulance service is “incredibly high”, the NHS said. The service transported 90,514 patients to hospitals in England last week, compared to 83,873 during the same period in 2023.
Meanwhile, 35,022 hours were lost to handover delays, up 87% from 18,703 this time last year. There were 413,426 calls to NHS 111 last week – with 73.1% answered within a minute, up 4.4% up on last year.
How crowded are hospitals?
An average of 96,587 adult general and acute hospital beds in England were occupied each day last week, the NHS has said, which is more than at this point in any other year.
The health service warns this could increase in the coming weeks, with problems discharging patients who no longer need to be in hospital continuing to have an impact on capacity.
An average of 11,969 beds each day last week were occupied by patients who were ready for discharge, taking up one in eight of all occupied adult beds.
Patricia Marquis, executive director for England for the Royal College of Nursing, said: “There is barely a spare bed in our NHS, with sky-high flu admissions and thousands stuck in hospital unable to be discharged due to a lack of capacity in social care.
“Before the cold weather hits, nursing staff and patients are desperately worried about what the coming weeks and months may bring.”Saffron Cordery, interim chief executive of NHS Providers, said: “Services are already feeling the strain from a worrying spike in nasty winter bugs and bad weather.
“Flu, norovirus, RSV and Covid-19 are piling the pressure on already stretched services and staff, and this is likely to get worse as we head into the depths of winter.”
In addition to high bed occupancy and a lag in hospital discharges, Ms Cordery warned social care and community services are “also under relentless pressure”.
What are the NHS and government doing about this?
The NHS has put measures in place to manage extra demand during winter, including an upgrade of its 24-hour live data centres, strengthening same-day emergency care and offering more fall services for older people.
In September, an independent review by Lord Darzi warned years of underinvestment have left the NHS with an ageing estate and outdated tech, making it harder for staff to deliver the best possible care.The government and NHS are now engaging the public, patients and staff in the biggest-ever conversation about the health service.
More than 1.1 million separate visits have been made to Change.nhs.uk, with almost 9,000 ideas now live as part of the 10 Year Health Plan, which aims to deliver an NHS fit for the future.
