The UK Department of Health says it is facing a worse scenario after the number of people in hospitals with influenza increased by 55% in one week.
NHS England chief executive Sir Jim Mackey warned that 5,000 to 8,000 hospital beds could be occupied by influenza patients by the end of this week.
Health experts at the King’s Fund pointed out that talk about an “unstoppable flu wave” has recently become a common concern over the past few years.
So how is the winter of 2025 really different from previous ones, and which groups are most affected by what health services are now calling “severe flu”?
Early start to influenza
The main difference between the 2025 influenza season and the previous three years is that the virus began spreading about a month earlier.
The first evidence of this came in October, according to data published by the UK Health Security Agency (UKHSA).
When a person visits their general practitioner or hospital with flu-like symptoms, they can be tested for several viruses, including influenza, Covid, and RSV.
The UKHSA records the percentage of tests that confirm influenza infection, giving a strong indication of whether infection rates in the community are rising or falling.
Virologists linked this year’s early influenza season to a slight drift in the genetic makeup of the main circulating type of influenza virus, known as H3N2.
“Severe flu” is a descriptive name and not a medical term, and it does not mean that the virus is more severe or more difficult to treat.
But the public has not been exposed to this exact version of influenza before, which means there may be less immunity built up in the community, allowing it to spread more easily.
Children and young people most affected
Children appear more susceptible to influenza than older adults, mostly because their immune systems are still developing, and because they spread viruses more quickly through close contact.
The latest UKHSA data shows that the rate of positive tests is currently much higher among children and young people who are still in school or university.
Some schools have been forced to reintroduce Covid-like measures to prevent virus spread, such as reducing group musical activities in educational events and adding sanitization points, while one site in Caerphilly had to temporarily close.
Every year, thousands of otherwise healthy children arrive at emergency rooms with complications after getting influenza.
But there is another concern: that young people will return home and then spread the illness to elderly relatives who are often more vulnerable.
Adding influenza to winter pressure
The NHS records the number of patients in hospitals each week who suffer from influenza and other respiratory illnesses.
The number has risen sharply in England, with the average number of influenza patients in hospital reaching 2,660 last week, up from 1,717 the week before.
People over the age of 85 are five times more likely to be admitted to hospital compared to the general population.
But the patients who are being admitted now were infected with the virus a few weeks ago when infection rates were lower.
The greatest concern for the health service is what will happen in the coming weeks when new cases start arriving in emergency departments.
The NHS has around 105,000 hospital beds in England and expects more than 95% of them to be occupied at any time during the winter.
If the number of patients who need overnight treatment rises to 5,000 or more, as predicted by Sir Jim Mackey, this could put the entire health system under greater pressure.
What about vaccine protection?
The message from doctors and NHS officials is that people in at-risk groups should continue showing up to receive the influenza vaccine.
Even with a change in the genetic composition of the virus this winter, the main vaccine is still believed to provide effective protection, especially against severe illness.
The influenza vaccine is offered free through the NHS to people over 65 years old, young children, pregnant women, people with certain health conditions, caregivers, and frontline health and social care workers.
People in other groups can get the same vaccine for £15 to £25 from pharmacies.
As of November 30, more than 40% of people in the at-risk group have taken up the free vaccine offer this year.
Influenza vaccine rates among NHS workers in England, which had declined since the Covid pandemic, have stabilized this year at around 42%.
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