Covid Situation Report: Feb 20, 2025
Update on Covid providing information on prevalence and hospital admissions for England and its regions. This post is best viewed using the browser or Substack app.
Introduction.
This report belongs to a weekly series summarising the Covid situation across the UK's home nations.
This week's report includes the latest weekly test positivity rates and hospital admissions data for England, along with the most recent data for Scotland, Wales, and Northern Ireland. The report also presents the latest data on deaths due to Covid in England and Wales. Finally, an update is provided on Covid variants in England.
Much of the data used in this Covid Situation Report comes from the UKHSA weekly influenza and COVID-19 Surveillance Report. UKHSA are presently asking for user feedback and you may like to provide your input at the following link.
In particular, there is a chance that UKHSA may revert back to only publishing their weekly reports during the winter season. Last year they continued to publish a shorter report every two weeks from March to October allowing me to publish these situation reports throughout the year. You may wish to complete the survey and suggest UKHSA continue this practice.
Summary.
This week continues with the good news regarding Covid, as the data indicates low levels across England, Scotland, Wales, and Northern Ireland.
Flu levels are currently higher than Covid and RSV but are falling fast across all Home Nations, indicating that the Winter Flu season is over. RSV infections remain at low levels.
This means that individuals with Covid-like symptoms are more likely to be suffering from flu or a cold rather than Covid or RSV.
In England, the Covid test positivity rate, hospital admissions and case rates remained stable, and at levels well below those of Flu.
Flu test positivity and hospital admissions levels are moderately high but continue to fall.
Unlike previous years, the test positivity rate for hMPV has yet to fall from its January peak indicating that it may be a bad year for this virus.
In Scotland, Covid hospital admissions and bed occupancy remain at very low levels with wastewater monitoring levels at their lowest ever. Flu admissions are now at relatively low levels.
This week, Covid hospital admissions in Wales remained low. Flu admissions fell again and are now at moderately low levels.
In Northern Ireland, Covid indicators continue at low levels and are below those of other respiratory viruses. Flu, RSV and Covid activity decreased across the majority of surveillance indicators.
The new LP.8.1 variant has been identified in England although levels remain low.
Bookings for the NHS Autumn Covid booster are now closed. However, there will be a Spring 2025 campaign which will run from April 1 to June 17, 2025. Those eligible will be:
adults aged 75 years and over;
residents in a care home for older adults; and
individuals aged 6 months and over who are immunosuppressed.
Further details can be found here.
A reminder that for individuals not covered by the NHS, Covid and Flu vaccinations may be obtainable for a fee at local pharmacies.
As always, it’s important to remember that the risk of hospitalisation from Covid increases significantly with age and for the immunocompromised. Therefore, it is important to take appropriate measures such as self-isolating when experiencing Covid symptoms and enhancing ventilation or wearing masks whenever possible.
Status of main respiratory diseases in England.
This section starts with the latest available data on positivity rates for primary respiratory infections in England. It is important to understand that positivity differs from prevalence, which refers to the overall percentage of COVID-19 in the general population. Appendix 1 provides a more detailed explanation of the difference and why positivity rates are a useful indicator of trends in Covid infection levels.
The first chart in this section shows the test positivity rate for all Covid samples taken, including those outside of hospitals, and is mapped against the UKHSA activity thresholds. The thresholds are based on the historical trend for Covid test positivity and, consequently, represent a relative risk. More details on this approach can be found in the Guide to Covid Surveillance Metrics published earlier this week.
The chart shows that the levels of Covid continue to be stable and well below the baseline threshold of activity indicating relatively low levels of risk.
The next chart displays the test positivity rates for the main respiratory illnesses in England, covering Flu, Covid, RSV, and Rhinovirus. This positivity rate is only for tests carried out in hospital so differs slightly from the previous chart. However, taking this approach allows a fair comparison between the different viruses.
The Covid positivity rate has continued to stay stable and remains very low this week. Although flu rates remain moderately high they are continuing to fall. RSV rates are also falling and are at low levels. Meanwhile, rhinovirus rates have increased over the past weeks and are at a relatively high level.
The chances are that if you have Covid-like symptoms you are more likely to be suffering from flu or a cold than RSV or Covid.
The following chart in this section shows weekly hospital admissions per 100,000 people in England for the main respiratory diseases.
Over the past week, weekly hospital admission rates for Covid remained at very low levels and well below those of Flu. Meanwhile, admission rates for Flu, although moderately high, are continuing to fall from their recent peak. Admissions for RSV are stable and at low levels.
Finally, although press coverage over the past few weeks about the risk of Human metapneumovirus (hMPV) has declined, UKHSA continue to report on its progress. The following chart shows the trend in the test positivity rate for hMPV in hospital patients admitted with respiratory illness in England for the past two years.
Human metapneumovirus (hMPV), a virus with symptoms similar to Flu, is a seasonal virus that usually peaks in early January and then falls in February. Although the peak of the positivity rate for hMPV is about the same as previous years it has yet to fall, indicating that this may be a worse that usual season for the disease.
Scotland weekly hospital admissions and bed occupancy
Scotland continues to publish weekly data on hospital admissions and bed occupancy for Covid as well as wastewater monitoring data. The dashboard for Scotland’s data can be accessed here.
The following panel chart shows the most recent data for weekly Covid hospital admissions depicted in blue, together with the number of beds occupied by Covid patients, shown in orange. The number of occupied beds represent patients being treated for Covid as well as those being treated with Covid.
This week Covid admissions and bed occupancy remained broadly unchanged and are at there lowest levels for over a year,
Scotland remains the only home nation that is monitoring Covid levels using wastewater sampling and the following chart shows the seven day average of Covid levels found up to Feb 14, 2025.
The wastewater sampling data shows that the high Covid levels observed at the start of August have significantly dropped and are now at very low levels. This week the data showed Covid levels remained at their lowest ever detected.
Finally, the following chart compares the weekly hospital admissions for the main respiratory viruses in Scotland.
The chart shows that flu-related emergency hospital admissions rose sharply in December and Public Health Scotland reported that this reached a record high of 1606 admissions for the week ending Dec 29. This surge placed a considerable burden on hospitals. However, admissions have fallen significantly in the past six weeks and the Winter surge is over.
Wales Covid hospital admissions.
Public Health Wales recently updated the published data on respiratory viruses, resulting in the currently available data being limited.
The following chart provides the trend for weekly hospital admissions in Wales.
Hospital admissions for Covid in Wales were stable this week and remain at low levels.
In contrast, the following chart illustrates that hospital admissions for flu in Wales were high during the holiday period but have fallen significantly and are now at relatively low levels.
Status of main respiratory diseases in Northern Ireland.
Recently Public Health Northern Ireland began issuing a combined surveillance report on influenza, respiratory syncytial virus (RSV), and COVID-19 to offer a comprehensive view of the epidemiology of these infections within Northern Ireland. The report, published every Wednesday, can be accessed here.
The first chart in this section shows the test positivity rates in Northern Ireland for the main respiratory illnesses — Flu, RSV, and Covid.
The chart shows that once again Covid levels, depicted in purple, have stayed stable this week and are at their lowest point in a year. Additionally, they continue to be much lower than the rates of other major respiratory viruses. Positivity rates for Flu, shown in green, have peaked and continued to fall in the past week although they remain at moderately high levels.
The chart below presents the weekly count of hospital admissions for the main respiratory illnesses where the infection was contracted in the community, thereby excluding patients who contracted Covid while in hospital. It is important to note that the hospital admissions data for other home nations include patients who contracted infections in the hospital, making them not directly comparable to the data from Northern Ireland.
The chart shows that for most of 2024, the bulk of hospital admissions for respiratory infections stemmed from Covid. However, since November hospital admissions for Covid, indicated in purple, have remained stable and at a low level.
Meanwhile, hospital admissions for the Flu, depicted in blue, increased significantly in December. However, Flu admissions have fallen for the past five weeks and are now relatively low.
Variants update.
The XEC variant received considerable attention when it emerged in September 2024 due to its higher growth advantage over other variants. However, less attention has been paid the emergence of the variant LP.8.1 derived from the JN.1 descendant lineage KP.1.1.3 first identified in July 2024.
The World Health Organisation report that the additional public health risk posed by LP.8.1 is low. The recommended Covid vaccines are expected to remain cross-reactive to this variant against symptomatic and severe disease, as LP.8.1 immune escape is comparable to XEC. Therefore, the spread of this variant is unlikely to increase the burden on national public health systems compared to other Omicron sub-lineages.
The chart below illustrates the prevalence of variants in sequenced cases up to the week ending January 26, 2025. For clarity, the various JN and FLiRT (KP) variants have been grouped into 'families'. Furthermore, the number of sequenced cases since August is low, leading to uncertainty in the recent numbers.
The chart shows that the FLiRT family of variants was dominant in September, yet the XEC variant was rapidly gaining ground. By the beginning of November, the XEC variant represented approximately one third of all sequenced cases in England and looked like it would become the dominant variant.
However, XEC did not follow the same path as the JN family and FLiRT variants to dominate the mix of variants. Indeed, since December, JN.1 and LP.8.1 levels are increasing. This indicates that presently no variant has a particular growth advantage in England.
In conclusion
Although the amount of data currently being published has decreased, the information available for England show that Covid levels are at relatively low levels and much lower than for Flu.
Recent data indicates that Scotland, Wales and Northern Ireland are also at low levels of Covid.
Across all home nations, Flu levels are falling fast and are at relatively low levels. The Winter peak is over.
There are mix of variants circulating in England with the new LP.8.1 variant being reported for the first time.
As always, if you have any comments on this Covid Situation Report or suggestions for topics to cover, please post a message below.
Appendix 1. Test positivity rates and prevalence
Positivity rates are derived from the results of hospital laboratory tests conducted on patients exhibiting symptoms of respiratory diseases. Test positivity is the percentage of patients who test positive for Covid of the total number of patients tested. Since the individuals tested for this measure are not a representative sample of the general population it differs from prevalence, which is derived from a representative sample of the population.
Test positivity rates, while not directly estimating the number of Covid infections in the general population, can be a valuable indicator of the infection trend. The panel chart below compares the weekly test positivity rate among hospital patients with respiratory symptoms to the prevalence of Covid in the general population, as reported in the Winter Infection Survey.
The chart shows that the weekly test positivity rates for patients with symptoms of respiratory infections follows the same pattern as the prevalence for Covid reported by the Winter Infection Survey. Since the Winter Infection Survey is based on a representative sample of the general population this supports using test positivity as a useful proxy for infection trends.
Thanks Bob, vulnerable family here able to take precautions and judge risk for social / family gathering, take tests etc.
Thank you Bob, as a parent of an immunocompromised child I struggle to get this information elsewhere, and having it so concisely is super helpful!