Covid Situation Report: Jun 19, 2025
Report providing the latest information on Covid activity in the UK and other countries. 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 and other countries.
This week's report covers the latest weekly test positivity rates for England, along with the most recent data for Scotland, Wales and Northern Ireland. An update on the UK’s Spring 2025 Covid booster campaign is given.
The report also provides an update on the impact of the Covid NB.1.8.1 variant on Covid levels in South-East Asia and the Western Pacific regions. Finally, Covid activity in selected European countries and the USA is covered.
Summary.
This week the good news continues with all Covid data indicating low levels across England, Scotland, and Wales. However, there are early signs of increasing Covid activity in Northern Ireland.
In England, Covid test positivity increased slightly this week but remains at relatively low levels. Hospital admissions for Covid remained low. Prevalence of the XFG Covid variant is increasing and is expected to become the dominant strain over the summer
In Scotland, Covid hospital admissions rose slightly but remain at low levels. Covid levels detected in wastewater were stable and at relatively low levels.
This week Covid hospital admissions in Wales remained relatively low, whereas admissions for Flu and RSV have virtually stopped.
Over the past two weeks, Covid activity increased across the majority of surveillance indicators in Northern Ireland.
The WHO recently declared NB.1.8.1 a variant under monitoring, reporting in it’s May 23 Risk Evaluation that:
Despite a concurrent increase in cases and hospitalizations in some countries where NB.1.8.1 is widespread, current data do not indicate that this variant leads to more severe illness than other variants in circulation.
The NB.1.8.1 variant is dominant in several countries across South-East Asia and the Western Pacific and has been associated with increased Covid activity in Hong Kong and Singapore. However, Covid activity in these countries has peaked and is now falling.
Cases of NB.1.8.1 have recently been identified in Europe and the USA but there are no signs of any significant increases in Covid activity in these regions at the moment.
The NHS Spring 2025 Covid Booster campaign opened on April 1 and closed on June 17, 2025 for England.
Those eligible for free vaccinations on the NHS are:
adults aged 75 years and over;
residents in a care home for older adults; and
individuals aged 6 months and over who are immunosuppressed.
Bookings for Spring 2025 booster vaccinations in England are now closed. However, the campaigns in Scotland, Wales, and Northern Ireland are available until June 30.
Details for booking a booster in Scotland can be found here, for Wales here, and for Northern Ireland 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.
Note that presently the UKHSA National flu and COVID-19 surveillance report is released every two weeks. Consequently, this section will not be updated next week.
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 tests 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.
The chart shows that the test positivity rate has increased over the past two weeks and and is now above the baseline threshold of activity. However, this still indicates a relatively low level of risk.
The next chart in this section shows weekly hospital admissions per 100,000 people in England for the main respiratory diseases.
Over the two weeks, weekly hospital admission rates for Covid remained stable and below baseline activity levels. Admissions for RSV and Flu are are no longer provided.
The final chart in this section presents an estimated of the prevalence of Covid variants circulating in England up to June 1, 2025.
Currently, a variety of variants are circulating in England. However, XFG prevalence is increasing rapidly and is expected to become the dominant strain over the summer, potentially leading to a rise in Covid activity.
Scotland weekly hospital admissions and test positivity
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.
Despite a slight increase in admissions and the number of beds occupied by Covid patients this week, they remain at low levels
Scotland is 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 June 12, 2025.
The wastewater sampling data shows that the high Covid levels observed at the start of August 2024 dropped significantly to very low levels in the first 3 months of 2025. The slight increases in the past month appear to have plateaued and levels remain relatively low. It remains to be seen if this signals a summer wave as seen last year.
This week there were 16 hospital admissions for Flu reported and just 2 for RSV.
Wales Covid hospital admissions.
The following chart provides the trend for weekly hospital admissions in Wales up to week ending Jun 15 2025.
Four weeks ago, hospital admissions for Covid in Wales fell to their lowest level in over two years. However, they have now returned to the slightly higher levels but are still relatively low.
This week there were 15 hospital admissions for Flu and none for RSV.
Status of main respiratory diseases in Northern Ireland.
Public Health Northern Ireland publish a weekly surveillance report on influenza, respiratory syncytial virus (RSV), and COVID-19 providing an overview of these infections within Northern Ireland.
Note that over the summer period the Northern Ireland surveillance report is only released every two weeks. Consequently, this section will not be updated next week.
In the past week, Flu and RSV activity remained low and stable, circulating at baseline levels. However, Covid activity increased across the majority of surveillance indicators.
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 the Covid test positivity rate, depicted in purple, has increased over the past two weeks indicating increased Covid activity. Positivity rates for Flu, shown in green, have fallen from the winter peak and are now at very low 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.
The chart shows that for most of 2024, the bulk of hospital admissions for respiratory infections stemmed from Covid, indicated in purple. Since November 2024 hospital admissions for Covid have been low; however they have started to increase in the past few weeks.
Flu admissions have fallen from the December peak and are now very low, well below those for Covid.
Spring 2025 Covid Booster Campaign
The NHS Spring 2025 Covid Booster campaign in England opened on April 1 and closed on June 17, 2025. However, the campaigns in Scotland, Wales, and Northern Ireland close on June 30, 2025. For details on booking a Covid booster in Scotland click here, for Wales click here, and for Northern Ireland here.
Those eligible for all Home Nations are older people in care homes, individuals 75 years and older, the immunosuppressed aged 6 months and over.
The data in this section is only for NHS vaccinations and does not include privately administered doses.
The first chart in this section compares vaccine coverage for those aged 75 years and older for each of the Home Nations. The date of the latest available data is in parenthesis after the Home Nations name. The latest data for Scotland will not be published until next week.
The table chart shows that the increase in coverage for England is slowing down and this means that Scotland now has a higher coverage for those aged 75 years and older than England. Coverage for Northern Ireland remains the lowest.
The following chart shows the number of Covid vaccinations given by week for each of the booster campaigns in England.
The Spring 2025 booster campaign has administered 3,970,587 doses in England to date. All Spring booster campaigns have the same eligibility criteria so it is possible to compare across each year. With the 2025 campaign almost closed, is is clear that the doses administered this year will fall short of the previous years Spring booster campaigns.
Covid levels in South-East Asia and Western Pacific regions.
The World Health Organisation (WHO) designated the variant NB.1.8.1 (sometimes called Nimbus) a variant under monitoring on May 23, 2025. A reminder that in their NB.1.8.1 Risk Evaluation Report they concluded that the present global health risk was low but uncertain. In reaching this conclusion the report stated that:
NB.1.8.1 is growing rapidly compared to co-circulating variants. However, NB.1.8.1 exhibits only marginal additional immune evasion over LP.8.1. While there are reported increases in cases and hospitalizations in some of the countries, which have the highest proportion of NB.1.8.1, there are no reports to suggest that the associated disease severity is higher as compared to other circulating variants.
The report also noted that ‘Currently approved COVID-19 vaccines are expected to remain effective to this variant against symptomatic and severe disease.’
The following panel chart shows the latest prevalence data for the NB.1.8.1 variant across a number of countries. The grey bars indicates when data is not yet available.
It is important to note that countries use different methods to sequence variants and are therefore not directly comparable. For example, Hong Kong sequences samples from wastewater monitoring whereas New Zealand sequences positive test samples. Also there is a low number of samples sequenced making the numbers uncertain.
Despite these caveats, it can be seen that NB.1.8.1 variant is growing fast in South East Asia, Australia, and New Zealand. But what is the impact of these increased levels of NB1.8.1 on Covid activity in these countries?
Data from Hong Kong provides a comprehensive picture available of the impact of NB.1.8.1 on Covid activity and the following panel chart shows the recent trend for Covid test positivity, Covid levels in wastewater, and the impact on health as measured by the consultation rate for Covid in out-patient clinics.
The charts indicate that NB.1.8.1 drove a significant increase in Covid activity resulting in an impact on health. However, the recent peak in Covid activity is over as these key indicators continue to fall rapidly.
Tests positivity data for Singapore also shows that Covid activity has peaked and is falling.
Covid Levels in Europe and the USA.
Newspaper reports across Europe and in the USA have highlighted that the NB.1.8.1 variant has been detected in these regions leading to concerns that there may be a new wave of Covid activity over the summer months. This section looks at the latest data available on NB.1.8.1 levels and Covid activity in Europe and the USA
At present, the prevalence of NB.1.8,1 is low in Europe. The latest report from the European Respiratory Virus Surveillance Summary found that the most common variants from the four countries reporting data were LP.8.1 (35%) and BA.2.86 (27%) for the two weeks ending June 6. The NB.1.8.1 variant was found in just 2% of the tests sequenced during this period.
Once again, it is important to note that the number of tests sequenced is low and these estimates have a wide range of uncertainty.
The following chart shows the latest levels of Covid as measured by monitoring wastewater in a number of European countries that still publish this information.
Whilst there have been some slight increases, most notably in Austria and Sweden, Covid activity measured in wastewater remains low across these countries at the moment.
In the USA the latest report from the CDC Covid Tracker Summary of Variant Surveillance includes a ‘Nowcast’ estimate of the share of Covid variants for tests sequenced. The report estimates that 38% of the tests sequenced in the USA were identified as NB.1.8.1 and 37% as LP.8.1 for the two weeks ending June 7. This represents a significant growth in NB.1.8.1 over the previous two week period where just 15% were NB.1.8.1.
However, the CDC COVID-19 Variants in Wastewater website presents a very different a picture. For the week ending June 7, the dominant variant found in USA wastewater samples was LP.8.1 (36%) followed by XFG (13%). NB.1.8.1 was only found in 8% of the samples that were sequenced. This illustrates the difficulty of getting reliable data on the prevalence of variants from the low number of samples being sequenced at the moment.
Despite media attention on the new variants, Covid activity remains historically low in the USA as measured by a number of key indicators. The following panel chart presents the recent trend for Covid test positivity, Covid levels in wastewater, and the impact on health as measured by the consultation rate for hospital admission rate (per 100,000) for Covid.
Data for wastewater monitoring is also available at a more granular level and the following panel chart shows the level of Covid detected in wastewater by major region.
Covid levels in wastewater are historically low across all regions of the USA
In conclusion
Although the amount of data currently being published has fallen, the information available for England show that Covid levels are at relatively low levels. Recent data also indicates that Scotland, and Wales are also at low levels of Covid. However, Covid activity increased across the majority of surveillance indicators in Northern Ireland
The Spring 2025 booster campaign has now closed for England with just over 56% of those aged 75 years and older vaccinated. The campaigns in the other Home Nations end on June 30.
The WHO declared NB.1.8.1 a variant under monitoring, but assessed the present risk to public health as low. This was because although it has a slight growth advantage over other variants circulating, there was now evidence that it was a more sever illness.
Singapore and Hong Kong have recently seen significant increases in Covid activity driven by the NB.1.8.1 variant but they have peaked and are now falling fast.
At present, NB.1.8.1 is at low levels across Europe and Covid activity is low as measured by wastewater surveillance for Covid.
The NB.1.8.1 variant is growing in the USA but there are no signs of increased levels of Covid activity at the moment.
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. However it is not possible to use test positivity to estimate prevalence.
The extensive international perspective Bob ís now offering alongside the usual first rate UK analysis makes these reports now especially illuminating. Very hard |(as an amateur - and perhaps as a professional ,observer too?) to work out what's awaits us during the summer.
Thank you for this continuing public service