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 and Wales. The report also presents the latest data on Covid levels in selected European countries and North America (USA and Canada). In addition, Covid activity in selected South-East Asia and Western Pacific region countries is covered.
Finally, there’s a brief section on Long Covid in England, with a more comprehensive report to follow next week.
Summary.
This week Covid indicators across England and Scotland increased slightly but remain at relatively low levels. Wales remained stable and at low levels of activity.
In England, Covid test positivity increased in the past week but remained at relatively low levels.
In Scotland, Covid hospital admissions and test positivity have risen in the past week, while levels detected in wastewater have decreased. Overall, the past month has seen a slow increase in the level of Covid indicators, though they remain relatively low.
This week, Covid hospital admissions in Wales fell slightly and remained at relatively low levels.
There was no update published for Northern Ireland this week. Covid activity was stable and low across key surveillance indicators over the previous four weeks.
Recently, the WHO declared NB.1.8.1 and XFG as variants under monitoring due to reported increases in cases and hospitalisations in some countries which have the highest prevalence of these variants. These remain the two most common variants globally.
NB 1.8.1 is dominant in many countries across South-East Asia and was linked to a rise in Covid activity in regions such as Hong Kong and other countries. However, Covid activity in these countries has peaked and has now fallen to baseline levels.
XFG is dominant in most European countries, including England and Scotland, as well as in North America, particularly the USA and Canada. This week, Covid indicators showed rising levels of Covid activity in many European countries, US States and Canada.
Results from the annual survey of adults registered as patients in England showed that about one in 24 respondents say that they had Long Covid in 2025.
The NHS Autumn Covid booster campaign will start on 1 October 2025 with the aim of completing most vaccinations by the end of November 2025. Those eligible for free vaccinations in the Autumn 2025 booster campaign for all home nations are:
adults aged 75 years and over;
residents in care homes for older adults; and
individuals who are immunosuppressed aged 6 months and over.
People registered with a GP surgery in England can now book their vaccination appointment and select a date and time starting from 1 October through this link.
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.
Long Covid in England
The GP Patient Survey, conducted by Ipsos for NHS England, is an independent survey sent annually to over two million adults who are registered with GP practices in England. In 2025, the response rate was 26%. The survey not only reflects how people feel about their GP practice but also gathers information about their health.
Since 2022, the survey has asked people the question ’Would you describe yourself as having “long COVID”, that is, you are still experiencing symptoms more than 12 weeks after you first had COVID-19, that are not explained by something else?’. Respondents can reply ‘Yes’, ‘No’, ‘Not sure, or ‘Prefer not to say’.
The following table shows the annual trend in the percent of adults who replied 'Yes' or 'Not Sure'.
The chart shows that Long Covid prevalence is slowly falling but remains high with about one in 24 respondents saying that they have Long Covid. Worryingly, there is a large and increasing number of people reporting that they are ‘Not Sure’ if they have Long Covid.
The survey data shows that Long Covid is still a problem, highlighting the need for better awareness among the general public. It remains a major concern, especially for 'Long Haulers' who have dealt with symptoms for over two years, emphasising the importance of creating reliable diagnostic tests and effective treatments.
Next week, I will be publishing an article diving deeper into the Long Covid data from the 2025 GP Patient Survey, focusing on how its prevalence varies across different sociodemographic and health characteristics.
Status of main respiratory diseases in England.
The UKHSA National flu and COVID-19 surveillance report has moved to a condensed summer report published every two weeks and is not available this week.
Consequently, this weeks report only provides an update on the test positivity rate as published weekly on the UKHSA data dashboard.
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 following chart shows the test positivity rate for all Covid tests taken as published on the UKHSA dashboard. The positivity rate 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 increased last week but remains at a low level of activity, signifying a relatively low level of risk.
Scotland weekly hospital admissions and test positivity
Public Health Scotland (PHS) continue to publish weekly data on Covid hospital admissions and test positivity as well as wastewater monitoring data. The dashboard for Scotland’s data can be accessed here.
The following panel chart presents the most recent data for weekly Covid test positivity shown in red, Covid levels in wastewater in blue, and Covid hospital admissions depicted in orange.
Covid hospital admissions and test positivity increased this week, while wastewater levels fell. The overall trend for the past months is that the indicators are rising slowly but remain at relatively low levels.
This week PHS published the monthly surveillance report on viral respiratory diseases (including Influenza and Covid) in Scotland which can be found here. The report found that for the four weeks up to August 10, the XFG variant grew as a proportion of all variants, rising from 40.3% to 65.8%. Meanwhile, NB.1.8.1 and LP.8.1 declined, dropping from 33.9% to 23.5% and from 8.9% to 8.1%, respectively.
Wales Covid hospital admissions.
The following chart provides the latest trend for weekly hospital admissions in Wales up to week ending Aug 31, 2025.
Hospital admissions for Covid fell slightly this week and remain at relatively low levels.
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 is not updated next week. Last weeks charts are included here for reference .
Flu and RSV activity remained low and stable over the previous two weeks, circulating at baseline levels. Covid indicators showed no significant change, with activity remaining steady and at low levels.
The first chart in this section shows the test positivity rates in Northern Ireland for the main respiratory illnesses — Flu, RSV, and Covid and Rhinovirus. Shading represents 95% confidence intervals.
The chart shows that the Covid test positivity rate, depicted in blue, has stabilised over the past four weeks indicating that the increase in Covid activity has stopped. 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, their was a small increase in May which has now plateaued.
Recent Variants Update
Recently, the WHO declared NB.1.8.1 a variant under monitoring but assessed the risk to public health as low. This was because although it has a slight growth advantage over other variants circulating, there was no evidence it was a more severe illness.
On June 25, the XFG variant was also classified as a variant under monitoring by the WHO. In their risk evaluation the WHO stated that the risk level was also low, noting that whilst XFG is growing rapidly compared to other variants circulating there are no reports to suggest that the associated disease severity is higher.
The following chart shows the latest global prevalence data for the main variants under monitoring by week.
Based on the limited available data, XFG and NB.1.8.1 remain the dominant variants globally with XFG continuing to grow.
The NB.1.8.1 variant has become dominant in several South-East Asian and Western Pacific countries, contributing to increased Covid activity in places like Hong Kong and New Zealand. However, as explored in the next section, Covid activity in these regions has already peaked and is now on the decline.
This weeks European Respiratory Virus Surveillance Summary reported that the most common Covid variants in GISAID for the European Region in August so far were XFG (68%) and NB.1.8.1 (12%). Once again, it is important to note that the number of tests sequenced is low and these estimates have a wide range of uncertainty.
Covid Levels in Europe and North America.
Media reports across Europe and in the USA have highlighted that the new variants, particularly XFG, have 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 on Covid activity in Europe and North America. While Covid levels are increasing in several countries across these regions, they generally remain much lower than those observed during earlier waves.
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.
Over the past week, Covid activity increased in many countries based on wastewater levels, although all countries remain at relatively low levels.
Covid activity in the USA has increased over the past five weeks as measured by a number of key indicators and are now at moderate levels. The following panel chart illustrates the recent trends in the USA regarding Covid test positivity and Covid levels in wastewater. It also highlights the health impact, measured by the percentage of Emergency Department visits diagnosed with Covid and the hospital admission rate per 100,000 people.
The increase in Covid test positivity rate and emergency department visits is a clear sign that Covid activity is continuing to rise in the USA.
Wastewater analysis also shows that Covid levels are increasing across many US States, as illustrated in the following map. The map shows wastewater viral activity levels across states for the week ending August 23, 2025.
Each state is coloured based on activity levels, ranging from very high (dark red) to very low (light green), with grey indicating no data available. States with increasing activity levels are marked with cross-hatching. The map is interactive, and moving the cursor over a state gives additional detail about wastewater viral activity levels.
The interactive map shows that wastewater activity levels increased in 28 states last week, and most are at a moderate or higher level of activity. Wastewater activity levels are typically highest in states that are holiday destinations.
Further details on the trend in Covid activity at the State level can be found at the CDC Current Epidemic Trends for States website which can be accessed here. Just to note that on August 15, 2025, CDC updated the methodology used to calculate the wastewater viral activity level. For more information, visit CDC’s Wastewater Surveillance Data Methodology page.
The final chart in this section shows that Covid activity in Canada, as measured by the latest wastewater levels, increased significantly this week but remains at a moderate level.
Covid levels in South-East Asia and the Western Pacific.
In a previous section we saw that the NB.1.8.1 variant is dominant in several South-East Asian and Western Pacific countries. But what was the impact of these increased levels of NB1.8.1 on Covid activity in these countries?
Data from Hong Kong provides a comprehensive picture of the impact of NB.1.8.1 on Covid activity. 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 large increase in Covid activity resulting in an impact on health. However, the recent peak in Covid activity is over as these key indicators have fallen rapidly and are now at low activity levels. Although NB.1.8.1 remains the dominant variant, its prevalence has significantly fallen to 76%, compared to over 95% during the peak of recent Covid activity.
New Zealand also publishes a wide range of Covid metrics and the next panel chart shows the data for cases, levels in wastewater sampling, and hospital admissions since the start of 2024. This shows a mixed picture but, unlike Hong Kong, levels are much lower than previous peaks for these indicators.
Covid levels in wastewater increased as the NB.1.8.1 variant increased in prevalence but have now fallen although they remain at moderately high levels. However, Covid cases only increased slightly and are low. Weekly hospital admissions increased at a higher rate and the latest data (up to week ending Aug 24) shows that they remain at a moderate levels.
These two examples show that the impact of a new variant can be very different depending in the country. It is likely that the lower impact on New Zealand is due to a greater level of population immunity in New Zealand through higher vaccine coverage and the lower population density from being a less urban country.
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.
Recently, the WHO have declared NB.1.8.1 and XFG as variants under monitoring due to reported increases in cases and hospitalisations in some countries which have the highest prevalence of these variants. These are now the two most common variants globally.
Hong Kong and New Zealand have recently seen increases in Covid activity driven by the NB.1.8.1 variant but they have peaked and returned to relatively low levels.
Covid activity in Europe and Canada are increasing but remain relatively low levels of activity. Activity measures have also increased in the USA where they are at moderate levels.
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.
Thank you for telling us about the survey into long covid. As a long hauler, now just completing my third year of symptoms, I deeply appreciate the need for increased public awareness.
Thank you so much for your hard work and public service.