Health chiefs on Wednesday appealed to millions of people in England to get vaccinated against both coronavirus and flu to stave off the risk of a “twindemic” hitting the UK this winter.

The UK Health Security Agency said waves of flu had already been seen in southern hemisphere countries, including Australia, deepening concerns that the UK may also experience its first significant outbreak since Covid-19 emerged.

The dominant flu virus worldwide is H3N2, a subtype associated with more severe disease. During the most recent serious outbreak of the virus in 2017-18, more than 40,000 people were hospitalised in England and there were 22,000 excess deaths, according to the health agency.

Last year, flu levels were kept in check by a lack of social mixing, officials said, but contact was now virtually back to pre-pandemic levels, intensifying concerns about the potential burden of illness this year.

In a typical year, up to 30 per cent of the population is exposed to flu, but the dearth of cases over the past three years means fewer people than normal have immunity.

Officials pointed out that flu deaths average between 11,000 and 20,000 in a typical year in England, with tens of thousands of people hospitalised.

At the same time, Covid variants were becoming more “immune-evasive” as they evolved, they said, raising concerns about a double strain on the UK’s already-stretched health system.

There are early signs that a resurgence in Covid infections is under way, with positive tests and hospitalisations on the rise. An estimated one in 70 people tested positive in England in the week to September 14, up from one in 75 in the previous week, according to the Office for National Statistics.

People who catch flu and Covid at the same time are around twice as likely to die compared to those who only have Covid, according to health officials.

Dr Susan Hopkins, chief medical adviser at UKHSA, said there were “strong indications we could be facing the threat of widely circulating flu, lower levels of natural immunity due to less exposure over the last three winters and an increase in Covid-19 circulating with lots of variants that can evade the immune response”. This combination posed “a serious risk to our health, particularly those in high-risk groups”.

NHS director for vaccinations and screening Steve Russell said: “This winter could be the first time we see the effects of the so-called ‘twindemic’ with both Covid and flu in full circulation.

“It is vital that those most susceptible to serious illness from these viruses come forward for vaccines in order to protect themselves and those around them.”

Last year, there was record uptake of the flu jab in people aged 65 and over, with more than eight out of 10 receiving it, but there was lower uptake among people in clinical risk groups and pregnant women.

Officials said it was particularly important for young children to be immunised as they would not yet have encountered the disease and therefore have limited natural immunity.

All primary school children and some secondary school children are eligible for the flu nasal spray this year. GP surgeries are also offering the spray to children aged 2 and 3.

In total, 33mn people are eligible for a flu vaccine and around 26mn for a Covid booster. Over-65s are being invited to book a booster jab and the invitation will be extended to over-50s from around mid-October.



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