I write this as I recover from an outbreak of gastroenteritis that has ripped through my household. An illness that I've previously thought of as a ‘winter bug’. This ties in with news reports I've seen lately, with Public Health England (PHE) warning that routine surveillance has shown an increase in the number of outbreaks of norovirus in recent weeks (PHE, 2021) and cases are returning to pre-pandemic levels across all age groups and settings in England – with far more incidents reported to PHE than would usually be expected in the summer months. Many of these cases are associated with early years childcare settings.
There are also reports of higher rates of respiratory infections in children (see p306) – particularly respiratory syncytial virus (RSV), an infection that is usually mild in healthy children. RSV is also mainly seen in the winter months. Paediatric A&Es are reporting that they have had the busiest couple of months on record, with one doctor saying ‘We are effectively running a winter-level emergency department response in the summertime’. Some evidence suggests parents are attending A&E unnecessarily when their child has a mild fever. One theory is that this is happening because those with young children born during the pandemic haven't experienced mild illness in their child before and are anxious.
The COVID-19 lockdowns did not only work to suppress COVID-19; last year had the lowest levels of flu ever recorded and other infections were also massively reduced as people avoided contact with each other and socially distanced. This may have had a knock-on effect on immunity to infections that is now being shown by resurgence in RSV and norovirus as society reopens and people – especially children – start mixing again.
All of this will require careful planning from the NHS. It is unclear whether we will see a big winter surge in infection this year – some argue that the high levels of infection now will prevent that – but we are planning for a worse flu season this year by implementing the biggest influenza vaccination programme ever undertaken in the UK (Department of Health and Social Care, 2021).
It will be key to encourage people to continue to follow basic hygiene principles like frequent handwashing, coughing and sneezing into tissues and most importantly staying at home when they are unwell to avoid spreading illness this winter.
Are you worried about how this winter will be? Let us know at pn@markallengroup.com
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