Influenza activity in England increased during the week to 4 October but remained at baseline levels, while COVID-19 activity rose and was assessed as low, in the UK Health Security Agency’s latest national surveillance report. The weekly report also provides the first provisional influenza vaccination uptake figures for the 2026–27 season.
The data describe the week ending 4 October, not conditions on the day the report appeared. Several indicators moved upwards, but the report’s activity classifications remain important: rising does not itself mean an epidemic or a high level of illness. Results are provisional and some vaccine figures may change as missing pharmacy information is added.
Flu indicators move upwards from a low base
Laboratory surveillance recorded influenza positivity of 6.5 per cent on the most recent Sunday in the reporting period, up from 5 per cent the previous Sunday. Among samples tested through participating GP practices during week 40, 10 per cent were positive, compared with 7.6 per cent a week earlier. The weekly rate of GP consultations for influenza-like illness rose from 4 to 5.6 per 100,000 registered patients.
Those increases sit alongside a baseline classification for influenza activity. The overall weekly hospital admission rate for influenza was 1.97 per 100,000. The rate for intensive care or high-dependency admissions was 0.06 per 100,000. Emergency-department attendances for influenza-like illness were above seasonally expected levels, while reported influenza-confirmed acute respiratory infection incidents in the community were stable compared with the previous week.
The measures capture different parts of the picture. Test positivity describes the share of tests that were positive, GP consultation rates describe visits in participating practices, and hospital rates are population-based measures. They should not be read as interchangeable counts of everyone infected or as a forecast of how the season will develop.
COVID-19 is increasing, with activity still classed as low
COVID-19 laboratory surveillance also showed an increase: hospital-setting PCR positivity reached 9.1 per cent on the latest Sunday, compared with 7.9 per cent a week before. The report recorded 1,638 cases identified in hospital settings in week 40, up from 1,328 in the previous week. The overall weekly hospital admission rate rose from 1.75 to 2.04 per 100,000.
In GP testing, 10.8 per cent of samples were positive for SARS-CoV-2, close to the 10.9 per cent recorded in the preceding week. The intensive-care and high-dependency admission rate remained low at 0.06 per 100,000, compared with 0.05. Taken together, the agency described COVID-19 activity as increasing but circulating at low levels. Emergency-department attendances for COVID-like illness were above seasonal expectations, another measure that should be considered alongside, rather than substituted for, the overall activity classification.
For the autumn COVID vaccination campaign, which began on 1 October, the report says 10.2 per cent of people aged 75 and over and 4.1 per cent of people under 75 with a weakened immune system had received a dose by the end of the week. These early figures cover only the first days of the campaign.
First seasonal flu uptake figures are provisional
By 4 October, GP-practice records showed that 9.9 per cent of people aged over 65 had received an influenza vaccine this season. Uptake was 4.9 per cent among people under 65 in a clinical risk group, 16.4 per cent among pregnant women, 16.5 per cent among two-year-olds and 16.4 per cent among three-year-olds.
The figures were reported by 98.7 per cent of GP practices for adults and 98.8 per cent for children. They are early-season proportions, not final coverage totals. Children and pregnant women have been eligible since 1 September; adult groups other than pregnant women became eligible from 1 October, so the groups have had different amounts of time in which to receive a dose.
Some pharmacy uptake data was unavailable or incomplete when the figures were compiled. The report specifically advises caution for older people, people under 65 in clinical risk groups and pregnant women, and says results could change when further data arrive. It notes that a fuller monthly uptake release is scheduled for 26 November, covering vaccinations given through 31 October.
Other respiratory viruses remain part of the picture
Respiratory syncytial virus activity remained at baseline levels. Laboratory positivity rose to 0.5 per cent from 0.3 per cent, while GP swabbing positivity fell to 0.7 per cent from 0.9 per cent. The weekly hospital admission rate, excluding intensive-care and high-dependency admissions, was 0.11 per 100,000, down from 0.13.
The report also tracks adenovirus, human metapneumovirus, parainfluenza and rhinovirus. Their laboratory positivity estimates moved in different directions during the week, reinforcing why a single headline trend cannot describe all respiratory illness. Activity levels are assessed against thresholds; the report notes that some methods are experimental for certain indicators and may be revised.
This update offers an early-season snapshot for England. It records increases in some flu and COVID-19 measures, but labels influenza as baseline and COVID-19 as low. The new vaccine figures provide a first view of uptake, with explicit warnings about timing, reporting coverage and missing pharmacy data. Further weekly surveillance and more complete vaccination returns will give a clearer picture as autumn progresses.
