England faces new COVID wave as NHS braces for winter strain

E ngland is once again experiencing a significant resurgence of COVID-19, marking the end of an unusually long period of stability. According to the latest UK Health Security Agency (UKHSA) data up to 29 September 2025, weekly COVID hospital admissions have climbed to their highest level in nearly two years.

Professor Christina Pagel, director of University College London’s Clinical Operational Research Unit, writes in her substack: “We are definitely in another significant COVID wave. The last time we saw this many hospitalisations was two years ago, and the current rise isn’t over yet.”

Hospitalisations climb as COVID outpaces flu

UKHSA surveillance reports show weekly COVID hospital admissions now exceed 5 per 100,000 people, ending 10 months of low and stable infection levels. This rise is not mirrored by influenza or RSV, which remain at baseline seasonal levels.

“Flu admissions last week were about fifty times lower than those for COVID,” Professor Pagel notes, adding that COVID remains the primary respiratory burden heading into winter. Unlike flu, which peaks during the first months of the year, COVID continues to circulate throughout the seasons, showing no fixed pattern.

UKHSA data (Week 39 report, 2025–26 season) confirm that while COVID peaks in autumn and winter are expected, the current wave is both larger and earlier than predicted.

Despite speculation, genomic data show no new variant is driving this wave. The Omicron sub-lineage XFG — dominant since July 2025 — accounts for around 70% of sequenced cases in England, according to UKHSA.

Christina Pagel says: “This isn’t a variant-driven wave. The dominant strain, XFG, has been around for months. What we’re seeing is likely caused by waning immunity, combined with more people mixing indoors as autumn sets in and schools and workplaces return to full activity.”

The UKHSA’s sequencing data indicate that other lineages such as KP.3.1.1 and XEC have declined since spring, reinforcing that the wave is behavioural and immunity-related rather than variant-led.

England no longer conducts routine wastewater surveillance for COVID. However, Scotland’s monitoring — managed by NHS Lothian — shows a modest increase in viral RNA since late summer 2025. This rise has not yet translated into a sharp spike in hospitalisations north of the border.

Across Europe, however, similar trends are emerging. Wastewater data from Germany, the Netherlands, Denmark, Austria, Sweden, and France reveal rising viral concentrations since August, according to data compiled by researcher Bob Hawkins.

Vaccination: Booster campaign begins

The government’s autumn COVID-19 booster campaign launched in late September, targeting adults aged 75 and over, people with weakened immune systems (aged six months to 74), and residents in care homes for older adults.

So far, only 14% of over-75s and 8% of eligible clinically vulnerable people have received their booster, UKHSA data show.

Professor Pagel urges faster uptake: “I’d encourage anyone eligible to get boosted. If you can afford a private vaccine, it might be worth doing so, especially heading into the festive season when infections spread more easily.”

Private boosters are priced at £100 at major UK pharmacies such as Boots. At the same time, NHS COVID vaccines remain free for those meeting eligibility criteria.

NHS under continued pressure

While COVID adds a fresh strain, underlying pressures on the NHS remain severe.

According to Nuffield Trust performance data, the average ambulance response time for Category 2 emergencies such as strokes was 30 minutes and 46 seconds in September 2025, exceeding the government’s 30-minute objective.

At the same time, 44,765 patients waited over 12 hours in A&E after a decision to admit, up sharply from 35,909 in August 2025 and vastly above the pre-pandemic figure of 458 in September 2019.

Elective care backlogs also remain stubborn. 6.26 million patients were waiting to begin treatment in August 2025, a reduction of 161,000 from the previous year but still far above pre-2020 levels.

Professor Pagel warns: “We’re heading into winter with an NHS that’s still stretched and under-resourced. Long waits have become the new normal, even in summer, when pressures should be lowest.”

Outlook: Vigilance amid fatigue

The government has not announced any new restrictions, focusing instead on vaccination and public caution. Experts believe widespread immunity continues to prevent most severe illness, but sustained vigilance remains necessary.

“If you feel unwell, especially with a fever or cough, assume it might be COVID and avoid close contact with vulnerable people. We’re all tired of it, but reducing transmission now will help protect those at greatest risk and relieve some pressure on hospitals,” Professor Pagel writes, before concluding: “COVID hasn’t gone away. We may not be facing a crisis, but we are once again reminded that it remains part of our lives — and part of the NHS’s burden.”

GOING FURTHER

• Professor Christina Pagel | UCL

• England is now experiencing a significant Covid wave, after 10 months of relative quiet | SUBSTACK

• National norovirus and rotavirus report, week 39 report: data to week 38 | UK HEALTH SECURITY AGENCY

• National flu and COVID-19 surveillance report: 9 October 2025 (week 41) | UK HEALTH SECURITY AGENCY

• Covid Situation Report: Oct 9, 2025 | SUBSTACK

• NHS kicks off flu and COVID jabs to ‘winter-proof’ vulnerable | NHS ENGLAND

• COVID-19 vaccine | NHS

• NHS performance dashboard | NUFFIELD TRUST

Sources:

▪ This piece was first published in Europeans TODAY on 13 October 2025.

▪ Cover: Dreamstime/Korwen.