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Lack of immunity

Most of us have had a dose of flu during the course of our lives. And as this virus circulates freely during the winter months, we're all likely to have been exposed to it frequently over the years.

However, strains of flu vary from year to year, and the virus is constantly evolving, which means if we have a year in which not as many people are exposed, immunity within the community is lowered.

"In ordinary times, we have a degree of cross-protection," explains Dr Stephen Griffin, Virologist and Associate Professor at Leeds Institute of Medical Research. "But if we miss a year of exposure, there are going to be bigger gaps in terms of the differences in the virus and therefore your immune response."

Early warning signs

Scientists are also concerned about the rapid spread of respiratory infections in children, which could be an indicator of how flu might circulate once the virus begins to take hold.

"As social distancing guidelines are reduced, we're already seeing a surge in respiratory infections such as RSV (respiratory syncytial virus - the virus that causes the common cold) and Crupe - usually these infections aren't prevalent until the winter," explains GP Dr Claire Ashley.

"However, as many children may not have been exposed to these infections in the last year due to social distancing and other measures, they are more likely to become unwell if exposed as their body hasn't tackled them for so long."

This surge in respiratory infections and increased susceptibility may be an early warning sign that this year's flu season could be worse than in normal years.

Lack of social distancing

The flu season last winter was minimised due to the measures in place for COVID-19. With lockdowns taking place in the UK in both November and January, and strict social distancing and mask-wearing mandated, flu - like COVID-19 - struggled to spread as widely as it would have otherwise. However, now that these restrictions have been lifted, influenza is more likely to spread and take hold.

Who should worry about flu?

Most of us don't spend much time worrying about the flu - and for many, an infection may be mild. However, influenza can become serious at any age, so should not be treated lightly. Those who are older or have underlying health conditions may be particularly vulnerable. As with COVID-19, even if we are healthy, we all need to be mindful of reducing the risk of illness to reduce the spread to those who are at risk.

"Flu should not be underestimated," says Dr Griffin. "Despite vigorous surveillance and an extensive vaccination programme, we still see a significant number of deaths each year. The illness can be serious for anyone - it's difficult to predict."

COVID-19 and flu

In addition, even for those vaccinated against COVID-19 there is a real risk of contracting both viruses simultaneously. "It is possible to contract both illnesses at the same time, which can lead to quite serious illness," says Dr Ashley. "Especially for those who are high-risk and vulnerable."

Finally, as with COVID-19, a high number of flu cases may put tremendous pressure on the NHS, with hospitals often reaching capacity even in pre-pandemic conditions. The combination of the two could be disastrous. To prevent our health services being overwhelmed, it's important we all take flu seriously.

When will flu season start?

Usually flu season peaks in January. However, there are signs that this year the illness might crop up a little earlier than usual. "The instances of RSV and croup are much earlier than usual. While we can't say for definite when flu season will peak this winter, it's likely to be less predictable than usual," explains Dr Ashley.

What preparations are in place?

As usual, vaccines are the best course of action against flu - and those aged 50+ should be able to get vaccinated from around the end of September. Children will also be offered a nasal spray, which will help to minimise the spread of the illness in schools and, as a result, the wider community.

What are my responsibilities?

The best course of action against influenza is the vaccine. "Vaccines sometimes vary in effectiveness," explains Dr Griffin. "As the virus is different every year, scientists must predict what strains to include in the vaccines. Some years this means the vaccine is more effective than others. But even if it gives lower protection in a given year, it is still much better to have the vaccine than not."

For those not eligible for free vaccination on the NHS, the vaccine will be available from pharmacies and some supermarkets for around £10 from September/October. "I have a vaccine each and every year," says Dr Griffin. "I'd recommend everyone get one if they can."

It is also advisable to continue the measures we are now used to for keeping COVID-19 at bay. "Social distancing, mask wearing and handwashing work," says Clare. These precautions, whilst no longer mandatory, are still advised to minimise the spread of COVID-19. Taking sensible steps like these should also keep the risk of flu to a minimum.