James GallagherHealth and science correspondent
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Flu should always be taken seriously. It is a virus that kills thousands of people every winter and puts intense strain on hospitals.
However, I can’t remember a flu season that has played out quite like this. There have been claims it is both a “superflu” and “unprecedented” across the media and even from NHS England – while experts say this year’s flu is not out of the ordinary with accusations of “crying wolf”.
So what’s really going on and is anything truly different this year?
As I reported in early November, there were concerns the flu season had the potential to be the worst for a decade.
Scientists who track the multitude of flu viruses around the world noticed seven fresh mutations appear in a strain of influenza – a type called H3N2 – in June.
This newly mutated virus rapidly became the dominant form of H3N2 and was named subclade-K.
The flu season took off a month early in the UK hinting the virus may have the potential to spread more widely than normal and it was too late to adjust this year’s flu vaccine to match the new mutations.
That was the concern, but the reality has been more in line with a normal flu than a super flu.
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H3N2 strain of influenza
The K-flu virus has not gained a dramatic ability to rip through the population.
“It was basically spreading at a very similar speed to previous years, it was towards the upper end, but it wasn’t an outlier,” says Prof Christophe Fraser, who is analysing the spread of the virus at the Pandemic Sciences Institute at the University of Oxford.
His team’s latest analyses, still to be published, suggest the mutations did give the virus a slight edge at slipping past our immunity – in the region of 5-10% more than usual. It is not clear if that applies to everyone or is concentrated just in children and young adults who have caught less flu in the past and who have been most affected so far.
H3N2 viruses always tend to be more severe for the elderly and there is no clear evidence the virus is worse than expected this year. A rapid analysis of the seasonal flu vaccine also suggested it was performing in line with previous years despite fears of a mismatch.
Dr Jamie Lopez Bernal, a consultant epidemiologist at the UKHSA, said: “The things that we saw that were unusual this season are the early start to the season, we also saw this change to the virus, with more evolution than we typically see.
“But overall, in terms of the impact on the NHS and the impact on people’s health, we’re seeing a broadly typical flu season.”
There are suggestions that flu may already be peaking, although this comes with significant uncertainty. There are questions about what happens over Christmas when everyone meets up and it’s easier for the virus to infect older people who are more at risk. There are also signs a different strain of flu – H1N1 – is picking up in Europe and may lead to an increase in cases here too.
But a “broadly typical flu season” is probably not the sense you’d get from watching or reading the news.
Statistical artistry was used to compare an early flu season to one that started much later allowing claims of flu cases being “an incredible 10 times higher” than in 2023.
It was technically true, but is like saying your train to Glasgow got you there in record time… but the journey time was identical, you just booked an earlier train.
NHS England was not the first organisation to start calling it superflu, but Prof Meghana Pandit, national medical director at NHS England, did label it an “unprecedented wave of super flu”.
It has been suggested by the British Medical Association that flu has been used to scaremonger while resident doctors were deciding whether to continue their strike action.
Superflu isn’t a scientific description and the BBC Health Team has not found any expert who thinks it is an accurate one.
“I don’t think it’s a helpful term, there isn’t a particularly unusual set of symptoms, there’s no indication of it being associated with exceptional severity, exceptionally rapid spread or exceptional health impact,” says Prof Fraser.
One of the UK’s top flu scientists, Prof Nicola Lewis, the director of the World Influenza Centre at the Francis Crick Institute, said the virus was “not particularly unusual” and that she saw “no evidence” the virus was “particularly different” and superflu “wouldn’t be my description”.
The former deputy chief medical officer for England through the pandemic, Prof Jonathan Van-Tam, posted: “I’m very unclear what is meant by the rather silly term of ‘superflu’.”
Crying wolf?
Persuading people to get the flu vaccine saves lives and last winter the jabs were estimated to have kept around 100,000 people out of hospital.
However, experts have started to question whether the escalation in language used since the Covid pandemic could harm trust in official health advice. Previous winters came with warnings of a tripledemic of flu, Covid and RSV; then it was upgraded to a quademic adding in norovirus; this year it’s superflu.
Dr Simon Williams, who researches psychology and public health at Swansea University, says there are issues with the “current language around every winter being ‘the worst’ in some way or another” and risks a “cry wolf” effect that damages trust and means people become “numb” to the advice.
He said there was a danger of “over-using the narrative that viruses will overwhelm the NHS” when “ultimately the NHS hasn’t got overwhelmed to the point of not being able to carry out emergency and basic functions”.
Instead he argues a “fine balance” is needed between raising awareness and “not falling into the trap of fear-messaging or being overly alarmist, which can backfire”.
Prof Jonathan Ball, a virologist at Nottingham University, agrees saying: “I think it is a concern to use words like super flu, when we may one day experience a real super flu.
“We have to be very, very careful about how we communicate these things to the public, because there is a risk that we can cry wolf.”
