Scientists fear rise in hospitalisations from non-Covid infections this winter

Non-Covid infections accounted for more than half of respiratory-related hospitalisations during the first peak of the pandemic, raising fears that the coming winter could be even worse

Patients were admitted with signs or symptoms of respiratory infections (AFP via Getty Images)

Scientists fear this winter is likely to be one of the worst on record for respiratory infections and hospital admissions in the UK following the complete relaxation of Covid rules.

New research from the University of Bristol suggests that non-Covid infections during the peak of the pandemic accounted for 55 per cent of respiratory-related hospitalisations — at a time when widespread Covid restrictions were in place.

Now, with all of the UK’s Covid measures removed, scientists believe this winter will see non-Covid respiratory infections circulate at higher levels and account for a greater proportion of hospital admissions than in previous years.

“Depending on what public health interventions we put in place this year, if we don’t limit things, then actually it’s going to be even worse than last year,” said Dr Catherine Hyams, the principal investigator behind the Bristol University study, adding that this winter could be one of the worst on record.

“Our results really highlight not only the huge burden of respiratory infection on the NHS and other healthcare systems, but also how bad things may get this winter.”

Using data from 135,014 hospitalisations from two large hospitals in Bristol between August 2020 and November 2021, researchers found 12,557 were for patients with acute Lower Respiratory Tract Disease (aLRTD).

Of these, 12,248 (98 per cent) patients, mainly older adults, consented to participate in the study.

Patients were admitted with signs or symptoms of respiratory infections, including cough, fever, pleurisy, or a clinical or radiological aLRTD diagnosis.

They were repeatedly tested for Covid-19 while in hospital, but weren’t screened for other respiratory illnesses, such as RSV or influenza, due to a testing shortage at the time, Dr Hyams said.

After conducting analysis of the 12,248 hospitalisations, the researchers found that 55 per cent (6,909) were due to a non-Covid infection.

Dr Hyams, a clinical research fellow at Bristol University, said the team had yet to establish which pathogens were responsible for these admissions, but added that “we are now working on analysing samples to look at what different infections were coming through”.

Sars-CoV-2, the virus that causes Covid-19, accounted for 26 per cent (3,178) of respiratory infections recorded by the study. The remaining 17 per cent (2,161) were due to infection with no infective cause.

Dr Hyams said it was “safe” to extrapolate the results of the study to the rest of the UK. “Each town and city will have its own peculiarities and little quirks to them,” she added. “But what we know is that the population of Bristol and is representative of the UK population as a whole.”

Professor Adam Finn, one of the study’s lead authors, said: “What is really surprising from our results is just how much other non-Covid respiratory infections there was during this time.

“Other infections clearly didn’t just disappear and despite significant public health measures… our findings show there was still a high incidence of non-Covid-19 disease causing hospitalisations alongside Covid-19 patients.”

Describing the results as “very surprising,” Dr Hyams said: “When you’re always focused on one thing, sometimes just don’t see what else is actually happening.

“We were so focused on Covid and the problems arising from it, that actually there was a huge amount of non-Covid respiratory admissions. We kind of didn’t notice it, and these infections didn’t go away completely.”

Dr Hyams said the number of people hospitalised with non-Covid respiratory infections had risen from the winter of 2020/21 to 2021/22 — “and that’s even with all the public health resources and everything that we did nationally to try and limit respiratory infection”.

She added: “There was a massive effort, a huge sacrifice for people to try and limit respiratory infection. And despite that, we actually saw more cases than ever before.

“You’ve got all these infections that are still in circulation, they’re still there, and they’re still circulating with Covid. And they’re not going to go away. They’re going to further rise this winter.

“It is therefore essential that appropriate healthcare planning and resource allocation is undertaken to care for patients with respiratory conditions, in addition to implementation of public health measures to reduce respiratory disease burden and improve patient outcomes.”

Nicholas Hopkinson, a professor of respiratory medicine at Imperial College London, said that in the absence of the “protective measures” enforced during the pandemic, “both Covid infection and other acute respiratory diseases are going to increase again over the winter”.

He added: “The healthcare system was already under-resourced and failing to meet targets before the pandemic started. The situation is much worse now and we have to face the coming triple threat of flu, Covid and the cost of living crisis driving millions more into food and fuel poverty.”