Minimising a ‘twindemic’

Australia announced the removal of the requirement for mandatory isolation associated with COVID-19 from 14 October 2022, stating that the country had moved on from its emergency phase. However, it noted that the COVID-19 pandemic was not over yet and isolation was still recommended for those infected (Healthdirect, 2022). The UK has no current domestic restrictions in any location. The COVID-19 illness remains a notifiable disease and SARS-CoV-2 remains a notifiable causative organism, as is the influenza virus (UK Health Security, 2022a). The UK Health Security Agency's recommendations for England remain: fresh air ventilation for indoor meetings if the meeting cannot be held outdoors; wearing of a face covering in crowded, enclosed spaces; and taking the COVID-19 vaccination offer (initial 1st and 2nd vaccination, and boosters, as offered depending upon age, clinical vulnerability, health or social care occupation etc).

Alongside concerns about an autumn spike of COVID-19 infections, is the possibility of a major influenza epidemic arising from the lack of circulating influenza virus over the last 2 years due to social distancing and working from home. The absence of the annual transmission cycle is expected to have lowered the usual levels of immunity against the influenza virus, especially among young children who may have had no prior exposure. While COVID-19 as a cause of death reduced in early 2022, it has remained higher than for influenza and pneumonia. The latest available data reported that at the end of April 2022, influenza and pneumonia were the cause of 20% of recorded deaths, which is similar to most weeks since March 2021 (Office of National Statistics (ONS), 2022). Influenza and pneumonia were the seventh leading cause of death in England and Wales in 2020 and 2021 (ONS, 2022), with between 10 000–20 000 people dying of influenza each winter.