England is moving into the autumn respiratory-virus season with both influenza and COVID-19 activity rising, according to the latest national surveillance report from the UK Health Security Agency (UKHSA). The important point for readers is not that England is in a severe wave right now, but that several indicators have started moving upward at the same time as families, schools, workplaces and care settings enter the period when respiratory infections usually become more common.
The UKHSA report published on 24 September 2026 covers data for the week ending 20 September. It says influenza activity increased but remained at baseline levels, while COVID-19 activity also increased and remained at a low overall level. Respiratory syncytial virus (RSV) remained low and at baseline levels.
For most people, that means there is no reason to panic. But the direction of travel matters, especially for older adults, people with long-term conditions, pregnant women, families with young children and anyone caring for somebody who becomes seriously unwell with respiratory symptoms.
What the latest UKHSA figures show
UKHSA uses several surveillance systems rather than relying on one single number. That is important because testing behaviour changes over time, not everyone with respiratory symptoms is tested, and no single measure gives a complete picture of what is happening in the community.
For influenza, laboratory surveillance showed the rolling seven-day positivity rate rising to 3.8%, compared with 3.4% the previous Sunday. In the GP sentinel swabbing scheme, 10.7% of tested samples were positive for influenza in week 38, up from 8.3% the week before. Emergency-department attendances for influenza-like illness also increased and were above seasonally expected levels.
COVID-19 indicators moved upward as well. Hospital laboratory PCR positivity increased to 7.0%, compared with 5.9% the previous Sunday. The overall weekly hospital admission rate rose to 1.20 per 100,000, from 0.81 per 100,000 the week before. UKHSA still classed overall COVID-19 activity as low, which is an important distinction: an increase does not automatically mean high community burden.
RSV remained at baseline levels. Laboratory positivity decreased to 0.4%, and GP swabbing positivity was 0.0% in the reporting week. That does not mean RSV is absent, only that national indicators remain low at this stage of the season.
Why increases matter even when activity is still low
Respiratory-virus surveillance is useful because it can show a change in direction before hospitals and families experience the full effect of a winter surge. A small rise in positivity or emergency attendances is not the same thing as a crisis, but repeated increases across different indicators can be an early signal that more infections are circulating.
This matters particularly in households where one person is at greater risk of complications. Older adults, people with weakened immune systems, people with chronic heart or lung conditions and some other clinically vulnerable groups may be more likely to become seriously unwell from infections that are mild for someone else.
Families should therefore think less in terms of “Is there a wave?” and more in terms of practical readiness. Do vulnerable relatives know how to access help if symptoms worsen? Are repeat prescriptions and usual medicines organised? Does everyone know who to call if breathing becomes difficult or someone deteriorates quickly?
Our Healthcare Navigation guide explains how to prepare useful information before contacting a GP, pharmacy, NHS 111 or another service, so that symptoms, medications and recent changes can be communicated clearly.
What the figures do not tell us
Surveillance percentages are often misunderstood. A positivity rate is not the same as the percentage of the whole population who currently have an infection. It is the percentage of tests in a particular surveillance system that are positive. Different systems test different groups of people, so figures should not be compared casually.
UKHSA also notes that testing policy and practice change over time, which can affect comparisons. Some influenza data have also been affected by an ongoing data-quality issue that may make historical positivity estimates slightly lower in reports published since week 25. The agency says those estimates will be updated when the affected data are corrected.
That is why it is better to read the overall pattern rather than fixate on a single number. In the latest report, the broad pattern is clear: influenza and COVID-19 indicators are rising from relatively low starting points, while RSV remains low.
What people can do now
For most households, the sensible response is straightforward. Stay aware of symptoms, follow current NHS and UKHSA vaccination guidance if you are eligible, and avoid exposing vulnerable people when you are acutely unwell.
If someone develops fever, cough, marked fatigue or other respiratory symptoms, rest, fluids and appropriate self-care may be enough for a mild illness. But people should seek medical advice when symptoms are severe, unusual, worsening, or when a person is at increased risk because of age, pregnancy, immune suppression or an existing health condition.
Breathing difficulty, severe chest pain, blue or grey lips or skin, confusion, collapse, or rapidly worsening illness are examples of symptoms that may need urgent or emergency assessment. If you are unsure what level of care is appropriate, NHS 111 can help direct you. Call 999 for a life-threatening emergency.
Autumn vaccination is part of the picture
The surveillance update arrives just as the autumn vaccination season is getting under way. Eligibility differs between flu, COVID-19 and RSV programmes, so readers should check current official guidance rather than assume that eligibility is the same for every vaccine.
For flu, NHS eligibility expands further from 1 October for groups including people aged 65 and over, adults in clinical risk groups, residents of long-stay residential care homes, some carers and eligible frontline social-care workers. COVID-19 autumn booster eligibility is narrower and should be checked against the current NHS offer.
Vaccination does not make infection impossible. Its main public-health value is reducing the likelihood of severe illness and complications in people most at risk. That distinction matters because it sets realistic expectations and avoids the misleading idea that a vaccine must prevent every infection to be worthwhile.
What carers should watch for
Family carers often notice deterioration before a scheduled appointment ever happens. A useful approach is to pay attention to change from the person’s normal baseline: breathing, alertness, food and fluid intake, ability to move around, sleepiness, temperature and whether normal medicines are being taken.
Older people do not always show illness in the same way as younger adults. A sudden change in confusion, weakness, mobility or appetite can sometimes be as important as a high temperature. Carers should not diagnose the cause themselves, but they can make clinical conversations more useful by recording when the change started and what has changed.
If you are supporting someone at home after illness or hospital treatment, our Family Carers & Home Recovery guide covers practical monitoring, medication organisation, discharge information and when to escalate concerns.
What happens next
UKHSA will continue publishing regular surveillance updates through the 2026–27 respiratory season. A single weekly report should never be treated as a forecast of exactly what will happen next. Activity can rise, level off or fall, and different viruses may peak at different times.
The more useful takeaway from the 24 September report is that England is entering autumn with both influenza and COVID-19 indicators moving upward. That makes this a good time for eligible people to check vaccination arrangements, for vulnerable households to think through what they would do if somebody became unwell, and for carers to make sure important health information is easy to find.
The bottom line
The latest data do not show a severe national respiratory-virus wave. Influenza remains at baseline levels, COVID-19 remains at a low level, and RSV remains at baseline. But both influenza and COVID-19 are increasing, and some emergency-care indicators are rising too.
For readers, the practical response is proportionate preparation rather than alarm: keep up with official vaccination guidance, avoid passing infections to vulnerable people where possible, know how to access NHS help, and seek urgent assessment when symptoms suggest serious deterioration.
How to interpret the next few weekly reports
One week of rising activity should not be read in isolation. The more useful approach is to watch whether several indicators continue moving in the same direction over multiple reports. If laboratory positivity rises but hospital admissions remain stable, the impact on serious illness may still be limited. If admissions, emergency attendances and community indicators all rise together, that suggests a broader increase in burden.
National figures can also hide local variation. One region may experience higher activity while another remains quieter. Local NHS services, GP practices and pharmacies may therefore experience pressure at different times. Families caring for vulnerable people should combine national surveillance with local advice and what they are actually seeing in the household.
Practical preparation for vulnerable households
A small amount of preparation can make illness easier to manage. Keep an up-to-date medicines list, make sure repeat prescriptions are not about to run out, know where a thermometer and other usual monitoring equipment are kept, and write down important phone numbers. If a vulnerable person has an agreed action plan for asthma, COPD or another condition, make sure it is current and easy to find.
Households should also decide in advance who can help with shopping, transport or collecting medicines if the main carer becomes ill. This is particularly important where one person provides most of the day-to-day support for an older or disabled relative.
Good respiratory hygiene remains useful even when national activity is low. Ventilation, handwashing, covering coughs and sneezes, and avoiding close contact with vulnerable people while acutely unwell can all reduce transmission risk. These measures are simple, but they are more effective when used consistently rather than only after several people in the household are already ill.
When headlines sound more alarming than the data
Respiratory-virus stories are often reduced to dramatic labels. UKHSA’s surveillance categories provide a more grounded way to interpret what is happening. In the latest report, influenza was increasing but still at baseline level, COVID-19 was increasing but remained at a low level, and RSV remained at baseline. Those labels matter because they describe current burden, not just direction.
That does not make increases irrelevant. It means readers can respond proportionately: stay informed, use vaccination and prevention advice where relevant, and know when to seek help without assuming that every rise in positivity represents an emergency.
What carers can document if someone becomes unwell
When a vulnerable person develops respiratory symptoms, a short written record can make a clinical conversation more useful. Note when symptoms began, temperature if measured, whether breathing has changed, food and fluid intake, alertness, mobility and any missed medicines. For someone with a long-term condition, record whether their usual symptoms are also worsening.
The purpose is not to diagnose the infection yourself. It is to give the clinician a clearer picture of change over time. That can be especially helpful if several family members or services are involved in the person’s care.
This article provides general health information and does not replace individual medical advice. Surveillance figures can change as data are updated.
