Save yourself from the quad-demic: It can be a highly contagious death sentence. Now doctors give their ultimate guide – from how to get help if your A&E is overrun to the jabs that really will help

We are bang in the middle of a raging storm as four viral infections – dubbed a ‘quad-demic’ – sweep the UK.

The warnings began in October. Now health services are under serious strain as millions battle flu, norovirus, respiratory syncytial virus (RSV) and Covid-19. It triggered more than a dozen NHS hospitals to declare critical incidents last week, which saw them scale back non-urgent services and implement Covid-era measures such as facemasks and visiting bans – with some 50-hour waiting times in A&E.

Social media is awash with people floored by illness and desperate for advice. And there are warnings that the worst is yet to come, as cases typically peak in February or March.

Despite this, experts speaking to The Mail on Sunday say there is a lot that can be done to avoid infection. And if you do pick up a bug, simple steps can be taken to treat yourself and avoid passing it on.

Read on to find out how to survive the winter outbreaks without resorting to locking yourself indoors until spring…

Flu: fevers, chills, fatigue… or a highly contagious death sentence

Flu may be familiar but it shouldn’t be taken lightly – roughly 15,000 people die from it every year. The virus, which causes fevers, chills, fatigue, coughing and body aches, infects millions every year. It is also responsible for about 800,000 GP visits annually.

This winter is bad mainly due to natural fluctuations in how contagious the circulating strains are.

In 2022, thousands died every day at the peak of this outbreak. Could this year exceed that?

It remains to be seen, but there was a daily average of 5,407 flu patients in hospital last week, including 256 in critical care – three-and-a-half times higher than the same week last year.

Q: Everyone seems to be really ill – it’s worrying. Is flu somehow worse this year?

A: There is nothing inherently worse about this year’s flu strains. A lower vaccine uptake, particularly in healthcare workers and over-65s, is part of the problem. The very young, the elderly and those with weakened immune systems are most at risk of severe illness, but even healthy younger adults can struggle with flu symptoms.

Q: How do I know if I am suffering with flu or just a bad cold?

A: A runny nose is not likely to be down to flu, but sore throats and a dry cough can be. The main difference is severe fatigue and body aches.

Doncaster-based GP Dr Dean Eggitt says: ‘Flu can feel awful, but most people who get it don’t need to see a doctor. Symptoms of flu normally worsen over a couple of days and you’ll feel better after a week. We advise patients to rest, stay warm and take paracetamol, which helps lower a fever and with the body pain. But if you have persistent symptoms for ten days you need to see your GP.’

Those at-risk – children, people with long-term health conditions and over 65s – should call 111 or their GP if they show symptoms. Those with sudden chest pain, trouble breathing or coughing up blood should call 999 as these could be signs of pneumonia.

Q: I did not get the flu jab this winter, but with rising cases I am worried. Am I too late?

A: The NHS has shut down its online booking system for the flu vaccine but that doesn’t mean you can’t get one. Pharmacies and GPs offer the jab – free of charge – to the over 65s, children and people with underlying health conditions until the end of March.

Patients can contact their pharmacist or GP and request the vaccine, but those not eligible on the NHS can get it privately. Most pharmacists charge £20.

‘Cases could continue to rise over the next couple of months, and if you are in an at-risk group a vaccination could be a life-saver,’ says Professor Paul Hunter, an infectious diseases expert at the University of East Anglia.

Q: I feel like almost everyone I meet says they’ve had or still have the flu. How can I avoid it?

A: Flu is highly contagious and can be spread from around a day before symptoms start to show until about five or seven days after becoming sick.

It is spread via moisture droplets in breath, coughs and sneezes which can live for about 24 hours on a surface. Anyone touching those surfaces can catch and transmit the infection.

As well as vaccines, hand hygiene is key. Wash hands regularly – particularly after touching surfaces in public places – for 15 to 20 seconds with soap. ‘You can’t eliminate the risk but you can minimise it,’ says Prof Hunter. ‘Anyone showing symptoms should stay home for at least three days.’

Norovirus: tummy bug that kills thousands

Britain has been battling a norovirus outbreak since May that’s been caused by a ‘super strain’ dubbed the Kawasaki variant, after the Japanese city where it was first found).

Also known as GII.17, the tummy bug is one of more than 30 norovirus strains that infect humans, causing violent diarrhoea and vomiting. But it is spreading quickly as it hasn’t been in the UK much in recent years, meaning no one is immune to it.

Hospital cases are double their normal figures, according to the UK Health Security Agency.

Q: I caught norovirus last year – am I now immune?

A: No. There are five main strains of norovirus in the UK. If you catch a different one, you will get sick. Immunity to norovirus is not life-long – studies suggest that it lasts anywhere from six months to eight years, so you can catch the same strain multiple times.

There is also no vaccine against norovirus, but that could soon change – an NHS-led trial is under way with hopes that one could be available by 2026.

Q: Why does norovirus spread so easily and what can I do to protect myself?

A: Norovirus infects the digestive tract and mainly spreads when people with the virus go to the loo, get small amounts of faecal matter on their hands and don’t wash it off.

Norovirus microbes can linger for days on any surfaces they then touch, or even up to a month on fabric if not thoroughly cleaned.

Norovirus can be detected in stool samples for up to eight week after the initial infection, meaning someone could be infectious for quite some time.

The best way to limit the spread is for everyone to regularly wash their hands – particularly after using the loo or public transport. Norovirus is resistant to alcohol, so hand sanitiser won’t get rid of it, but water breaks down the virus’s protective outer shell, so wash with soap and water.

Professor Mark Fielder, virus expert at Kingston University, says: ‘A good clean of all the surfaces in your house during and for the weeks after someone in your house has been infected is critical.

‘I recommend a bleach-based product to further reduce the risk of infection.’

Q: A friend got it so badly they ended up in hospital. How do I know if it’s really serious?

A: While symptoms usually clear up after a few days, norovirus hospitalises about 12,000 people each year – often due to severe dehydration caused by lost bodily fluids from sickness and diarrhoea – and around 80 deaths.

If vomiting lasts for more than two days, or diarrhoea for more than seven, seek advice from NHS 111. Call 999 if vomit looks bloody, green or like ground coffee – it’s a sign of internal bleeding.

Prof Hunter says: ‘Watch out for light-headedness, as this can be a sign of dehydration.’

Covid: still here but not like the bad old days

Nearly five years have passed since the Covid pandemic started, but some who catch it are still falling severely ill and even dying. The UK no longer runs a Covid testing programme, making it difficult for officials to know the exact number of cases, but the data available shows that it spiked in October, largely due to a new variant.

The number of infections seems to be falling, but hospitalisations and deaths linked to Covid are still on the rise.

Q: But I thought Covid wasn’t a concern any more?

A: For the majority, Covid is nothing to worry about. Most adults have had at least three vaccines against the virus – some older people have had eight.

But vaccines don’t stop it from spreading. Last summer, a highly contagious variant, XEC, took off across the UK and was responsible for October’s rise in cases.

Since most people are well-protected, this rise in infections has only translated to a comparatively small increase in hospitalisations and deaths. Nonetheless, last week just over 1,000 patients were admitted to hospital with Covid, and 100 died as a result.

‘Covid is always going to be a concern,’ says Dr Cheryl Walter, a virus expert at the University of Hull. ‘However, the variant currently in the community is a milder disease than some of those we have previously experienced.’

Q: Who is falling sick if everyone is well-protected?

A: Most of those who develop severe Covid symptoms are likely to be very elderly.

As people age the body tends to have a weaker response to vaccines, meaning fewer defensive antibodies are produced. The immunocompromised – people with weakened immune systems – are also more at risk of severe Covid symptoms.

The relatively low take-up of the most recent Covid booster could be to blame for some hospitalisations and deaths.

The NHS began offering a booster in October. Over-65s, care home residents, the immunocompromised and frontline NHS workers were all given the chance to get jabbed. However, less than 60 per cent of them took up the offer.

Your GP could still organise a jab, if you want one.

Q: Should I start testing again? And what about wearing a face mask?

A: Both became part of life during the pandemic, but experts say it is not time for them to return.

With multiple viruses circulating, it is better to simply limit social contact when ill.

Masks reduce the spread of respiratory viruses by trapping droplets when coughing, sneezing or talking, but they are not going to stop you catching something in the first place.

And they won’t curb the spread of Covid unless used by everyone.

‘What is more useful than testing or mask wearing is if you can stay home when ill, no matter what virus you have,’ says Dr Walter.

RSV: Under the radar but targets its victims

For most healthy adults, respiratory syncytial virus, or RSV, is just a bad cold. But it can be life-threatening for young children and the elderly.

The virus hospitalises about 30,000 children and 18,000 adults every year and causes thousands of deaths in older people.

Official figures last week showed nearly one in ten children under five were infected with RSV.

Q: I’ve never heard of RSV. Is it a new virus like Covid?

A: No, but until recently there has been no effective way to protect against RSV, meaning it was not often discussed.

The virus is usually spread via coughs and sneezes, close contact with an infected person or contaminated surfaces.

The symptoms are similar to a cold: a runny nose, cough or fever. For this reason, most people with RSV don’t realise they have it. But for young children and older adults it can lead to breathing difficulties and even deadly pneumonia lung infections.

There are also no drug treatments for severe symptoms. Patients are usually given oxygen and IV fluids to fight dehydration.

But the UK became one of the first countries to begin offering an RSV vaccine in September. Research suggests it is about 80 per cent effective at preventing infection or severe symptoms.

Q: How do I know if I am eligible for the RSV vaccine?

A: It’s being offered to a limited number of NHS patients – pregnant women and those aged 75 to 79.

Eligible patients should have been invited by their GP to get the vaccine in September – just over half of those invited have taken the offer, according to figures.

Those who didn’t take the offer can request one from their GP or pharmacist.

There is some confusion over the fact that the vaccine is not being offered to those over 80 despite them being at-risk of severe RSV symptoms. This is partly due to uncertainty that the vaccine provides long-lasting protection in this older cohort.

‘It is important that if you are pregnant or aged 75 to 79 that you get the vaccine, as it is the best way of reducing your risk,’ says Imperial College London vaccine expert Professor John Tregoning.

Q: Is there anything I can do to stop myself catching RSV?

A: Careful hand-washing can reduce the risk of infection.

Because cases among children under five are high, spending time with them increases the chance of catching RSV.

Dr Walter says: ‘You don’t need to avoid seeing family, but if anyone is showing symptoms then you might want to steer clear for a few days, just for now.’

Experts say not to panic about that mystery Chinese virus 

A virus outbreak in China has left many worried the UK could be hit by another pandemic – but experts suggest it is nothing to worry about.

Alarming videos on social media appear to show hospitals overrun with patients in face masks, and the lack of official comment over what is causing it have drawn similarities to the early days of Covid.

Local news reports (pictured below) suggested a virus called human metapneumovirus (HMPV) is to blame. It has symptoms that are similar to a common cold – coughing, blocked or runny nose, sore throat and slight fever – which typically clear up in about five days.

The virus particles are spread via coughs and sneezes, and in some cases it may cause nausea and vomiting. Crucially, HMPV is not a new virus – as Covid was – and it already regularly circulates in the UK, although it is unclear whether the variant that is said to be spreading in China is more virulent.

Very few people are tested for HMPV, but Government data suggests about one in 20 cases of respiratory disease in the UK are linked to it.

‘HMPV is a virus we see every winter – this year is no different,’ says Professor Paul Hunter a virus expert at the University of East Anglia.

‘It is often milder than flu and is not something people need to worry about. If you catch it, rest and hydration are the best treatments.’