Early Flu Surge Prompts Mask Mandates In UK Hospitals

Hospitals across England are ramping up precautions as the country faces an unusually early and severe flu season, prompting renewed debate over mask guidance and public health messaging. On December 10, 2025, staff, patients, and visitors at Royal United Hospital Bath, Cheltenham General, Gloucestershire Royal, and several hospitals in Wiltshire were asked to don face masks in various departments, including accident and emergency (A&E), due to a surge in flu and other respiratory illnesses in the community, according to reporting by BBC.

This move comes as the number of flu patients admitted to hospitals in England has hit a record high for this point in the year. In fact, flu cases are currently 50% higher than they were at the same time in 2024, a striking jump that has caught both medical staff and the public off guard. While the flu season typically begins in late December or early January, this year’s spike arrived weeks ahead of schedule.

Virologist Dr Chris Smith explained to BBC that several factors are fueling the early rise: “While the numbers we’re seeing are higher for this time of year they are not high for a normal flu season. It does happen but most of the time it happens in late-December or early-January. But this year we have got the season starting a bit earlier.” He pointed to the cold snap and the presence of a different flu strain compared to last season as key contributors. “We’ve got more people that are more vulnerable and a colder snap kicking in has made it take off a bit faster,” Dr Smith added.

Hospitals aren’t leaving anything to chance. Masks are now being provided at entrances, and only those able to wear them are required to do so. Dr Smith and hospital administrators are also urging anyone exhibiting signs of illness to stay home rather than visit loved ones in hospital, in a bid to protect vulnerable patients and staff.

But as hospitals tighten their protocols, the conversation around mask-wearing in public spaces has become muddled, with differing advice from health officials and NHS leaders. Daniel Elkeles, chief executive of NHS Providers—a trade body representing England’s 204 health trusts—sparked controversy on December 10 by stating that people with flu symptoms "must wear a mask when you’re in public spaces, including on public transport," even if they are not unwell enough to miss work. His comments, widely reported by The Guardian, were intended to help curb the virus’s spread, but they quickly drew criticism from health experts concerned about public confusion.

Simon Williams, a behavioural scientist and public health researcher at Swansea University, told The Guardian, “One thing we learned from Covid is how important it is that messages from health authorities and governments are clear and aligned. When people receive conflicting, unclear or mixed messages about health advice, such as when to wear masks, this can be confusing for people and can undermine the messages.” Williams warned that such confusion could lead to “alert fatigue,” causing the public to tune out health advisories altogether.

Williams was not alone in his concerns. Paul Hunter, professor of medicine at the University of East Anglia, echoed the sentiment: “In public health … one of the biggest problems with miscommunication is if experts disagree. So if you’ve got people arguing different things, that undermines the message, whatever it is.” Hunter added, “If people who are allegedly representing the consensus view, or are perceived by others to be part of that official view, then giving advice which conflicts actually undermines the advice full stop. It always causes confusion. It’s not just me saying that – there’s research to support that going back decades.”

Hunter also cautioned that inconsistent messaging about masks could spill over into other areas of public health, particularly vaccine uptake. “It undermines not only that advice [on flu and masks] but more general advice. You know … ‘If the experts can’t agree about whether or not we have to wear masks, what about their advice on vaccines?’” he said.

The official stance from the UK Health Security Agency (UKHSA) is more measured. Last week, Dr Jamie Lopez Bernal, a consultant epidemiologist at UKHSA, advised that people with flu-like symptoms who need to go out should “consider wearing a face mask.” The distinction between “must” and “consider” is more than semantic, say experts—it’s about clarity and public trust.

Government officials have also weighed in, emphasizing that mask-wearing remains a personal choice rather than a directive. On December 10, a spokesperson for No 10 said there are “different measures people can consider taking to help limit the spread of winter bugs if they have flu-like symptoms.” The spokesperson clarified, “That was neither new nor an instruction, but simply something people can consider when trying to limit the spread of winter respiratory illnesses.”

Other NHS and health organizations have distanced themselves from Elkeles’s more forceful language. Rory Deighton, director of acute care at the NHS Confederation—which is set to merge with NHS Providers next year—pointed back to UKHSA guidance, saying, “There are a range of sensible measures that people can take to help to reduce the spread of flu, including getting vaccinated if they are eligible and either staying at home if they feel unwell or wearing a mask if they have to go outdoors.”

Prof Mumtaz Patel, president of the Royal College of Physicians, declined to comment on masks directly, instead urging everyone, including NHS staff, to get vaccinated against flu. The message from hospital administrators is clear: vaccination, staying home when sick, and mask-wearing in high-risk settings are all important tools in the fight against this year’s aggressive flu season.

Meanwhile, more hospitals are introducing mask mandates on certain wards, such as A&E, intensive care units, oncology, and renal dialysis, where the risk is highest. “As rates of flu continue to rise, we expect this to continue,” Deighton told The Guardian.

For now, the country finds itself navigating not only a challenging flu season but also a delicate balance between individual responsibility and collective action. The debate over mask guidance underscores a larger truth: clear, unified messaging is crucial for maintaining public trust and compliance in times of health crisis. As winter deepens and hospitals brace for further admissions, the hope is that sensible precautions—grounded in science and communicated with clarity—will help keep communities safe and the NHS resilient.