Scotland’s hospitals and schools are facing an early winter storm of illness, as flu cases have soared by a staggering 45% in just a single week, according to official data from Public Health Scotland (PHS). The sudden surge, documented in the week ending November 23, 2025, has left health professionals, educators, and families scrambling to cope with the fallout. The number of laboratory-confirmed flu cases jumped from 555 to 805, pushing the infection rate to 14.5 per 100,000 people—up from 10 per 100,000 the previous week.
The impact has been felt across all age groups and regions. Hospital admissions due to flu climbed from 279 to 391 in the same period, with test positivity rates increasing from 11.0% to 15.8%. Dr. Victoria Shotton, a Glasgow-based GP, told BBC Scotland News, “We are seeing a massive increase in presentations on a daily basis. It has started early this year and is more severe than last year.” She noted that her surgery in Glasgow’s east end is seeing three times as many flu patients compared to last year.
Schools have not been spared. South Ayrshire and East Lothian councils both reported significant increases in pupil absences, with East Lothian seeing an 8.1% sickness absence rate among students—up from 5.3% in the same week last year. Staff absences, too, have climbed in some areas, adding to the pressure on already stretched systems. Falkirk and Midlothian councils reported higher staff absence rates, though pupil absences remained broadly similar to last year in those regions.
Hospitals across the country are feeling the strain. NHS Dumfries and Galloway, which recorded the highest incidence rate at 24 cases per 100,000 people, has had to close some wards to new admissions and reintroduce visitor restrictions and mask mandates. Dr. Kenneth Donaldson, medical director for NHS Dumfries and Galloway, sounded the alarm: “These illnesses are circulating widely in the community and are now having a major impact on services.” He urged, “Even mild symptoms can easily pass to others and have serious consequences for vulnerable patients.”
NHS Greater Glasgow and Clyde, the country’s largest health board, reported 272 cases in the week ending November 23, an 18% jump from the previous week. The infection rate there hit 22.3 per 100,000 people. The board has been sending out texts and letters to patients and parents, urging those with mild or moderate symptoms to stay home and avoid A&E. In the words of a health board spokesperson, “Visiting GP practices, A&E, or hospital wards with mild or moderate flu symptoms risks spreading the virus to vulnerable patients who may already be admitted or awaiting care. This can lead to further outbreaks and increased strain on services.”
Across NHS Grampian, Western Isles, Lanarkshire, and Ayrshire and Arran, similar stories have emerged: increased hospital occupancy, higher rates of flu, and more respiratory symptoms across all age groups. Some hospitals, like those in NHS Highland, have managed to avoid ward closures despite a slight rise in cases, but the overall picture is one of mounting pressure and concern.
The situation is complicated by the emergence of a new flu mutation, which has made this year’s vaccine less effective than hoped. Dr. Shotton explained, “Unfortunately it looks like this year’s jab isn’t offering the same protection as last year. Through no fault of anyone involved, it isn’t quite covering the main strain that’s going around. However, that doesn’t mean that it’s not worth getting because it will still offer some protection and prevent the flu from getting so serious that you need to go to hospital.”
Data from the UK Health Security Agency (UKHSA) offers some reassurance: the flu vaccine is still preventing severe disease, with children who are vaccinated around 70-75% less likely to be hospitalized and adults 30-40% less likely. The agency notes that vaccine effectiveness against severe disease typically ranges from 30% to 60%, with higher rates seen in younger age groups.
Yet, the challenges are not only medical. During two weeks in November, there were 13 deaths linked to flu, with five listing it as the main cause—four among those aged 75 and over, and one under 44. As these numbers rise, so too do concerns about the resilience of the National Health Service. Nursing staff are stretched thin, with Eileen McKenna of the Royal College of Nursing warning, “Hospital overcrowding is not just an inconvenience—it puts patient safety and dignity at serious risk. Flu outbreaks make an already challenging situation even worse.”
Political leaders have not been silent. Health Secretary Neil Gray has urged everyone entitled to a flu jab to get immunized, stating, “Do everything you possibly can to make sure you are getting the immunisation you are entitled to because that is the best way that we protect ourselves from flu.” However, critics from across the political spectrum have accused the government of being slow to respond. Scottish Conservative shadow health secretary Dr. Sandesh Gulhane, himself a GP, said, “The SNP health secretary has completely failed to support frontline services for the months ahead and his winter plan isn’t worth the paper it is written on. Unless Neil Gray gets a grip then patients’ lives will be put at risk from the effects of flu and our health service will collapse this winter.”
Scottish Labour’s health spokesman Jackie Baillie pointed out that there are “400,000 fewer adults vaccinated now than there were this time two years ago, while children’s vaccination rates are down and some areas have not even started vaccinations yet.” She called the latest statistics “a stark reminder of the need to get our health service back to where it needs to be, and the importance of having a truly substantive plan for recovery in place.” Alex Cole-Hamilton, Scottish Liberal Democrat leader, echoed the call for greater investment in preventative healthcare, warning that the “worrying spike” in cases risks “intensifying the winter pressures on our NHS.”
Amid the political wrangling, frontline medical professionals are urging the public to take common-sense precautions. Dr. Chris Provan, Chairman of the Royal College of GPs in Scotland, observed, “In my own practice, there has been a marked increase in patients presenting with respiratory symptoms, which reflects the national data.” He emphasized that while many will recover with rest, fluids, and over-the-counter remedies, certain groups—older people, babies, young children, pregnant women, and those with chronic conditions—face a much higher risk of complications.
For those wondering about when to seek medical help, Dr. Shotton advised, “If you are struggling to breathe or getting severe pain in your chest or suffering from vomiting and diarrhoea, those are the three big areas that suggest you need further support.” She reminded the public that everyone eligible for the flu jab should have received a notification by now and can book an appointment through NHS Inform.
The symptoms of flu remain familiar but no less daunting: sudden intense fever, breathing difficulties, severe chest pains, body aches, chills, lethargy, sensitive skin, and, for some, vomiting and diarrhoea. As Scotland faces down this early and virulent flu season, the message from health professionals is clear—vaccination, vigilance, and staying home when sick are the best ways to protect both individuals and the wider community.
