As the leaves turn and the days grow shorter, the United Kingdom finds itself bracing for a familiar, if unwelcome, seasonal surge: a wave of winter respiratory infections. This year, the challenge is compounded by the emergence of new Covid-19 variants, rising case numbers, and a landscape where the lines between common colds, flu, and other viral bugs are increasingly blurred. The UK Health Security Agency (UKHSA) has sounded the alarm, issuing fresh guidance to help households distinguish among these illnesses and navigate the months ahead with greater confidence.
According to the UKHSA, the urgency is clear. In the seven-day period leading up to September 24, 2025, confirmed coronavirus cases across the UK leapt by 22.2%, with a 5.1% rise in deaths in the same week. Hospitals in England and Wales have responded by reinstating mandatory face masks in certain departments, hoping to curb the spread of infection as the dominant 'Stratus' and 'Nimbus' Covid variants sweep through communities.
But it’s not just Covid that’s making the rounds. Flu cases are also on the rise, with NHS England reporting an increase in positivity rates from 1.9% to 3.3% in the last week before October 9. The NHS has already vaccinated nearly a million more people against flu this autumn compared to last year, reflecting both heightened concern and a robust public health response. As the UKHSA warns, “Flu can cause serious illness, especially in children, older people and those with certain long-term health conditions.”
So how can people tell the difference between these viruses? It’s not always straightforward. The UKHSA has outlined key distinctions, but as anyone who’s tried to self-diagnose in the middle of a sniffle-filled night knows, the symptoms often overlap.
Flu, for instance, strikes quickly and hard. “Symptoms of the flu develop very rapidly and often come with extreme tiredness,” the UKHSA explains. Typical signs include a sudden high temperature, aching body, exhaustion, dry cough, sore throat, headache, difficulty sleeping, loss of appetite, diarrhoea, and vomiting. The agency emphasizes that while a cold might leave you feeling unwell but able to “carry on as normal,” the flu tends to knock people off their feet, making them “too unwell to carry on as normal.”
The common cold, most often caused by rhinovirus, develops more gradually over two to three days. Symptoms include a blocked or runny nose, sneezing, sore throat, hoarse voice, cough, and feeling tired or generally unwell. Children, in particular, may experience longer-lasting symptoms, irritability, difficulty sleeping, and trouble feeding—details that will be all-too-familiar to many parents. The NHS points out that while both colds and flu can cause a sore throat and cough, the flu is more likely to be accompanied by fever and body aches, and its onset is usually much more abrupt.
Then there’s Covid-19, which, thanks to its ever-evolving nature, has become something of a moving target. As of October 2025, nearly 90% of all Covid cases in England are linked to two Omicron subvariants: NB.1.8.1 ('Nimbus') and XFG ('Stratus'). According to virologist Lawrence Young of Warwick University, the Nimbus variant spreads more easily, while Stratus has the ability to dodge antibodies from previous infections or vaccinations. The UKHSA is quick to note that, so far, these new variants do not seem to cause more severe illness than earlier strains—but the risk of hospitalisation and death remains, particularly for vulnerable groups.
Covid symptoms now often mimic those of a cold, but with some notable twists. The UKHSA describes the current symptom profile as “cold-like symptoms,” sometimes accompanied by fever or chills, continuous cough, shortness of breath, tiredness, body aches, headache, sore throat, blocked nose, loss of appetite, nausea, diarrhoea, or changes in sense of taste or smell. Some people have reported a hoarse voice or a particularly painful sore throat, which the media has dubbed “razor-blade throat.” The Stratus variant is especially linked to a hoarse voice, while Nimbus is associated with that severe sore throat sensation. Still, as reported by the Express, some experts caution against using these as definitive diagnostic clues, since other respiratory viruses can present similarly.
Despite the shifting symptom landscape, the UKHSA’s advice remains consistent: stay home if you have symptoms of flu or Covid-19, to protect the most vulnerable. And if you must go out while unwell, wear a mask. Simple measures—catching coughs and sneezes in a tissue, regular handwashing, and opening windows during indoor gatherings—can make a meaningful difference in reducing transmission.
Vaccination continues to be the cornerstone of the UK’s public health strategy. Last year’s flu vaccine, according to the UKHSA, led to “an almost 40 per cent reduction in the number of those aged 65 and over being hospitalised, and a 75 per cent reduction in those aged between two and 17 years.” This autumn, over a million people have already received the Covid-19 vaccine, with appointments and walk-in sessions available at pharmacies, GP practices, and community clinics nationwide. Those eligible for a Covid jab include people aged 75 and over, care home residents, and those who are immunosuppressed. The flu vaccine is offered to everyone aged 65 and over, people with certain medical conditions, immunocompromised individuals, frontline health workers, and pregnant women.
RSV (respiratory syncytial virus) is another major player in the winter illness sweepstakes. The UKHSA says RSV is common between November and February and can cause bronchiolitis in infants, leading to approximately 20,000 hospitalisations annually in children under one. While symptoms are usually mild—cough, wheezing, shortness of breath, tiredness, and fever—RSV can be particularly serious for babies and young children, sometimes making it difficult for them to breathe or feed. RSV can also pose a threat to older adults, causing pneumonia or exacerbating chronic lung diseases.
Other viruses, such as adenovirus, human metapneumovirus (hMPV), and parainfluenza, are also circulating and tend to cause mild, cold-like illnesses. While present year-round, their transmission rates spike during winter, especially in infants, young children, older adults, and those with weakened immune systems.
For those seeking relief, pharmacies and supermarkets offer a range of cough and cold medicines, though, as always, the best remedy is often rest, hydration, and time. The UKHSA underscores that while distinguishing among these viruses can be tricky, recognizing the subtle differences can help people seek appropriate care sooner—and potentially prevent the spread to those at greater risk.
As the country heads into what could be the busiest winter ever for the NHS, public health officials are urging everyone to take the guidance seriously. Whether it’s a runny nose, a fever, or that infamous “razor-blade throat,” a little vigilance—and a lot of community spirit—could make all the difference this season.
