About this release

This weekly release by Public Health Scotland presents epidemiological information on respiratory infection activity, including COVID-19, across Scotland.

As part of our continuous review of reporting, over the comings months Public Health Scotland will be implementing some changes to present a consolidated weekly respiratory publication.

Main points

Weekly respiratory main points

  • The proportion of NHS24 calls for respiratory symptoms increased from Low to Moderate activity level overall.
  • Influenza incidence remained at Moderate activity level overall.
  • There were 423 influenza cases: 364 type A (subtype unknown), 16 A(H1N1)pdm09, 35 A(H3) and eight type B.
  • Seasonal coronavirus (non-SARS-CoV-2) and Mycoplasma pneumoniae remained at Baseline activity level. Rhinovirus and parainfluenza decreased from Low to Baseline activity level.
  • HMPV remained at Low activity level. Adenovirus decreased from Moderate to Low activity level.
  • RSV remained at Moderate activity level. The number of laboratory-confirmed RSV cases was 262. This compares with 270 laboratory-confirmed cases in week 47.
    • RSV by NHS Board: one was at Baseline, seven were at Low, four were at Moderate, one (NHS Borders) was at High and one (NHS Shetland) was at Extraordinary activity level.
    • RSV by age group: the under 1 and 1-4 age groups remained at Low activity level. The 5-14 age group decreased from High to Low activity level. The 45-64, 65-74 and over 75 age groups remained at Moderate activity level. The 15-44 age group decreased from High to Moderate activity level.
    • The majority (50.4%) of RSV detections in week 48 were in those aged under 5 years, followed by those aged 75 and over (17.9%). In recent weeks, there have been increases in the incidence rate among the age groups over 5 years.
  • The hospitalisation rate for influenza has been generally increasing since week 25 and was 3.3 per 100,000 in week 47, with the highest hospital admission rate for confirmed influenza noted in patients aged less than one year old (24.7 per 100,000). The number of hospitalised patients who tested positive for influenza reported so far this season is higher than the previous seasons (since 2017), with the total for week 47 higher than the week 47 of the previous five seasons (from 2017 to present).
  • The hospitalisation rate for RSV was 2.5 per 100,000 in week 47, with the highest hospital admission rate for confirmed RSV noted in patients aged less than one year old (92.5 per 100,000). The hospitalisation rate for RSV peaked in week 38 and 39 in 2021 (4.5 per 100,000).
  • In the Community Acute Respiratory Infection (CARI) sentinel surveillance system, carried out at general practices across Scotland, rhinovirus has been the highest circulating pathogen since the start of the season and has the highest swab positivity in week 48, followed by RSV in many of the weeks, and influenza A since week 40. Adenovirus has also increased from previous week.
  • Influenza vaccine data for the 2022/23 winter programme are now available on the PHS flu and COVID winter vaccination dashboard. These data indicate that at the end of week 48, an estimated total of 2,337,193 individuals have received their vaccine. This includes 1,830,350 eligible adults of whom 952,663 are aged 65 years and over. In addition, 90.8% of those receiving their COVID winter booster and eligible for flu vaccine have received both vaccines at the same appointment.
  • All-cause excess mortality increased to Low activity level overall, and in all age categories, apart from the 5-14 age group, which remained at Baseline activity level.

COVID weekly main points

  • In Scotland, in the week ending 21 November 2022, the estimated number of people testing positive for COVID-19 was 91,100 (95% credible interval: 74,000 to 110,100), equating to 1.73% of the population, or around 1 in 60 people (Source: Coronavirus (COVID-19) Infection Survey, UK - Office for National Statistics)
  • In the week ending 27 November 2022, there were 40 deaths involving COVID-19 (the same as the previous week) (Source: National Records of Scotland)
  • In the week ending 04 December 2022, there were on average 622 patients in hospital with COVID-19, a 9.1% increase from the previous week ending 27 November 2022 (570)
  • In the week ending 04 December 2022 there were 7 new admissions to Intensive Care Units (ICUs) with a laboratory confirmed test of COVID-19, a decrease of 4 from the previous week (27 November 2022)
  • By week ending 04 December 2022 of the 1,878,002 people vaccinated for COVID-19 as part of the Winter 2022 vaccination programme, 90.8% were vaccinated for Flu at the same vaccination appointment


Weekly national respiratory report:

Surveillance of respiratory infection is a key public health activity as it is associated with significant morbidity and mortality during the winter months and particularly in those at risk of complications of influenza, e.g., the elderly, those with chronic health problems and pregnant women.

The spectrum of respiratory illnesses varies from asymptomatic illness to mild/moderate symptoms to severe complications including death. There is no single respiratory surveillance component that can describe the onset, severity and impact of influenza or the success of its control measures each season across a community.

This requires several complementary surveillance components which are either specific to respiratory infections or their control, or which are derived from data streams providing information of utility for other PHS specialities (corporate surveillance data). Together, the respiratory surveillance components provide a comprehensive and coherent picture on a timely basis throughout the winter respiratory season. influenza page on the HPS website (external website) for more details.

COVID-19 weekly statistical report:

Since the start of the outbreak, Public Health Scotland (PHS) has been monitoring a number of key indicators to assess the impact of the virus, including demands on the health system.

This report summarises the current COVID-19 data in Scotland, presenting statistics on estimated infection levels from the ONS COVID Infection Survey, wastewater infection levels, reproduction (R) number, reported COVID-19 cases, COVID-19 hospital and ICU admissions and Flu and COVID-19 Winter 2022 Vaccination Programme uptake.

Further information

The next release of this publication will be 14 December 2022

General enquiries

If you have an enquiry relating to this publication, please contact phs.flu@phs.scot.

Media enquiries

If you have a media enquiry relating to this publication, please contact the Communications and Engagement team.

Requesting other formats and reporting issues

If you require publications or documents in other formats, please email phs.otherformats@phs.scot.

To report any issues with a publication, please email phs.generalpublications@phs.scot.

Older versions of this publication

Versions of this publication released before 16 March 2020 may be found on the Data and Intelligence, Health Protection Scotland or Improving Health websites.

Last updated: 06 December 2022
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