'American Covid' XFG isn't new: England's COVID admissions are rising but below last autumn

Admissions: about four times the summer low, below last autumn

COVID-19 hospital admissions in England averaged 166.9 a day in the seven days to 30 September 2026, according to the UKHSA data dashboard. That is up from 125.0 a day a week earlier and 42.3 a day on 2 September, about four times the early-September level, and the number was still rising on the last day published.

It is also 44% below the same date last year, when admissions averaged 296.7 a day on 30 September 2025. Last year's daily figure went on to peak at 348.9 on 8 October 2025. This daily series comes from the NHS England hospitalisations report and is updated once a month, on the second Thursday, so 30 September is the latest day available. The next update is due on Thursday 12 November.

UKHSA's weekly surveillance report, published on 22 October, gives a more recent measure. In the week of 12 to 18 October, the hospital admission rate for COVID-19 was 2.64 per 100,000 people, which UKHSA describes as an increase on 2.48 the week before. In the same week last year it was 3.43 per 100,000. Admissions to intensive care or high dependency units were 0.05 per 100,000, against 0.10 a year earlier.

Our flu and COVID tracker shows these series week by week, against last year.

Positivity is flat, and it shows direction, not how many are ill

The share of COVID-19 tests coming back positive, as a seven-day average, was 9.11% on 19 October. It has been at about 9% for three weeks, after rising from 3.73% at the end of August. On the same day of the week a year earlier, 20 October 2025, it was 9.17%.

Positivity is the share of tests that are positive among people who were tested. It tells you which way the virus is moving, not how many people are ill. UKHSA's summary for the latest week is that COVID-19 activity 'showed mixed trends and is circulating at low levels'.

The 'American Covid' claim, checked

Some headlines this month describe XFG as a new 'American Covid' strain behind the rise, with a hoarse voice as its sign. XFG is not new. The World Health Organization has listed it as a variant under monitoring since 25 June 2025. In UKHSA's report a year ago, covering samples from 15 to 28 September 2025, XFG and three of its sub-lineages made up 72% of sequenced cases in England.

UKHSA's latest breakdown, for samples from 14 to 27 September 2026, lists XFG itself at 4.2%. That does not mean it has gone. Several of the larger groups on the list, including TA.1 (25.9%) and ST.1 (18.9%), are XFG offshoots under shorter names, according to the international Pango naming system. Together, XFG and its listed descendants are 64% of sequenced cases. UKHSA notes that sequencing numbers are low, so the shares should be treated with caution.

Neither UKHSA's report nor WHO uses the 'American' nickname. The NHS list of COVID-19 symptoms does not include a hoarse voice. It does include a sore throat, a cough, a high temperature, tiredness, aches and a blocked or runny nose, and the NHS says the symptoms are very similar to those of colds and flu.

Flu and RSV

Flu is at what UKHSA calls baseline levels. The weekly flu admission rate was 1.94 per 100,000 in the week to 18 October, up from 1.81 the week before and below 2.25 in the same week last year. Flu test positivity was 6.3% in the seven days to Sunday 18 October, against 6.2% a week earlier.

RSV is also at baseline levels. Its admission rate rose to 0.33 per 100,000 from 0.23, against 0.49 in the same week last year.

Who can get this autumn's COVID vaccine

In England, the NHS says you can get a COVID-19 vaccine this autumn if you are aged 75 or over (including those who will be 75 by 31 January 2027), if you live in a care home for older adults, or if you are aged 6 months to 74 and have a weakened immune system because of a health condition or treatment.

You can book online or in the NHS App, or go to a walk-in site, and you do not need to wait for an invitation. The last date for this round is 31 January 2027. By 18 October, UKHSA says, 33.9% of people aged 75 and over had had an autumn dose.

If you are not sure whether a condition or treatment makes you eligible, the NHS says to ask your local pharmacy, GP surgery or specialist.

Who can get a free flu vaccine

The NHS offers adults a free flu vaccine if they are aged 65 or over (including those who will be 65 by 31 March 2027), aged 18 to 64 with certain long-term health conditions, pregnant, living in a care home, the main carer for an older or disabled person or receiving carer's allowance, living with someone who has a weakened immune system, or aged 16 or over and sleeping rough or staying in a hostel or shelter. Frontline health and social care workers get it through their employer. Children have their own flu vaccine programme.

You can book online, in the NHS App, at a pharmacy that offers it, or through your GP surgery. The last date is 31 March 2027. Uptake among people aged 65 and over was 44.1% by 18 October, behind 49.3% at the same point last season.

For what cold weather means for health at home, see our guide to cold weather health alerts.