The NHS in England has warned of a so-called “quad-demic” of disease, but what does it mean?

Here the PA news agency answers questions about additional pressures the NHS is expected to face this winter.

– What does the NHS mean by quad-demic?

The term is a phrase coined by NHS officials to describe the four conditions expected to heap additional pressure on hospitals in the winter months.

It is a play on the word “pandemic” – described by the Dictionary of Epidemiology as an “epidemic occurring over a very wide area, crossing international boundaries, and usually affecting a large number of people” – and quad, meaning four.

These four conditions are: flu; Covid-19; respiratory syncytial virus (RSV) and norovirus.

– Why is flu being singled out?

Last week NHS officials announced that hospitals in England are managing “record flu levels going into winter”.

The latest figures show that since then, the number of people with flu needing hospital care has risen by 70%.

Flu, or influenza, will largely get better on its own but some people do get seriously ill and will need hospital care.

Symptoms include fever; aches; fatigue; a dry cough; a sore throat; headache; diarrhoea and vomiting.

A number of groups are eligible for a free flu jab on the NHS and health officials have urged them to come forward as soon as possible to avoid “festive flu”.

– What is RSV?

RSV is a common respiratory bug that usually causes mild, cold-like symptoms, and most children will have the virus before they are two.

But for a small number of children, it can lead to severe disease, or even death.

In infants, the virus can cause bronchiolitis which leads to the inflammation of the small airways and significant breathing difficulties.

Symptoms include a runny nose, decreased appetite, coughing, sneezing, fever and wheezing.

Each year in the UK the virus circulates in the winter months and typically peaks in December.

The UK started its first RSV vaccination campaign this September.

The vaccine is recommended for women during pregnancy – to help protect their baby after birth – and for adults aged 75 to 79.

– Is Covid-19 still around?

Yes, Covid-19 is still circulating.

The head of the World Health Organisation, Dr Tedros Adhanom Ghebreyesus, said earlier this week: “We cannot talk about Covid in the past tense. It’s still with us, it still causes acute disease and long Covid, and it still kills.”

In the week to December 8, the number of hospital beds in England occupied each day by patients who had tested positive for Covid-19 averaged 1,343, down slightly week-on-week from 1,390.

Because Covid-19 is included in the NHS’s “quad-demic” definition, it looks like health officials expect these numbers to rise.

– Why do people need hospital treatment for norovirus symptoms?

Most people can treat themselves at home if they have a vomiting bug.

But vomiting and diarrhoea causes the body to lose water and salts, which can lead to dehydration.

Elderly people, young children and those with weakened immune systems are at most at risk of becoming dehydrated and needing treatment.

Norovirus can spread very easily, which means it can also spread once it is in a hospital.

– Why does the NHS face winter pressure?

Every year the NHS faces additional pressure going into winter.

Demand for services increases as flu and other bugs spread in the community and the cold weather sets in – which can exacerbate symptoms of pre-existing medical conditions.

Experts have expressed concern that the NHS is running “red hot” right at the start of winter, with some sounding the alarm that this winter could be “one of the worst the NHS has faced”.

Record numbers of hospital beds are occupied as the service heads into winter – leaving little room for the expected rise in the number of people needing to be admitted to hospital.

An average of 96,661 beds were filled each day last week, 94.6% of the total available. This is up very slightly from 96,587 for the previous week, which was also 94.6%.