Professor John Robertson OBA
From Viral respiratory diseases in Scotland surveillance report, published on 20 November 2025 (Latest release):
Whilst influenza activity in Scotland remains at low level overall in week 46, an increasing trend continues. This is progressively seen across all age groups, having more affected the 5-14 age group in earlier weeks. Increases in laboratory confirmed cases, from 446 to 528, and test positivity, from 9.6% to 11%, are relatively moderate in week 46 compared to week 45. Test positivity for influenza A in CARI surveillance remained stable between weeks 46 (24.2%) and 45 (24.8%) although increased in adult age groups. Hospital admissions for influenza increased slightly to 240 from 231. Genetic characterisation of samples continues to show the novel drifted strain H3N2 (subclade K) predominates.
Given the many media stories about this predicting an extremely bad flu season, what might explain the above moderate development in Scotland?
Scotland’s flu season starts early but with TWICE as many jags done, 30% more beds and 71% more nurses, SNP better prepared
in Scotland in the past week, up 72%. The number of patients admitted to hospital has almost doubled too according to Public Health Scotland data, Experts have been warning of an early flu seasonwith a new variant that spreads more easily and may be more severe.
Professor John Robertson OBA
BBC Reporting Scotland last week had the above, missing key facts on vaccine uptake and the resilience of NHS Scotland. Here they are:
Scottish Government significantly widened access to free flu vaccine to give more than twice as many, per capita, protection from worrying new mutation
First, availability in England – you can get the free NHS flu vaccine if you:
- are aged 65 or over (including those who will be 65 by 31 March 2026)
- have certain long-term health conditions
- are pregnant
- live in a care home
- are the main carer for an older or disabled person, or receive a carer’s allowance
- live with someone who has a weakened immune system
Source: https://www.nhs.uk/vaccinations/flu-vaccine/
In Scotland, significantly wider free availability is in place
This includes:
- those aged 65 and over (on or before 31 March 2025)
- those aged 18 to 64 with an eligible health condition (as defined in the chapter 19 of the Green Book)
- those who are pregnant
- those living in a long-stay residential care home or other long-stay care facility
- those living with someone who has a weakened immune system
- an unpaid or young carer
- a frontline health or social care worker
- a non-frontline NHS worker
- a poultry worker or bird handler
- an asylum seeker living in a Home Office hotel or B&B accommodation
- those experiencing homelessness
- those experiencing substance misuse
- those living in a Scottish prison
Second, uptake-levels in key groups are already significantly lower in key >65 group in England.
For 2024-2025, early trends show Scotland with stronger uptake among over-65s (71.6% vs. England’s ~60-65% estimated based on historical patterns) – multiple sources at: https://x.com/i/grok?conversation=1987603360061788291
Perhaps most indicative of the risk is the number of doses given and the contrast is shocking.
NHS Scotland has given 927 000 doses so far (down 20% on last year’s total): https://www.publichealthscotland.scot/publications/viral-respiratory-diseases-in-scotland-surveillance-report/viral-respiratory-diseases-in-scotland-surveillance-report-6-november-2025/
All things being equal, we might expect the figure in England to be around 9.27 million but it was only 4.3million: https://www.gov.uk/government/statistics/national-flu-and-covid-19-surveillance-reports-2025-to-2026-season/national-flu-and-covid-19-surveillance-report-6-november-2025-week-45
So, less than half the Scottish uptake per capita, in England, reflecting the wider free availability, above.
Has any journalist in Scotland noticed this?
NHS Scotland nearly 30% more beds, per head, than NHS England, to cope better with future pandemics
From Acute hospital activity and NHS beds information (annual) Year ending 31 March 2025 published today:
In 2024/25, the average number of available staffed beds per day for acute specialties was 13,717 – a 0.3% decrease on the previous year (2023/24) and a 3.7% increase compared to five years ago (2019/20).
From NHS England’s Bed Availability and Occupancy Data (KH03 collection) for Quarter 4 2024/25 (January to March 2025), published on the NHS England statistics website:
106,068 is the total number of available general and acute beds (overnight) in NHS England for Quarter 4 of 2024/25 (January to March 2025), the most recent full quarter as of September 30, 2025.
All things being equal, per head, pro rata, NHS England might be expected to have around 10 times as many beds as NHS Scotland, 137 000, but had only 106 000, 31 000 fewer.
This NHS Scotland has, per head, 29.2% more beds than NHS England.
Might that have played a part in Scotland having a far lower Covid 19 pandemic death rate?
When adjusted for population (deaths per 100,000 people), the rates were closer: England (260 per 100,000), Wales (260), Scotland (190), and Northern Ireland (170). England and Wales had the highest rates overall. https://en.wikipedia.org/wiki/Statistics_of_the_COVID-19_pandemic_in_the_United_Kingdom
Scotland has 71% more nurses
In England there were nearly seven nurses per 1,000 people, while there were nearly 12 per 1,000 in Scotland. https://www.dailyrecord.co.uk/news/politics/uk-fewer-nurses-per-head-33961132
OMG if the Daily Record doesn’t attempt to hide that, it must be true!
So, 5 more than 7 per 1 000 people, is 71.4%
Talking-up Scotland 'Albatraz' 
Dame Jaikie of Baillie said, “These bastardin Jocks cannae even get a proper flu epidemic gaun so that the Labour Party can blame thae EssEmPee.”
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