Covid infection levels in England remain around the Very High level, although there has been a recent small decline. We continue to recommend taking maximum precautions against catching Covid, as around 1 in every 112 people in England were infected as of 19 October. Please ensure you get your Covid booster immediately if you are eligible or consider a private booster if not. People should also get their flu vaccine if available.
Not Past The Peak
Do not be misled by people suggesting that England has ‘passed the peak’ of the current Covid wave. All three major Covid waves in England in 2024 built in stages, with small declines followed by large increases. Our assessment is that we have not yet reached the peak of the current Covid wave, and we will see further increases in the weeks to come. Please continue to take maximum precautions.
We have decided not to reduce the risk level from Very High to High, despite current infection levels falling into the ‘High’ band. This is because the data we use is often revised upward after first publication, so it is entirely possible that infection levels remain in the Very High band. Also, reducing the risk level in what is most likely only a blip between rising infection levels gives a misleading impression.
Medium vs Very High?
The NHS and UKHSA say that Covid infection levels in England are currently ‘medium’, and many people have asked why we say that they are at Very High levels. The short answer is that the UKHSA infection level descriptions are grossly misleading as a guide to risk, whereas the BuDS risk levels are based entirely on the risk of catching Covid.
The long answer is that UKHSA has adapted an international model designed to help epidemiologists set thresholds based on historical infection levels. The thresholds tell epidemiologists how much the Covid infection level differs from a historical mathematical average. These thresholds are very misleadingly labelled as if they related to absolute levels of Covid in the community – for example, the ‘medium’ threshold means that Covid infection levels are one standard deviation above the mean level of Covid over the whole pandemic. This is technical information relevant only to epidemiologists. For practical purposes, for example whether you are likely to meet a Covid infected person in the supermarket, these thresholds are useless, and worse, grossly misleading.
We feel that UKHSA should not use descriptions for these mathematical bands which have completely different everyday meanings. By doing this, the UK Health Security Agency is helping to minimise Covid and confuse people, rather than help them to understand risk and what to do to keep themselves healthy.
BuDS wants to help people avoid catching Covid. Our risk assessment system looks at the likelihood of meeting a Covid infected person in the community, in your everyday life. When the risk of meeting someone is Very High, we say so. Very High means that more than 1 in 100 people are infected in the community, which means that in a medium sized busy supermarket, there will be 3 infected people to catch Covid from. You can see our other risk levels on our website.
Although this has not been widely publicised, England is currently in the middle of a ‘tripledemic’ of airborne respiratory viruses. Covid, influenza, and the common cold (rhinovirus) are all surging at the same time. This last occurred in the winters of 2022-23 and 2023-24, and on both occasions the NHS was put under extreme strain, with an impact on all health services well into the following summer. Only time will tell whether this will occur in 2026 as well, but it is a real risk. If you are expecting elective treatment or surgery in the first half of 2026, you may find that it is delayed.
Remember, precautions against Covid will also protect you against other respiratory viruses.
Infection Etiquette
If you or someone you have met does have symptoms of Covid (or of a respiratory virus which might be Covid), please do the decent, patriotic, thing and keep it to yourself. Unless you are unable to do so, please isolate until your symptoms have been gone for a couple of days. If you can’t isolate, wear a tight-fitting non-valved PPE respiratory mask (FFP2/FFP3) whenever you are in contact with other people indoors. You can buy these masks at pharmacies or online. They both protect you against viruses in the air and protect others if you are infected. We recommend everyone stocks up on them now.
BuDS recommends that anyone with symptoms of a respiratory virus tests themselves for Covid using lateral flow home test kits (about £2 each from pharmacies or online). If the test is positive, do self-isolate or wear a mask to protect others, even if you don’t feel particularly ill yourself. Do also tell your GP surgery that you have had a positive home test and ask them to note the fact on your medical records (they are obliged to do so under NHS Standard Operating Procedures). Knowing that you had Covid might be very important in the future if you develop a post-Covid condition or ‘Long Covid’. Remember, lateral flow home rest kits are very accurate if showing that you do have Covid, but much less accurate when they show you do not have Covid. If you have symptoms of Covid, but test negative, it is always worth testing again at a later date to be sure.
If you have a condition which makes you extremely clinically vulnerable to Covid, you are entitled to free NHS lateral flow test kits and, if you test positive, you may be eligible for antiviral treatments to help you survive the infection. More information is available on the NHS website.
Risk Analysis
BuDS strongly recommends that everyone takes precautions against catching Covid. These precautions should be taken in all indoor places, unless you are sure that the space is very well ventilated or has HEPA filtration in place. We continue to not recommend Covid precautions outdoors, unless you are in a dense crowd of people.
| Risk | Places | Risk factors | Likely number of infected people on a single visit/journey this week | Risk mitigations (things you can do to protect yourself) |
| High | Buses, trains, taxis, transit systems like the London Underground, hospitals, GP practices, dentists, vaccination clinics, pharmacies, schools, universities and colleges | Used by very large numbers of people, who are not taking precautions. Typically poorly ventilated. Risk on journeys is calculated assuming that people visit several places in one trip, e.g. railway station, train, railway station is assessed as one “journey” | Minimum 9, potentially 45+ | Minimise visits. Wear a PPE respiratory mask (FFP2/3 rated) on every visit. Maximise fresh air ventilation (open windows if possible, etc). |
| Medium-high | Bars and clubs, large supermarkets, indoor shopping centres, large office buildings, most cinemas and theatres. | Used by large numbers of people, who are not taking precautions. Typically poorly ventilated. | Minimum 7, potentially 13+ | Minimise visits. Wear a PPE respiratory mask (FFP2/3 rated) on every visit. Maximise fresh air ventilation (open windows if possible, etc). |
| Medium | Medium-sized restaurants (200 seats or more), smaller supermarkets, smaller offices, individual larger shops | Used by medium numbers of people, who are not taking precautions. Typically poorly ventilated. | Minimum 3, potentially 5+ | Minimise visits. Wear a PPE respiratory mask (FFP2/3 rated) on every visit. Maximise fresh air ventilation (open windows if possible, etc). |
| Lower | Small cafes (around 25 seats), small shops, infrequently used buildings e.g. churches (outside of services), buildings which, at the time of visit, have very few people inside them | Used by small numbers of people, who are not taking precautions. Can be poorly ventilated. | You are statistically unlikely to encounter an infected person on a single visit, although this risk cannot be excluded. After 2 to 5 visits, statistically you are likely to encounter one infected person over all of those visits. Remember, however, especially with rising infection levels, you may well be unlucky and meet a Covid-infected person on your first visit. | Minimise visits. Maximise fresh air ventilation (open windows if possible, etc). The Covid risk is rising. While statistically the risk remains lower, we encourage a cautious approach to taking risks. Not wearing a PPE respiratory mask (FFP2/3 rated) should be exceptional when the risk is clearly lower, for example in a nearly empty building. |
| Low | Outdoors (except when in a dense crowd) | The moving fresh air makes transmission of Covid from one person to another unlikely, except where two people are very close together. | The number of infected people is less relevant because the risk of transmission of Covid from one person to another is unlikely. | Avoid very close contact (under 1m) with potentially infected people. For complete peace of mind, remain 2m from potentially infected people. |
| Covid, flu, norovirus, bird flu and measles are all airborne. An infected person in an unventilated indoor place creates an invisible cloud of virus which hangs in the air like smoke for you to breathe in. The virus cloud can be dispersed and made less harmful, or harmless, using fresh air ventilation – e.g. opening a window or door. Fresh air is the enemy of Covid and the friend of Covid-cautious people. Another way to deal with an indoor cloud of Covid is to use a HEPA filter. These filters suck in the air, remove the viruses, and blow out virus-free clean air. HEPA filters are essential when an indoor space cannot be ventilated with fresh air, e.g. no (or little) opening windows. PPE respiratory masks filter viruses out of the air you personally breathe, if they are fitted and used correctly. PPE masks are the last line of defence against airborne viruses. As we explain in the table above, Covid-cautious people can use one or a combination of these precautions to help make indoor spaces safer for them. | ||||
Covid is not just dangerous for clinically vulnerable people. The virus has been proven to have an adverse health impact on most people who catch Covid. No-one should be relaxed about catching Covid.
More Information
This is BuDS’ 247th Covid risk assessment since the beginning of the pandemic, and we are still the only organisation publishing free risk data for disabled and clinically vulnerable people. We will update you on the situation again next week.
If you’d like to get our weekly Covid risk assessments direct to your email inbox, completely free of charge, you can subscribe here: https://budscovidinfo.substack.com/
To understand more about our Covid risk levels and what they mean, use this link: https://buds.org.uk/covid-19-risk-levels-in-bucks/
For more Covid information and help, or if you’d like to know more about how we calculate risk, please contact BuDS and we will be happy to help.