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By Cassidy Morrison Senior Health Reporter For Dailymail.Com

Published: 14:36 EDT, 22 September 2023 | Updated: 15:06 EDT, 22 September 2023

NHS waiting lists have soared to another record high, grim data revealed today.

Around 7.68million patients in England — or one in seven people — were in the queue in July for procedures such hip and knee replacements, official figures show. 

This includes almost 390,000 patients who have waited at least one year for treatment, often in pain.

NHS bosses blamed medic strikes for heaping extra pressure onto already struggling hospitals — with 400,000 appointments rescheduled this summer due to walkouts.

Health leaders warned that the service is ‘heading for even more extremely troubled times’ as winter approaches. 

NHS England monthly performance data released today that the waiting list grew by more than 100,000 between June and July. 

The 7.68million toll marks the highest figures logged since NHS records began in August 2007 and a rise of nearly three quarters of a million (742,000) on July 2022. 

For comparison, around 4.4million were stuck in the system when the pandemic reached the UK. 

Rishi Sunak made cutting waiting lists one of his 2023 priorities, pledging in January that ‘lists will fall and people will get the care they need more quickly’.

However, he claimed that strikes across the health service were making the task ‘more challenging’.

And the NHS said today that industrial action had piled pressure on the health service, with around 900,000 appointments cancelled since strikes began in December. 

It said the true impact of walkouts is much higher, as many hospitals avoid scheduling operations for strike dates.

Junior doctors have already staged 19 days of action since March and will undertake four days of joint strike action this autumn with coordinated walkouts in England over separate days next week and into October. 

Radiographers will walk out for 24 hours from 8am on October 3, joining medics on the picket lines. The strike days also coincide with Rishi Sunak’s first Tory party conference as leader and prime minister.

Emergency care – through A&E departments and 999 – is still available but patients have been told to contact NHS 111 or their local pharmacy for minor health worries. 

Professor Julian Redhead, NHS England’s national clinical director for urgent and emergency care, said: ‘Today’s figures show that despite ongoing pressures across the NHS, including record demand for emergency care this summer, and an increase in Covid cases during July and August, NHS staff are continuing to deliver for patients.’

He added: ‘But even as we talk about a summer of record demand we have already been preparing for winter, and the improvements seen in today’s data show the hard work of staff is already paying off.

‘Alongside expanding the use of out-of-hospital care – such as more virtual ward beds – and the rollout of our winter vaccination programme, we are doing all we can to prepare ahead of what has the potential to be another challenging winter with Covid and flu.

‘As ever, the public can also play their part by getting your winter vaccines when invited and use services in the usual way – 999 in an emergency and NHS111 online for other health conditions.’

Miriam Deakin, director of policy and strategy at NHS Providers, said: ‘Challenges including severe staff shortages, capacity constraints – including of beds and equipment – and ongoing strikes are hindering vital progress on performance targets.’

She added: ‘With more strikes on the horizon, including coordinated action between junior doctors and consultants for the first time, even greater disruption looms.’

Summer months usually offer hospitals a break ahead of the usual busy spell, when seasonal pressures like flu and norovirus typically kick in. But NHS England said this summer is ‘on trajectory to be the busiest in NHS history’. 

Separate data for A&E shows that patient care plummeted in August as emergency departments faced their busiest summer yet. 

Just under three-quarters of emergency department attendees (73 per cent) were seen within four hours in August, down from 74 per cent in July. 

NHS standards set out 95 per cent should be admitted, transferred or discharged within the four-hour window.

Meanwhile, 28,859 patients who sought help in emergency departments were forced to wait more than 12 hours, up from 23,934 in July.

There were more than 6.5million attendances in A&Es across June, July and August — 20,000 more than the previous record in 2019. 

Dr Tim Cooksley, president of the Society for Acute Medicine, said the figures show that there is ”a trajectory towards a winter equally as bad as last year’s ‘worst ever’.’

He said: ‘A small wave only is needed to deepen the crisis in urgent and emergency care; well-illustrated by the hot weather last week which caused many hospitals great challenges.’

Dr Cooksley pointed to the case of a 90-year-old Harold Pedley in Blackpool, who died waiting to be seen by a doctor in a chair in an overcrowded emergency unit.

He said: ‘His case not isolated and many more will sadly have similar experiences over the next few months.

‘There is a tacit acceptance and almost normalisation of poor urgent and emergency care heading in to this winter.

‘Corridor care, overcrowded and understaffed emergency departments and acute medical units, ongoing industrial action and a target that only one in four people wait more four hours. 

‘This is an environment perfectly designed to ensure there are more patients like Mr Pedley this winter.’

He warned the NHS was ‘inevitably’ heading for ‘more extremely troubled times’, but said ‘mitigation is possible’.

He added: ‘Resolving industrial action, a stronger commitment to funding the workforce plan and a significant emergency package to support social care are essential – but the window of opportunity to do so is getting increasingly narrow.’

Separate NHS data on ambulance figures for August however show response times improved — but patients were still left waiting too long.

Heart attack and stroke patients in England, known as category two callers, had to wait an average of 31 minutes and 30 seconds for paramedics to arrive, shaving 20 seconds off the previous month. 

However, this is still nearly double the NHS 18-minute target.

Ambulances took an average of eight minutes and 17 seconds to attend the most life-threatening category one calls, such as cardiac arrests. The NHS target stands at seven minutes.

Separate data shows 2.2million tests and checks were delivered in August, contributing to the busiest summer ever for diagnostics — a total 6.6million across June, July and August.

However, NHS figures on cancer waiting times showed that just six in ten cancer patients (62.6 per cent) were seen within the two-month target in July. 

NHS guidelines state 85 per cent of cancer patients should be seen within this time-frame. However, this target has not been met nationally since December 2015. 

Meanwhile, almost a quarter (74.1 per cent) of patients urgently referred for suspected cancer were diagnosed or had cancer ruled out within 28 days, up from 73.5 per cent the previous month. The target is 75 per cent.

The proportion of cancer patients who saw a specialist within two weeks of being referred urgently by their GP fell from 80.5 per cent in June to 77.5 per cent in July, missing the 93 per cent target.

The figure is one of several cancer targets that are being discontinued from October, after the NHS vowed last month to diagnose and treat cancer patients quicker, with  ministers accepting its request to streamline performance targets.

The controversial reforms will see the number of cancer waiting time indicators that hospitals are measured against slashed from ten to three.

Cancer Research UK’s chief executive, Michelle Mitchell, said: ‘Today’s data is yet another snapshot of the challenges facing England’s cancer services and a message to the UK Government that things need to change. 

‘These figures are amongst the worst on record and represent anxious delays faced by patients and the immense pressure on NHS staff.

‘People affected by cancer deserve more. With strong leadership and proper funding, the UK Government has the power to put an end to these unacceptable delays for tests and treatment in England.’

It comes as data published on Tuesday also showed the number of Brits paying for private medical treatment has now hit a record high. 

Around 227,000 people in the UK sought private treatment in the first three months of 2023. 

It marks a four per cent jump on the previous record of 219,000 set in the final quarter of 2022. 

The rise in demand for paid-for care is being driven by continuing growth in insured treatments — 156,000, up from 149,000 in the fourth quarter of 2022 — as more businesses and households turn to private healthcare plans to safeguard the health of employees due to the growing difficulties in getting treatment on the NHS. 

The NHS is ‘not sufficiently resilient’ to look after patients this winter, a top doctor has warned.

Dr Adrian Boyle, Royal College of Emergency Medicine president, fears the health service could face a similar situation to last winter, described as one of the worst on record.

His comments come as Rishi Sunak and Health Secretary Steve Barclay met with health leaders and charities in Downing Street to discuss how to keep the NHS running smoothly.

Doctors expect an influx of Covid cases, flu and other respiratory illnesses over the coming months.

Dr Boyle, who attended the meeting at No 10, said: ‘We remain concerned about how we’re going to be able to look after our patients this winter.

‘We still have far too many patients spending too long, waiting to be admitted into hospital. This will inevitably cause problems with ambulance handovers and also the problems with people being looked after in corridors last winter.

‘(Last winter) was extremely difficult and in terms of objective measures, it was the worst we ever saw.’

Asked if the NHS could see a repeat this winter, he said: ‘It is certainly a possibility. We still think our system is fragile and not sufficiently resilient to avoid a similar situation next winter.’

Dr Boyle said he would call for urgent action to tackle the numbers waiting for more than 12 hours in A&E. The figure in England was 23,934 in July, down 10 per cent from 26,531 in June. It hit a record 54,573 in December 2022.

The RCEM is calling for more to be done to vaccinate frontline health workers against flu and Covid.

Speaking ahead of the meeting, the Prime Minister said: ‘This year we started planning for winter earlier than before. We invested in more beds, ambulances and discharge lounges through our Urgent and Emergency Care Recovery Plan, and we’re freeing up 15 million GP appointments through our Primary Care Recovery Plan.

‘To drive forward that progress, today we’re bringing together the best minds in healthcare who all have one shared aim – protecting patients and making sure they get the care they need this winter.’

Mr Barclay added: ‘Winter is always an extremely busy period and we’re working across the NHS to make services more resilient, ensuring those who most need help and support will get the care they need.

‘I’m working closely with NHS and social care leaders to provide additional hospital capacity, protect emergency care and harness the full potential of technology to deliver the best possible service and intensify our efforts to tackle waiting lists.’

Earlier this year, NHS England announced plans for cash incentives for hospitals who ‘over-achieve’ on performance measures such as waiting times.

It also announced plans to introduce social care ‘traffic control centres’ to help speed up hospital discharges so patients could be shipped out of hospitals when they no longer needed to be there.

Other plans include having more ambulances on the road, extra beds in hospitals and ramping up the use of ‘acute respiratory hubs’.

Sarah-Jane Marsh, NHS England’s national director of urgent and emergency care, said: ‘The forthcoming winter will be another challenging one for health and social care, which is why teams across the NHS have been planning for this busy period since the start of summer, including getting more ambulances on the road and putting more hospital and virtual ward beds in place.’

Around three-quarters of patients in England were seen within four hours in A&Es in July. The figure hit a record low of 65 per cent in December.

The NHS recovery plan has set a target of March 2024 for 76 per cent of patients attending A&E to be admitted, transferred or discharged within four hours.

Meanwhile, a record 7.6 million people are waiting for treatment in England.

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By Cassidy Morrison Senior Health Reporter For Dailymail.Com

Published: 11:36 EDT, 12 September 2023 | Updated: 14:06 EDT, 12 September 2023

More than 30 cases of the Pirola Covid variant have been spotted in the UK, health chiefs revealed today.

The UK Health Security Agency (UKHSA) confirmed that 36 cases of the strain, scientifically known as BA.2.86, have been spotted, up from just three a week ago. 

Two are in Scotland while 34 are in England. 

Of the cases in England, 28 came from a single outbreak in a care home in Norfolk, which infected 87 per cent of residents and left one hospitalised.

Health chiefs said this signals a ‘high attack rate’ and could be an early indicator that the strain spreads easily indoors. 

In total, five people with confirmed Pirola infections have so far required hospitalisation, though UKHSA analysts said no deaths have been recorded.

Experts told MailOnline the data suggests that the Omicron sub-variant is more transmissible than its predecessors but that it is no more severe.

UKHSA said it was notified about the care home outbreak on August 21.

All residents and staff took PCR Covid tests which were sent to labs for analysis.

Results showed that 87 per cent of residents were infected, whilst 12 staff also tested positive. 

One resident was hospitalised and four remain unwell. 

Health chiefs are spooked over the variant’s high number of mutations.

These signal that the variant could potentially be more infectious or be different genetically enough from previous variants that the protection offered by jabs or prior infection is significantly reduced. 

But the UKHSA said it will be ‘some time’ before it knows how quickly the variant is spreading, how effective it is at making people ill and how good it is at dodging immunity from jabs or previous infections. 

Dr Renu Bindra, UKHSA incident director, said the agency is working with scientists around the globe to study the strain.

The agency is advising Norfolk County Council on its outbreak to curb the spread of the infection, she said.

Dr Bindra urged people to come forward for Covid vaccine drive, which was recently accelerated to launch on Monday due to fears surrounding Pirola. 

‘It remains vital that all those eligible come forward to receive their autumn vaccine as soon as it is offered to them,’ she said.

Reacting to the UKHSA report Professor Ian Jones, a virologist at the University of Reading, said: ‘It does indicate that the general trend we have seen since variants arose, towards transmissibility rather than pathology, is holding and that we can reasonably expect the same to be true of the variants to come.’ 

Professor Paul Hunter, a respected infectious disease specialist at the University of East Anglia, also told MailOnline that while ‘early days’ the fact only one person in the care home outbreak required hospitalisation ‘doesn’t raise any red flags’.

Apart from the care home outbreak, all the other Pirola cases are unlinked, suggesting Pirola is spreading in the community, the UKHSA said.

The agency’s Pirola cases only reflect a fraction of the true toll. 

Brits are no longer testing en masse like they were earlier in the pandemic — with community mass testing ending in May 2022.

Therefor it is unclear how many Brits are infected with Covid and how many of those have Pirola.  

While only two cases have been confirmed in Scotland, more are suspected. Traces of the variant being found in wastewater analysis by Scottish authorities. 

No Pirola cases have been detected in Wales or Northern Ireland. 

While the prevalence of the virus is unclear, data from the ZOE Covid study, which tracks self-reported infections, suggests there were 100,516 new cases of symptomatic infection on September 6 — double the 50,000 it reported at the start of August.

The study, which is based on data from millions of users of the ZOE app, estimates around 1.2million in the UK are currently infected, roughly one in 57 people. 

The figure is the highest for five months but it is still far lower than the estimated toll during earlier peaks, with it reporting that 3.8million people were infected in April 2022.

Experts predict Covid cases will continue to rise as the UK heads into the autumn, as people mix more indoors.

This could exacerbate NHS pressures, with the season traditionally a busier period for the health service than summer. 

The UKHSA’s report today also included an analysis of the Pirola cases which have undergone genetic trusting.

Results suggests several slightly different Pirola strains have entered Britain multiple times from overseas, rather than in one singular superspreader case.

Tests include whether the closely related ‘Kraken’ variant — which arrived in the UK in the first half of 2023 — offers some protection from Pirola.

They are also analysing how accurate the current generation of lateral-flow-tests are at detecting a Pirola infection.

UKHSA is also working with other British scientists on determining how fast Priola could spread and how effective the current batch of Covid jabs are against the heavily mutated variant. 

Globally, the variant has been spotted in more than dozen countries, including the US, Denmark, South Africa, Portugal, Sweden, Canada, France and Switzerland.

The variant’s meteoric rise on the global stage and its host of over 35 mutations has sparked alarm among scientists.

Such concerns prompted the Department of Health and Social Care to accelerate the autumn Covid and flu jab drive.

Annual vaccinations for care home residents and vulnerable adults, who are at most risk of a severe infection, were due to start in October.

However, they will now start from Monday in a bid to boost protection earlier in the year amid fears that Pirola could trigger a fresh wave.

Ministers said they had made the decision to reduce pressure on the health service while scientists rush to learn more about the variant.

But virologists have warned it is too early to pinpoint whether BA.2.86 triggers more severe illness than earlier versions of the virus, as scientists are still analysing recently discovered cases.

Professor Francois Balloux, an infectious disease expert based at University College London told MailOnline: ‘Based on the tiny number of BA.2.86 cases diagnosed to date there is no evidence for, but also no reason to expect, a significant shift in symptoms.’

Professor Lawrence Young, a virologist at Warwick University, said that a combination of immunity induced by previous infections, Covid vaccinations and ‘a combination of changes in the virus’ has seen Covid symptoms alter over the last three years. 

‘It’s much more like a cold now than when we first experienced Covid,’ he said.

Early results from a US lab earlier this week suggested Pirola may not be as dangerous as initially feared.

The research, published by the Dan Barouch Lab, part of the Center for Virology and Vaccine Research at Harvard University School of Medicine, analysed how well the immune system of the 66 participants fought-off 10 Omicron subvariants, including BA.2.86. 

They found that antibodies — proteins that protect against infection — were less effective against Pirola than its ancestor BA.2.

However, when compared to other Omicron variants currently circulating, the results were similar, suggesting Pirola is no better at dodging immunity.

While this won’t stop people from catching the virus, it suggests the UK’s wall of immunity — built up from waves of infection and vaccine rollouts — should help prevent a dramatic spike in people from becoming severely ill.

Doctors have been put on high alert about rising cases of a potentially severe respiratory virus in parts of the United States, which could signal a bad nationwide outbreak is to come. 

The Centers for Disease Control and Prevention warned medical professionals the rising rates of respiratory syncitial virus, or RSV, in Florida and Georgia in recent weeks signal the start of the respiratory virus season.  

And the Food and Drug Administration (FDA) has advised healthcare workers to brace for what could be a ‘tripledemic’ of RSV, flu, and Covid-19 cases this winter.

RSV infects the lungs and the respiratory tract and typically causes cold-like symptoms, though it can be deadly to seniors who have weaker immune systems and infants whose already-narrow airways fill with mucus, making it hard to breathe. 

RSV is the leading cause of hospitalization for infants one or younger in the US. Each year, the virus causes up to 80,000 hospitalizations and 300 deaths in children under age 5. 

And in seniors, the virus can cause up to 160,000 hospitalizations and 10,000 fatalities every year.

Treatments and preventive measures for RSV have become more widely available in just the past year, and the CDC is urging clinicians to stock up on vaccines for adults and pregnant women and monoclonal antibodies for infants when they become available.    

This summer ushered in the most substantial win for protecting babies FROM RSV, though, with the Food and Drug Administration’s (FDA) approval of a monoclonal antibody to protect against RSV called Nirsevimab, which will become available in October.

Nirsevimab is a single-shot monoclonal antibody that, in clinical trials, cut the chance of serious RSV infection requiring hospitalization by nearly 75 percent. 

For seniors 60 years and older, there are now two new vaccines to help fend off the virus, with one of them proving to be 80 percent effective at preventing RSV infection. 

But the vaccines for older adults are not like a traditional flu shot that is available to all who want one. Doctors must decide after consultation with their patients whether the rare, yet potentially severe health risks associated with the vaccine, such as atrial fibrillation and neurological complications, outweigh the benefit of protection. 

Regional increases early in the season, such as those currently occurring in the Southeast, offer health officials a glimpse of what may be to come for the rest of the country in the next several months. 

Agency officials monitoring disease testing results in Florida found the number of diagnostic tests coming back positive for RSV exceeded five percent for about a month. The typical test positivity rate for RSV this time of year is around three percent. 

In Georgia, the CDC observed an uptick in the number of hospitalizations due to RSV. Around two for every 100,000 children in Georgia were hospitalized for RSV during the week ending on August 5. By August 19, that rate had risen to seven hospitalizations per 100,000 children. 

The uptick in cases this time of year would not otherwise be noteworthy, as seasonal RSV, along with influenza, typically begins in early fall and peaks in the winter. 

But the last few years have been an exception to that rule thanks to pandemic-era social distancing measures like masking and isolation. Meant to stave off Covid, the measures also largely stamped out seasonal virus outbreaks as we knew them.

But when the world gradually reopened in 2021 after Covid-19 vaccines became available, seasonal viruses came back too. 

Last year’s RSV season was among the worst. 

Covid, flu, and RSV began to circulate with some overlap, garnering fears of a ‘tripledemic’. 

Now, there is renewed concern of another ‘tripledemic’, a situation in which three diseases join forces and overwhelm the healthcare system, which so far has not had the devastating consequences at the scale many epidemiologists feared. 

Still, the CDC is recommending doctors ramp up testing for RSV, as well as Covid and the flu, in schools, daycares and long-term care facilities, and stockpile the latest medicine. 

The health agency also recommends all infants under eight months born during RSV season should receive the antibody within their first week of life, while infants born outside the typical season should get Nirsevimab before the next RSV season begins. 

While the shot has been shown to be extremely effective, the CDC acknowledged not all hospitals will have it in their arsenal immediately due to high demand. 

Pregnant women can also receive a vaccine that confers immunity to their unborn babies for a continuous six months of protection after birth. 

An American father has been put on a ventilator after being struck down by a ‘mystery respiratory infection’ while in the Philippines for his mother’s funeral. 

Armando Ramos, 53, from California, has tested negative for Covid and the flu — leaving doctors struggling to work out the cause of his illness.

The father-of-three — who has no underlying conditions — has also been intubated and suffered a collapsed lung, brain inflammation and kidney problems.

He is being treated at a hospital in Manila after his sore throat progressed into chest pains and breathing problems within five days. He had flown to the country in early August.

His daughters Emma and A.J. Gaines-Ramos told local news the illness felt like a ‘cruel deja vu’ with the Covid pandemic.

‘Right now, it’s a mystery,’ Emma told the publication. ‘Every day, we still don’t know what’s happening to him.

‘It’s traumatizing, in the sense, when the pandemic first occurred, nobody knew what was happening.

‘You’re kind of just treating the symptoms, but not getting to the source of it. 

‘That’s what it feels like is happening right now.’

A.J. added: ‘It’s a cruel deja vu with the pandemic. Every day, anticipating his state and not knowing, it’s scary.’

Mr Ramos had flown to the Philippines from Chula Vista, California, in early August for his late mother’s funeral.

He attended the ceremony where he placed a vase containing her ashes inside a mausoleum.

He began to suffer from a sore throat and persistent tiredness and five days later he went to hospital when his symptoms progressed to chest pains and breathing problems, where doctors diagnosed him with pneumonia and placed him on a ventilator.

His condition continued to deteriorate with his daughters saying that as well as lung, brain and kidney problems, he also had complications with his heart and liver.

He was transferred to the Intensive Care Unit at the hospital as doctors battled the infection.

Recently, doctors also pumped bacteria-filled fluid from his lungs. 

Tests for viral infections were negative, but it was not clear whether swabs had also been carried out for bacterial infections — like streptococcus pneumoniae.

He is also being tested for meningitis, a condition where an infection causes inflammation of the fluid and membranes surrounding the brain and spinal cord. This can be caused by a bacterial or viral infection. 

The father has already been in hospital for a week battling the illness.

Over the last few days, there have been some signs of improvements with his kidney function improving and a rise in oxygen levels in his blood — although he remains in the ICU.

Doctors say he will likely be in the unit for at least another two weeks while they wait for his condition to improve. 

The daughters’ mother has flown out to be by his bedside.

They added that their father was otherwise healthy and would exercise regularly. 

The family revealed their case in a GoFundMe where they are appealing for $50,000 to help cover international hospital bills. Currently, they have raised $20,000.

Jill Biden tested positive for Covid for a second time Monday, prompting multiple rounds of tests on President Joe Biden, who continues to result negative.

As a precaution, the president, 80, wore a face mask for the first time in months as he went about his duties at the White House today. 

However, he took it off during a Medal of Honor ceremony and did not put it back on – an act that encapsulated Americans’ fatigue with Covid masks.

The 72-year-old First Lady’s positive result is a reminder the virus that has been a backdrop issue for months is still disrupting people’s lives as cases are on the rise again and positivity rates have climbed as high as 20 percent in some parts of the US.

But Covid is no longer the deadly threat it once was. While hospital admissions involving the virus have been rising for weeks, they are still about 10 times lower than levels seen at the peak in January 2022 and deaths are about 40 times below the peak in late 2020.

Many doctors now compare the virus to the common cold or the flu, which while disruptive and deadly among vulnerable groups, will not cause serious illness in the vast majority of people.

The transition from deadly virus to manageable seasonal illness can be attributed to the high levels of immunity among Americans from infection or vaccination, plus an arsenal of highly-effective therapies and drugs. 

For these reasons the federal government declared the pandemic over in May this year and ended the public health emergency, scrapping legal requirements to mask, isolate, test and get vaccinated.  

But with Covid making a comeback, here’s everything you need to know about the situation in the US: 

Will mask mandates be reinstated? 

While some individual companies and universities have put mask requirements in place, there is no indication state or federal mask mandates will return. 

When asked last week, the CDC said it had no intentions to bring back compulsory masks in any setting.

Instead, a spokesperson said: ‘Anyone may choose to wear a mask in crowded or poorly ventilated indoor areas, including on public transportation and in transportation hubs at any time.’

Health officials in New York went one step further in saying that it was a ‘good idea’ to wear face coverings in indoor spaces over Labor Day weekend.

Meanwhile, Morris Brown College in Atlanta, Georgia, from reinstating a mask requirement for 14 days for students and staff just days after classes began late last month. 

The college also banned parties and large student events on campus and implemented temperature checks. 

Additionally, a recent editorial by the American College of Physicians called for mask mandates to return to healthcare facilities.

A Kaiser Permanente hospital in California and several in New York state reinstated mandates for at least several weeks.

Hollywood movie studio Lionsgate also reinstated its mask requirement briefly last month, before quickly reversing its decision. 

Do I need to isolate if I test positive for Covid?

People are encouraged to but there is no legal requirement. 

According to the Centers for Disease Control and Prevention’s (CDC) latest guidelines, as of May 2023, people who test positive for Covid should isolate and keep separate from others for at least five days, regardless of vaccination status. 

If someone with Covid is showing no symptoms, the isolation period begins the day after they receive a test.

However, if the person develops symptoms any time within 10 days of when they tested, the isolation period restarts on the day of symptom onset. 

If a person is showing symptoms, day one of the isolation period is the first full day following the day symptoms began. 

Isolation can end after day five if symptoms are improving and a person is fever-free for 24 hours without the use of medications.

If symptoms do not approve after day five, people should continue to isolate until they are fever-free. 

However these are all recommendations, rather than rules. 

While isolation can end after five days, people who test positive should continue to wear a high-quality mask around others and in public for 10 days or until they receive two negative tests 48 hours apart. 

People with Covid should also inform anyone they recently had close contact with that they have the virus, though no one is legally obligated to report if they’ve tested positive.

Do I have to stay home from work? 

There is no legal requirement but people are encouraged to take sick days if they become sick with Covid.

Before May, some states forced employers to provide an additional amount of paid leave for reasons that applied to Covid – to help employees follow mandatory quarantine periods without using all of their sick and vacation leave.

But those rules have lapsed in several jurisdictions. 

For example, California’s COVID-19 Supplemental Paid Sick Leave expired on December 31, 2022. 

However, some jurisdictions, such as New York State, still have COVID-19 sick leave laws in effect that require employers to provide separate paid leave beyond what an employee may otherwise be entitled to under a state or local paid sick leave law or an employer’s policy for certain employee needs related to COVID-19.

Do I need to test if I am exposed to Covid? 

Current CDC guidelines recommend people who are exposed to Covid wear a mask as soon as they find out about their exposure. 

They should continue wearing a mask for 10 days and get tested for the virus five days after exposure. 

Even if the result is negative, the CDC says people should continue wearing a mask in public and around others for 10 days as symptoms can still develop.

If a person tests positive, they should isolate immediately. 

Tests for Covid-19 had long been freely available and covered by government and private health insurances. 

However, with the Biden administration ending the Covid public health emergency in May, health insurance plans no longer need to cover tests and free test kits from the government are no longer being sent out, meaning Americans may need to pay for their own Covid testing.

However, some insurers may still choose to cover testing.

What are the new variants?

Two variants driving the surge in cases, EG.5, or Eris, and BA.2.86, or Pirola, were thought to be highly mutated and transmissible and doctors believed they could be better at avoiding current vaccine immunity. 

While concerns over Pirola prompted concern from public health officials and new mask mandates, early lab results carried out in the US, Sweden and China suggest these warnings may have been overblown.

Results indicated Pirola may be another ‘scariant‘ and not the second coming of Omicron, Dr Dan Barouch, a virologist at Beth Israel Deaconess Medical Center in New York who was behind one of the lab tests, told CNN.

The tests found antibodies from people vaccinated against Covid and people who had recovered from an infection in the previous six months were just as effective at protecting against a Pirola infection as they were with other variants. 

Dr Barouch said after reviewing test results, he was confident Pirola did not pose the public health risk originally thought.  

What are my chances of becoming severely ill or dying from Covid? 

While Covid cases are on the rise in the US, public health officials say the majority of people are experiencing mild symptoms comparable to a cold or flu. 

Additionally, the CDC considers the hospitalization rate of Covid patients to be low and the weekly death rate is near a historic low. 

There were more deaths during the week ending Aug. 19 from Alzheimer’s disease, which killed more than 1,649 people, diabetes, responsible for more than 1,107 deaths and cancerous tumors, which more than 8,796 people died from, according to the CDC’s Weekly Provisional Counts of Deaths by State and Select Causes.

Are cases, hospitalizations and deaths on the rise? 

In recent weeks, public health agencies have observed an increase in the number of positive Covid tests and hospitalizations. Over the past month, however, deaths from Covid have declined. 

The CDC reports there were approximately 4.5 new hospital admissions for every 100,000 people in the US in the week ending Aug. 19, the most recent data available.

The CDC considers this a low rate and it is nearly 10 times lower than at the peak of hospital admissions in January 2022. 

The Covid death rate per 100,000 people in the week ending Aug. 26, was 0.1, compared to the high of 7.8 per 100,000, which was recorded in January 2021. 

Covid is now responsible for approximately two percent of all deaths in the US, compared to the peak of 30 percent in January 2021.

While these numbers are promising, the elderly, those with comorbidities or those who are immunocompromised are still at a high risk of contracting the virus and suffering potentially dangerous complications and should take precautions amid the uptick.

Do I need another Covid vaccine? 

Doctors are advising people to hold off on getting another Covid booster until an updated one is available, which should be in mid- to late-September.

Medical experts say people who are not immunocompromised or extremely vulnerable should postpone an immediate booster until the fall to maximize the protection gained from the updated vaccine. 

Vaccine manufacturers, such as Moderna, are updating their shots in order to better protect against new strains.

Health officials say the new boosters, formulated based on subvariants of the Omicron strain, have been shown to provide significant antibodies against some of the circulating variants. 

Vaccines are currently free to most Americans with private or federal health coverage and to the uninsured. 

The US government has been paying about $26 per dose of the vaccine, but some manufacturers, such as Pfizer and Moderna, are planning to increase the price up to $130 when the shots are sold on the private market this fall. 

This price hike will be especially concerning in the fall, when the federal government plans on shifting Covid vaccine distribution to the commercial market, meaning manufacturers can sell their updated vaccines directly to healthcare providers instead of the government. 

Federal and corporate programs are planning to assist uninsured Americans in paying for the vaccine should they want to receive one and Pfizer and Moderna intend to establish patient assistance programs. 

Pirola, the new Covid variant dubbed the ‘real deal’ by experts, may not be as dangerous as initially feared, new data suggests. 

Early results from a US lab found those who had previously been infected with Covid or had a jab had a similar level of immunity to other fellow Omicron Covid variants. 

While this won’t stop people from catching the virus, it suggests the UK’s wall of immunity should still help prevent many people from becoming severely ill.   

Experts say however this depends on the success of the autumn jab drive topping up immunity levels, which has been brought forward starting next week.  

Four Pirola cases have now been officially confirmed in the UK, after Scotland recorded an additional case yesterday.

Alarm bells were initially raised due to Pirola, technically called BA.2.86, having a catalogue of 35 mutations which experts feared could help it to evade immune defences, driving up infections and cases of severe illness.

But the US study suggests that despite Pirola coming from a different branch of the Omicron family trees than other recent and less concerning variants, including Eris and Arcturus, the protection offered from jabs and prior infection still holds.  

British experts today welcomed findings of US data labelling it ‘encouraging’ and said it ‘reinforces the value’ of the UK’s autumn Covid booster campaign. 

Others however cautioned that the results ‘only tell part of the story’ and it is still ‘difficult to say’ whether the strain will really take off.   

The research, published by the Dan Barouch Lab, part of the Center for Virology and Vaccine Research at Harvard University School of Medicine, involved 66 volunteers. 

Scientists analysed how well the antibodies of 44 of the participants — who had all received a Covid vaccine — neutralized 10 Omicron subvariants including BA.2.86. 

Antibodies are a key part of the immune response to Covid and a critical indicator of how likely someone is to be protected. 

They found the neutralising antibody (NAb) response was lower in BA.2.86 than its ancestor BA.2, suggests people are less protected against Pirola. 

However, when compared to other Omicron variants currently circulating, the results were similar suggesting Pirola is no better at dodging immunity.  

Researchers also compared the NAb response in the 22 who had not received a bivalent booster vaccine for up to six months. 

Of these, those with the highest levels of neutralizing antibodies against BA.2.86 had recently recovered from an Omicron infection. 

The results align with previous experiments by labs in China and Sweden last month.

Using the blood of vaccinated mice and from vaccinated and recently infected people, researchers in China found BA.2.86 can partially evade our immunity but was around 60 per cent less infectious than XBB.1.5 virus, nicknamed Kraken.

At the time scientists suggested this may explain why the strain has been detected in so many different countries, but only at low levels.

In a second Swedish experiment, researchers found that antibodies from older blood samples from late 2022 struggled to neutralize BA.2.86. 

But more recent blood samples, from more recent Covid waves, showed improved efficacy. 

Professor Stephen Griffin, an infectious disease expert at the University of Leeds, told MailOnline: ‘It is welcome news to see studies emerging that show BA.2.86 to perhaps be somewhat less antibody evasive than suspected.’

‘This begs the question though, of how this very divergent virus has spread across multiple continents. 

‘The answer may lie in another advantage that the virus has over present dominant XBB strains that we have not yet assessed. 

‘This may involve evading the very early, or “innate” immune response, or possibly infection of a different part of the lungs.’

‘It is hard to tell the extent of spread due to limited testing, so it is welcome to see more.’ 

The study however was small and further research is required, he noted.  

He also added: ‘Only with increased numbers will we see whether more severe disease occurs at the population level, we cannot tell this yet from the limited number of documented cases. 

‘Whether or not BA.2.86 becomes a variant of concern, it represents another new evolutionary branch for the virus that further demonstrates the folly of trying to treat SARS2 like other respiratory viruses. 

‘We should act preemptively, including mitigations and broadening the vaccine programme.’

Professor Lawrence Young, a virologist at Warwick University, also told MailOnline today: ‘Data from three different labs provides evidence that the immune evasiveness of the BA.2.86 variant isn’t as extreme as originally feared. 

‘These early studies suggest that previous vaccinations and infections should provide protection from severe disease for most people. 

‘This work also reinforces the value of the autumn booster vaccine campaign, particularly the use of XBB-lineage updated mRNA vaccines.’ 

He added: ‘Other data indicates that the BA.2.86 variant is less infectious than previous Omicron variants, at least in laboratory studies. 

‘It remains a puzzle as to why this variant is spreading. 

‘It could be due to other changes in the virus – noting that, like other variants, this one is continuing to change. 

‘That’s why we can’t be complacent and need to keep monitoring for the spread of infection and particularly for new variants.’ 

Responding to the findings, UKHSA epidemiologist Meaghan Kall, also tweeted: ‘This is very encouraging for XBB vaccines. 

‘Now with three sets of data with similar results, I am feeling more confident of this result. 

In a second tweet addressing the data, she added: ‘Right now our best protection against a bad Covid season is the booster.

‘With the autumn booster campaign starting in days and XBB monovalent vaccine in the pipeline, these lab data — comparing with/without XBB infection — suggest a XBB vaccine will be effective vs BA.2.86.’

Concerns over the variant prompted the Department of Health and Social Care to u-turn on the autumn Covid and flu jab drive start date, with vaccinations for care home residents and vulnerable adults now starting earlier than scheduled.

GPs and pharmacies are now set to begin dishing out the jabs under the autumn booster campaign from September 11, a full month earlier than originally planned.

Ministers said they had made the decision to reduce pressure on the health service while scientists rush to learn more about Pirola.

Globally the variant has now been spotted in the UK, US, Israel, Denmark, South Africa, Portugal, Sweden, Canada, France, Thailand and Switzerland.

But Professor Paul Hunter, a respected infectious disease specialist at the University of East Anglia, told MailOnline: ‘It is now difficult to say whether a new variant will really take off or not.’ 

He added: ‘For most people immunity to infection will be being driven primarily by what infections they have already had and recovered from rather than their recent vaccination history. 

‘But for the vulnerable immunisation remains important to prevent severe disease, hospitalisation.’

It is still unclear how long the variant has been in circulation, he noted and ‘is only now cropping up in countries that still do a reasonable amount of sequencing’.

Meanwhile, Dr Simon Clarke, a microbiologist from the University of Reading, told MailOnline: ‘Looking at the effectiveness of antibodies in people’s blood is useful, but only tells part of the story. 

‘Immunity is complex and made up of lots of different components, of which antibodies are just one important factor, and while these findings are encouraging, they probably don’t tell the whole story. 

‘And studies in a lab often don’t mirror exactly what happens in the real world.’

He added: ‘We know that immunity induced by vaccines is excellent at protecting against disease, but not so good at protecting against transmission, so even very effective protection against getting ill may not stop BA.2.86 spreading around the world.’

Virologists have also warned it is too early to reliably pinpoint if BA.2.86 has any new specific symptoms, as scientists are still analysing the recently discovered cases. 

Professor Francois Balloux from University College London told MailOnline: ‘Based on the tiny number of BA.2.86 cases diagnosed to date there is no evidence for, but also no reason to expect, a significant shift in symptoms.’

Professor Young, also added that a combination of immunity induced by previous infections, Covid vaccinations and ‘a combination of changes in the virus’ has seen Covid symptoms alter over the last three years. 

‘It’s much more like a cold now than when we first experienced Covid,’ he said.

However, he noted: ‘That doesn’t mean that those who are more vulnerable due to underlying conditions won’t suffer more severe symptoms if infected with BA.2.86.’

During a meeting last week the UKHSA’s variant technical group confirmed the UK’s three known BA.2.86 cases at the time, were identified through hospital testing and ‘have no known recent travel history’. 

The group is tasked with forecasting scenarios of Covid variants and producing assessments on the risk of emerging strains. 

‘The first UK case was mildly unwell and the second UK case — in England — did not have respiratory symptoms’, they said. 

A third case in Scotland however was symptomatic. But officials noted there was no laboratory data available yet, with two of the UK samples currently ‘in culture’.

Public Health Scotland (PHS) yesterday also confirmed a second case in Scotland had been identified through PCR testing. 

But details surrounding the fourth case have not yet been disclosed. 

These are also signs the virus is spreading within the community with PHS confirming Pirola had also been found in wastewater testing, in an undisclosed part of the country. 

Scientists can test community wastewater samples to monitor the prevalence of the virus through the stools of infected people. 

It comes as Covid cases in the UK are rising sharply — almost doubling in a month — just as the country heads into the autumn when the NHS gets busier.  

Data from the ZOE health study shows there were 93,432 new daily cases of symptomatic infection on September 2 — up from about 50,000 at the start of August. 

The study, which is based on data from millions of users of the ZOE app, estimates there are around 1.17million people in the UK with the virus right now – roughly one in 57. 

But the estimated peak of the pandemic, in cases, was in late March 2022, where at one point about 4.9million people were thought to have the virus.

Experts predict Covid cases will continue to rise as the UK heads into the autumn, as people mix more indoors.

This could contribute to NHS pressures, with the season traditionally a busier period for the NHS than summer. 

Two people in Michigan have been diagnosed with swine flu after attending county fairs, health officials confirmed today.

The patients – whose infections are not linked to one another – caught different strains at separate fairs last month, where they were exposed to infected pigs.

Both sufferers – whose identities have not been revealed – experienced mild illness, and there is no sign they spread it to others. 

But the infections come amid an unprecedented influenza outbreak in animals that has many experts fearful of a spillover into people. 

The first patient, a Lapeer County resident, was working at the Oakland County Fair, which took place at the Springfield Oaks County Park in Davisburg between July 7-16.

They were infected with an H3 variant of swine flu which was confirmed via a test carried out by state health officials on July 26.

The Centers for Disease Control and Prevention (CDC) tested a sample from the patient which came back inconclusive, which it said was likely due to the sample not containing enough virus.

The second patient attended the Tuscola County Fair in Caro, about 50 miles from Davisburg, between July 23 and July 29.

The patient was confirmed to have a H1 strain of the virus, which is typically more mild than H3 types. 

Neither patient required hospitalization, and both were treated with flu antivirals. They are now recovering.

The CDC advised people to take general precautions to limit the spread of swine flu, including not eating or drinking while pigs are present, avoiding contact with pigs that appear sick, and washing hands with soap and water before and after contact with pigs.

Flu viruses can spread from pigs to people, but it’s rare, with only a handful of spillover events occurring in the US each year.

Like any flu, when infected pigs cough, sneeze or even just breathe, droplets with pieces of flu virus in them can spread through the air. 

If these land in a person’s nose and mouth, or are breathed in, they can become infected with swine flu.

Swine flu surges in pigs around the fall months, raising the risk of the disease spilling over into humans.

People who become infected tend to suffer similar symptoms to seasonal flu, including fever, cough, runny nose and body aches.

But cases are normally mild and clear up on their own in a few weeks. There is little risk of death.

Scientists say, however, that children under five, people over 65, pregnant women and those with underlying health conditions are more at risk of complications if they become infected.

A major swine flu outbreak was triggered in 2009 after a mutated version of the virus — strain H1N1 — spilled over into humans.

In the end, about one in five people globally became infected. For the US, there were estimated to have been about 60 million cases alongside 275,000 hospitalizations and 12,000 deaths.

But the case fatality rate — the proportion of patients that died from the disease — was thought to have been around 0.03 percent. For comparison, when Covid first struck, it had a fatality rate of up to three percent.