11% and rising: Covid leads Europe's autumn tests, flu is knocking, and the epidemic has not started

Europe’s respiratory season has a shape this week, and it is not the one you would guess. In its week-44 overview, published on 9 November, the European Centre for Disease Prevention and Control (ECDC) says consultation rates for respiratory illness are “slowly increasing” but still at low or baseline levels in every reporting EU/EEA country¹. The main contributor is SARS-CoV-2, with median test positivity of 11% in both primary and secondary care¹. A week earlier the figures were 5.2% in primary care and 4.8% in hospitals². Desk arithmetic: roughly a doubling in one reporting week, from a low base.

Flu is the other half. ECDC puts influenza test positivity at around 5% and says detections have been consistently above inter-epidemic levels since week 37, “but the epidemic has not yet started”¹. The viruses are type A, mostly A(H1N1)pdm09; most hospital detections are in adults over 65¹. RSV remains “very low”¹.

Germany looks similar, a week behind in the published data. The Robert Koch-Institut’s report for 26 October to 1 November found respiratory viruses in 58 of 90 sentinel samples, mostly rhino- and enteroviruses (43%); influenza A was in 6% and SARS-CoV-2 in 4%, and no RSV was found³. Among hospital patients with severe respiratory infections, 4% had a Covid-19 diagnosis and 3% influenza³. Wastewater shows SARS-CoV-2 now circulating nationwide, still clearly below last year’s level but rising for several weeks; the flu load is edging up too³.

None of this is an alarm. It is the dull machinery doing what it is paid for: sentinel doctors swabbing, labs typing, wastewater plants sampling, two agencies writing “low but rising” in time for anyone who wants to act on it. The time to arrange a jab, if your doctor recommends one, is while the line reads “not yet started”.