What is the ‘quad-demic’ – and how can you protect yourself?
Four illnesses are circulating in the UK this winter, in what has been dubbed the “quad-demic”.
Over a year since the official end of the COVID-19 pandemic, the virus is still prominent, with the UK Health and Security Agency (UKHSA) monitoring its activity levels weekly.
The governmental department also monitors levels of flu, respiratory syncytial virus (RSV) and norovirus, which all peak at different times during the season.
It is these four that make up the “quad-demic”, which one NHS doctor said can affect everyone – including the “fit and healthy”.
What is the ‘quad-demic’?
The term “quad-demic” refers to the “four very common viral illnesses that circulate every winter in different peaks,” Dr David Lloyd, an NHS GP told Sky News Breakfast.
The risk and complication rate of people catching all four of these illnesses at once heightens at this time of the year, hence the term, he added.
It comes as weekly figures released by the UK Health and Security Agency (UKHSA) on Thursday showed an increase of flu, RSV and norovirus.
COVID-19 was the only one where levels remained stable, but this could change week-on-week.
Data showed that RSV – which is a common cause of coughs and colds – was circulating at “medium levels”, with “increases seen in most age groups”. Hospital admissions and A&E visits caused by RSV also increased.
Flu – or influenza – activity levels increased, with a weekly mean positivity rate of 6.5%, while norovirus increased across all age groups, with adults aged 65 or over particularly affected, according to the UKHSA.
It said reports of the winter vomiting bug between 4-17 November were “almost double” the average of the past five seasons for the same two-week period.
Dr Lloyd explained that illness in winter happens more frequently because people spend more time in their houses together and socialising over Christmas.
“This is peak time so even if you are fit and healthy, your chances of catching all of these illnesses if quite high,” he said.
How can you protect yourself?
“Vaccines work against the quad-demic,” Dr Lloyd emphasised.
In fact, by getting vaccinated you halve your risk of catching any of the four illnesses, he said.
The NHS provides vaccinations against three of the four illnesses; flu, COVID-19 and, as of September this year, RSV.
The new RSV vaccine was developed as the illness can prove to be extremely dangerous for young babies and older people, especially those with heart or lung conditions, according to the NHS.
The health service said the vaccine would be a “game changer” and could typically prevent 5,000 infant hospitalisations and 2,500 adult hospitalisations.
Dr Lloyd says vaccines ‘work against the quad-demic’. Pic: iStock
Analysis of the latest NHS vaccination data showed 335 vaccinations were given for COVID, flu and RSV per minute on average from 30 September to 17 November.
This works out at around 3.4 million vaccinations a week.
In total, nearly 25 million vaccinations have been delivered for the three illnesses since rollout began in September.
Dr Lloyd added that getting only one vaccination could help protect people from other illnesses due to what is known as viral interference.
“If you have had a vaccine against one of these diseases, it is triggering your body to produce non-specific chemicals that fight viruses in general. So by having one vaccine, you are protecting yourself against others as well,” he said.
“These illnesses all occur in different peaks, so it makes sense to get the flu vaccine because that’s the one that comes earliest, that will increase your chances of being protected against the quadruple, the triple, the double and the single infection.”
How to stop the spread if you are ill?
As with any spread of germs, it is best to wash your hands with soap and water and avoid close contact with others if you are ill, the NHS advises.
If you have diarrhoea or vomiting, the NHS says not to return to work, school or nursery until 48 hours after symptoms have stopped.
Dr Lloyd added that although mask wearing has “gone out of fashion”, wearing a face covering will also help prevent the spread.
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“We [the NHS] gear ourselves up for dealing with these illnesses every year and I think it is going to be tough,” he said.
“But if we all do the things that we are meant to do, which is get vaccinated and be sensible, I think we will all come through.”
The NHS advises asking for an urgent GP appointment or getting help by calling 111 if you are worried about your or a relative’s symptoms.
If symptoms become more serious, it is advised to call 999 or go to A&E.
Hayat Tahrir al Sham (HTS) went from a jihadist movement once aligned to al Qaeda to forming the official government of Syria.
It was a monumental transformation for them, their country and the wider Middle East.
But potentially too for British people who went to Syria – and who were stripped of their citizenship as a result, on the grounds of national security.
Tauqir Sharif, better known as Tox, went to Syria in 2012 as an aid worker. He was accused of being part of a group affiliated with al Qaeda, which he denies, and the then-home secretary Amber Rudd deprived him of his British citizenship in 2017.
“As of now, I am deprived of my UK citizenship but I’m not a convicted terrorist – and the reason for that is because we refused, we boycotted, the SIAC [Special Immigration Appeals Commission] secret courts, which don’t allow you to see any of the evidence presented against you,” he said.
“And one of the things that I always called for was, look, put me in front of a jury, let’s have an open hearing.”
Tox went to Syria in 2012
HTS is still a proscribed terrorist organisation but the British government has now established relations with it.
Foreign Secretary David Lammy travelled to Damascus to meet the jihadist-turned-Syrian interim president – the man who swapped his nom de guerre of al Jolani for Ahmed al Sharaa.
David Lammy shakes hands with Ahmed al Sharaa in Damascus. Pic: X / @DavidLammy
If the UK government takes HTS off the terror list, what does that mean for those who lost their citizenship after being accused of being part of it?
People who joined HTS are only a subset among the scores of people who have had their citizenship revoked – a tool the UK government has been quick to use.
According to a report by the Parliamentary Joint Human Rights Committee, the UK “uses deprivation of citizenship orders more than almost any country in the world”.
The peak of that was in 2017, and mainly in relation to Syria – especially in the case of people joining Islamic State, perhaps most famously Shamima Begum.
Shamima Begum was stripped of her British citizenship on national security grounds
And because people cannot be made entirely stateless, and need to have a second nationality, or be potentially eligible for one, there are worries of racism in who the orders apply to.
Countries like Pakistan and Bangladesh offer dual nationality, whereas other nations do not. In 2022, the Institute of Race Relations said “the vast majority of those deprived are Muslim men with South Asian or Middle Eastern/North African heritage”.
Legal grey areas
Sky News submitted Freedom of Information requests to the Home Office asking for a breakdown of second nationalities of those deprived of citizenship, but was refused twice on national security grounds.
The independent reviewer of terrorism legislation, Jonathan Hall KC, told Sky News there are issues around transparency.
“I do think there is a problem when you have people whose relationship with the country that they’re left with is really technical and they may never have realised that they had that citizenship before and may never gone to that country,” he said.
“Me and my predecessors have all said, owing to how frequently this power is used, it should be something that the independent reviewer should have the power to review. I asked, my predecessor asked, we’ve both been told no, so I agree there’s a lack of transparency.”
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No automatic reversal
Even if the government does remove HTS from the terror list, it would not automatically invalidate decisions to deprive people of their citizenship.
Macer Gifford fought with the Kurdish People’s Protection Units (YPG) as a foreign volunteer. Pic: AP
Macer Gifford gave up a career as a banker in London to join the Kurdish People’s Protection Units (YPG) as a foreign volunteer between 2015 and 2017.
He told Sky News that decisions “made years ago in the interest of the British public have to remain”.
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“We can’t sort of go through previous cases nitpicking through it, wasting time and money to bring it up to date,” he added.
“We can’t be naive because the intent to go out, the decision to go in itself is a huge decision for them. So it shows commitment when they’re there, they then, if they take an active participation in the organisations that they’ve been accused of joining, again, that involves training and perseverance and dedication to the cause.”
But those born and raised in Britain, who joined the same cause, and lost their citizenship as a result, might reasonably ask why that should remain the case.
Criminals face being banned from pubs, sports grounds and concerts under new government plans to give judges powers to pass tougher community sentences.
The new measures, which would apply to people in England and Wales, “should remind all offenders that, under this government, crime does not pay”, Justice Secretary Shabana Mahmood said.
Offenders’ freedom could also be curtailed with limits on driving, travel bans and restriction zones confining them to specific areas, the government said.
Similar measures could also apply to prisoners let out on licence, while drug testing would be expanded to include all those released, rather than just those with a history of substance misuse.
While judges are currently able to impose limited bans for specific crimes, such as football bans for crimes committed inside a stadium on match day, the new measures would allow for such bans to be handed down for any offence.
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Inside one of Britain’s most overcrowded prisons
The justice secretary said: “When criminals break society’s rules, they must be punished.
“Those serving their sentences in the community must have their freedom restricted there too.
“These new punishments should remind all offenders that, under this government, crime does not pay.
“Rightly, the public expect the government to do everything in its power to keep Britain safe, and that’s what we’re doing.”
The proposals are part of the Labour government’s efforts to tackle overcrowding in prisons.
Back in June, it emerged that prisoners were to be transferred to lower security jails in an effort to ease overcrowding, as part of a new measure quietly unveiled by the government.
Sky News reported earlier this month how the prison system was close to collapse on a number of occasions between autumn 2023 and summer 2024, according to an independent review by former chief inspector of prisons, Dame Anne Owers.
The report said there was a systemic problem which has led to recurring prison capacity crises over the last 18 years.
Protesters have gathered across the country as groups demonstrated against asylum seeker housing and were met by anti-racism campaigners.
Demonstrations under the Abolish Asylum System slogan were held in England, Scotland and Wales, including in Bristol, Exeter, Tamworth, Cannock, Aberdeen, Mold, Perth, Nuneaton, Liverpool, Wakefield, Newcastle, Horley and Canary Wharf.
Counter-protests were also organised by campaign group Stand Up to Racism.
Police officers scuffle with demonstrators during protests at Castle Park in Bristol. Pic: PA
In Bristol, mounted police separated the two groups in the Castle Park, with officers scuffling with protesters.
Police kept around 200 anti-immigration protesters draped in English flags away from roughly 50 Stand Up to Racism protesters in Horley, Surrey.
People take part in a protest outside the Sheraton Four Points Hotel in Horley, Surrey. Pic: PA
One man, wearing a West Ham United football shirt, was held by police as he yelled: “You’re not welcome here, you’re not welcome here, you’re not welcome here” at anti-racism protesters.
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Anti-immigration protesters also chanted: “Tommy, Tommy, Tommy, Tommy Robinson” in support of the far-right activist, whose real name is Stephen Yaxley-Lennon.
A confrontation between a protester and a counter-protester outside the Sheraton Four Points Hotel in Horley, Surrey. Pic: PA
The anti-racism protesters chanted “say it loud, say it clear, refugees are welcome here” and held signs calling for solidarity and to “stop deportations”.
The Stand Up to Racism protesters were shepherded into a smaller area as they continued to chant: “No hate, no fear, refugees are welcome here”, which was met with “No they’re f****** not” from the other side of the street.
People inside the hotel look at protesters outside the Radisson Hotel in Perth. Pic: PA
In Perth, protesters gathered outside the Radisson Hotel.
The anti-migration protesters held up signs with slogans such as “Perth is full – empty the hotels” and “get them out”.
People take part in a counter-protest outside the Radisson Hotel in Perth. Pic: PA
Stand Up to Racism Scotland said it had achieved “victory” in Perth, with more than 200 gathering to oppose the Abolish Asylum System demonstration.
In Liverpool, a dispersal order was issued to try and contain the protests.
Saturday’s events come amid continued tension around the use of the hotels for asylum seekers.
Regular protests had been held outside the Bell Hotel in Epping, Essex, which started after an asylum seeker housed there was charged with sexually assaulting a 14-year-old girl on 10 July.
Hadush Gerberslasie Kebatu, 38, was charged with trying to kiss a teenage girl and denies the allegations. He is due to stand trial later this month.
In the wake of those protests, Epping Forest District Council sought and won an interim High Court injunction to stop migrants from being accommodated there – a decision which the government is seeking permission to appeal.
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