The flu comes early and puts hospitals on alert

The flu has come early this season and it is already noticeable in the health system. As of November 16, the estimated incidence, which takes into account detections in Primary Care and the positivity of the tests, was at 82.9 cases per 100,000 inhabitants –65.1 the previous week–, registering three consecutive weeks of increases, according to the latest report published by the Carlos III Health Institute (ISCIII).

This figure is much higher than what was reported, at that same time of the year, both in 2023 (102% more) and in 2024 (77% more), and is interpreted by experts consulted by 65AND MORE, as the head of Immunology at the Virgen de la Arrixaca Hospital, Manuel Muro (@manuelmuro5), or the immunologist and professor at the University of Valencia, Rafael Toledo (@alfwarrior), as a sign of an early start of the epidemic, even with a “low” intensity.

Along these lines, recently, several communities in the north of the country have confirmed this upward trend, such as Galicia, Basque Country, La Rioja, Aragon or Navarra, among others, where the expansion of the virus seems to be increasing and in which it is expected that the peak could arrive for Christmas.

An increase at European level

What’s more, it seems that this is not a specific trend in Spain. According to the latest report of the European Center for Disease Prevention and Control (ECDC) –with data up to November 14–, “the circulation” of the virus at the regional level would be “increasing, continuing a trend that began between three and four weeks earlier than in the previous two seasons.”

At the regional level, the European organization assures, this increase would be driven, in part, by the influenza A(H3N2) strain, subclade K –present in 46% of the samples analyzed in the last week–.

A mutation, which would also have caused increases in other countries in the northern hemisphere, like Japan or the United Kingdom, although this newspaper does not know if, in the Spanish case, this specific ‘variant’ It would also be playing some role in the advancement of the epidemic.

More cases in Primary Care

One of the health services that is most noticing this early start to the season is Primary Care, where, as of November 16, a rate of 33.1 cases/100,000 was recorded (23.9 the previous week) and a positivity of 17.3% of the tests carried out.

As explained to 65AND MORE the spokesperson for the Spanish Society of General Physicians and Family (@SEMG_ES), Lorenzo ArmenterosDuring the last week, the increase in cases, especially of influenza A and other pathologies typical of this time, It would have been remarkable.

“At the syndromic level, the rate of Acute Respiratory Infections is 479.3 cases/100,000 (449.3 cases/100,000 h in the previous week)”, they explain in the ISCIII report.

And this increase would be generating greater pressure on care, with more visits to health centers and out-of-hospital emergencies. In this second case, Armenteros details, respiratory pathologies are “almost 70% of the consultations.”

Regarding the profile of those affected, he details, they are “predominantly younger and unvaccinated people.”

From the civil servants union CSIF (@CSIFnational), they also warn of the beginning of a saturation of the system in certain communities and denounce “the lack of foresight of the administrations to reinforce their staff before the arrival of winter and the respiratory infections associated with this time of year.

“The result is an overload of work that begins to have consequences: Consultations and agendas in Primary Care are already saturatedwith waits of 10 days on average and with peaks of more than 20 days in rural areas or with low population density,” they point out. And they add: “The lack of human reinforcements is also evident in the current flu and covid vaccination campaign, since the same personnel who assume daily assistance in many health centers must make it compatible with vaccination, without additional support.”

Situation in hospitals

On the other hand, although to a lesser extent for now, the increase in cases It is also being felt in hospital emergencies.

The coordinator of Infections in Emergencies of the Spanish Society of Emergency Medicine (@SEMES_), Juan G. Del Castilloconfirms to this newspaper that an increase is already being observed in the number of treatments for respiratory pathology, including the flu.

And even though the rise is still “small”he indicates, the pressure has indeed increased and they are working with the expectation that it will continue to worsen over the next four weeks, until reaching the peak.

Specifically, according to ISCIII data, at the national level, flu hospitalization rate It has gone from 1.2 to 2.4 cases/100,000 in the week of November 10 to 16 and the percentage of test positivity is 18.3% (10.9% in the previous week).

Regarding the people who are coming to this hospital service with flu symptoms, Del Castillo assures that fundamentally They are older than 70-75 years and people with chronic comorbidities (lung, kidney or heart problems).

When to go to the emergency room?

In this sense, the Infections coordinator at SEMES recommends that citizens use the health system in a stratified manner, considering the Primary Care and its emergencies like the first filter.

However, if serious signs occur, such as difficulty breathing, a feeling of shortness of breath, increased respiratory rate, or chest pain that does not subside, you should go to the emergency services as soon as possible. hospital emergencies, qualifies.

Furthermore, if a patient with a known chronic pathology begins to develop symptoms, it is recommended that they contact their doctor to keep a check and adequate monitoring of their health status.

Flu mortality and vaccination

Recently, a team of researchers from ISCIII has shown that the flu caused more than 33,000 hospitalizations in Spain, 1,811 admissions to Intensive Care Units (ICU) and 1,825 deaths between October 2024 and May 2025, becoming the main respiratory virus in the country.

For this reason, the experts consulted remember that the recommendation to avoid complications remains the same as in other seasons: Get vaccinated as soon as possible if you have not already done so, since it can help significantly reduce the risk of serious symptoms or complications during the disease.

The dosage is recommended for the following groups:

• People 60 years of age or older.
• Child population between 6 and 59 months of age.
• People from 5 years to 59 years of age with the following risk conditions:

– inmates in disability centers, nursing homes and closed institutions.

– diabetes mellitus and Cushing’s syndrome; morbid obesity.

– chronic cardiovascular, neurological or respiratory diseases, including bronchopulmonary dysplasia, cystic fibrosis and asthma.

– chronic kidney disease and nephrotic syndrome.

– hemoglobinopathies and anemias or hemophilia, other coagulation disorders and chronic bleeding disorders, as well as recipients of blood products and multiple transfusions.

– asplenia or severe splenic dysfunction; chronic liver disease, including alcoholism; serious neuromuscular diseases.

– immunosuppression.

– cancer and malignant hemopathies.

– chronic inflammatory disease.

– disorders and diseases that lead to cognitive dysfunction.

– celiac disease.

– cerebrospinal fluid fistula, cochlear implant or waiting for it.

• Smoking people.
• All pregnant women in any trimester of gestation and women during the puerperium.
• People of 5-18 years old who receive prolonged treatment with acetylsalicylic acid, due to the possibility of developing Reye’s syndrome after the flu.
• Staff of public and private health and socio-health centers and establishments.
• People who work in essential public services, with special emphasis on the following subgroups: State security forces and bodies, with national, regional or local dependence; Armed forces; firefighters; and civil protection services.
• People who provide home care and cohabitation with patients collected in the previous section.
• Staff and interns in public and private health and social health centers, centers for minors, both primary and hospital care, as well as pharmacy office staff.
• Staff of daycares and centers of early childhood education (up to 6 years old).
• People with direct occupational exposure to animals or to their secretions on farms or farms.

ECDC Recommendations

Likewise, from the European Center for Disease Prevention and Control (ECDC) have made the following recommendations in light of the increase in cases:

• People at higher risk of developing serious illness should get vaccinated without delay, as well as those who work in the health sector or in a nursing home.
• Health centers and nursing homes must reinforce your preparation plans and infection prevention and control measures, as well as encouraging staff and visitors to use masks during periods of increased circulation of respiratory viruses.
• Healthcare professionals should consider immediate administration of antivirals to patients at higher risk of developing severe disease to reduce complications.
• Healthcare professionals should consider the use of antiviral prophylaxis during outbreaks in closed settings, such as nursing homes.
• Countries must promote clear and adapted communication to specific needs on vaccination, hand hygiene and respiratory etiquette to help reduce community transmission.