About this release

This is a weekly release by Public Health Scotland (PHS) on epidemiological information on seasonal respiratory infection activity in Scotland including COVID-19.

Since the beginning of the COVID-19 pandemic, health care services have functioned differently now compared to previous winter respiratory seasons, so the consultation rates are not directly comparable to historical data.

Main points

Overall assessment for week 20 (week ending 21 May 2023):

  • The proportion of NHS24 calls that were for respiratory symptoms in week 20 remained at Baseline activity level.
  • Influenza remained at Baseline activity level (0.5 per 100,000 population). There were 26 laboratory-confirmed influenza cases: nine type A (not subtyped) and 17 type B. This compares to 36 laboratory-confirmed cases reported during week 19.
  • Adenovirus and rhinovirus remained at Low activity level. Parainfluenza decreased from High to Low activity level.
  • In the CARI sentinel surveillance programme, rhinovirus was the most detected pathogen with a swab positivity of 20.5%. SARS-CoV-2 positivity decreased to 3.1%. Parainfluenza decreased to 10.3% in week 20 from a peak of 18.9% in week 19.
  • The overall number of emergency hospital admissions associated with RSV, influenza and SARS-CoV-2 has decreased from the high plateau seen in weeks 51 and 52. The largest proportion of admissions in week 19 2023 (89%) was for SARS-CoV-2, with the individual number of admissions for SARS-CoV-2, influenza and RSV showing a decrease.
  • During the period 26 April 2023 to 09 May 2023 wastewater COVID-19 levels were in the range of 14 to 24 Mgc/p/d.
  • In the most recent week ending 21 May 2023, on average there were 161 patients in hospital with COVID-19.
  • During the current spring COVID-19 vaccination programme, a total of 383,178 COVID-19 vaccines have been delivered to eligible adults currently resident in Scotland.


Surveillance of respiratory disease pathogens is a key public health activity as infection is associated with appreciable levels of morbidity and mortality, especially during the winter months and particularly among those at risk of complications, including the elderly, children under two years of age, those with chronic health problems, and pregnant women.

Respiratory infection can be caused by a number of pathogens and there is no single surveillance system or data source that can describe the onset, severity and impact of SARS-CoV-2, influenza and other respiratory pathogens, or the success of any control measures. In Scotland, respiratory infection levels and their impact are monitored using various sources of data, including microbiological sampling and laboratory test results from community and hospital settings, NHS 24 calls, primary care consultations, and hospital (including intensive care) admissions. The intelligence generated from these different data sources provide a comprehensive picture of current respiratory illness in Scotland.

Seasonal patterns and variations

Many respiratory illnesses, including influenza, are typically associated with a seasonal increase in the autumn and winter. These seasonal patterns have been established based on many years of surveillance data. However, in some cases, circulation of these pathogens have deviated from their usual seasonal trends due to changes in social mixing patterns during the COVID-19 pandemic.

As yet, SARS-CoV-2 has not been shown to follow the same seasonal patterns as other respiratory pathogens. Increases in infections outside the winter season may be occurring for a variety of reasons, including the emergence of new variants and time-varying fluctuations in population immunity associated with SARS-CoV-2 infection.   

Further information

The next release of this publication will be 1 June 2023.

PHS is moving to dashboard only updates for respiratory infection and COVID-19 surveillance on a weekly basis and are reducing the frequency of the accompanying narrative report to monthly. This approach aligns to the pre-pandemic one for respiratory pathogens, which typically follow a seasonal pattern with most cases occurring between October and May. PHS will continue to monitor COVID-19 and other respiratory infection levels and reinstate the weekly narrative report before 05 October 2023 if necessary. A written report will accompany the dashboard update on 22 June, 20 July, 17 August and 14 September 2023.

Find out more

Previous Publications

Versions of the Weekly national respiratory report publication released before 30 November 2022 may be found on the Public Health Scotland website

Versions of the COVID-19 weekly statistical report publication released before 30 November 2022 may be found on the Public Health Scotland website

Open data

Open data from this publication is available from the following weblinks:

Further data

General enquiries

If you have an enquiry relating to this publication, please email phs.flu@phs.scot.

Media enquiries

If you have a media enquiry relating to this publication, please contact the Communications and Engagement team.

Requesting other formats and reporting issues

If you require publications or documents in other formats, please email phs.otherformats@phs.scot.

To report any issues with a publication, please email phs.generalpublications@phs.scot.

Older versions of this publication

Versions of this publication released before 16 March 2020 may be found on the Data and Intelligence, Health Protection Scotland or Improving Health websites.

Last updated: 29 May 2023
Was this page helpful?