Watch: Viruses and coronavirus could leave NHS 'unable to cope'
As many as 60,000 people could die from flu this winter and a combination of seasonal viruses and COVID-19 could leave the NHS "unable to cope", according to a report.
The stark warning was made by scientists who say the flu season could be particularly deadly but the enhanced flu jab programme and rapid tests for flu could help to mitigate the risks.
COVID-19 restrictions meant that many respiratory viruses were not able to spread last winter as they normally would and this has concerned some virologists who say population immunity to seasonal respiratory illnesses might be compromised.
As people socialise more these viruses will spread again.
The new report from the Academy of Medical Sciences says flu and RSV (respiratory syncytial virus) hospital admissions and deaths could be twice that seen in a "normal" year and could coincide with an increase in COVID-19 infections.
Professor Sir Stephen Holgate, chair of the Expert Advisory Group which wrote the report, said: "There are four main challenges: firstly a surge in respiratory viruses could cause wide-spread ill health and put pressure on the NHS.
"Secondly, we're dealing with a third wave of COVID-19 and multiple outbreaks and the NHS has got to catch up with the backlog that it has accumulated over the last 15 months or so, and that's going to be a real challenge.
"Thirdly, the NHS is already under pressure, so is likely not to be able to cope with these winter challenges going forward.
"Finally the worse physical and mental health within the UK population due to the pandemic."
He added: "Society as a whole will have learned from the last 15 months that it isn't acceptable that (we had) all these respiratory viruses washing around in the winter and nearly closing our National Health Service.
"If there are things we should do to prevent transmission we should do that. Even if it means wearing masks and respecting each other's space.
"We really do deserve to have a change in the way we operate as a society to stop the annual continual pressure on the health service created by all these viruses and that just means a change in behaviour."
And due to the current wave of infections the NHS could face difficulties trying to catch up on the backlog of care - with more than five million people in England on the waiting list.
The report highlights other problems that the health service faces going into winter including staff shortages and reduced bed capacity.
On top of this, people putting off seeking help for illness could also lead to a rise in support needed for conditions such as asthma, heart attack and stroke this winter.
They also called for the expansion of COVID-19 testing to also include tests for flu and RSV - for instance if GPs were able to quickly confirm whether a patient has flu they would be able to prescribe their antiviral medication sooner which means that the person's illness would be reduced, and lessen the burden on the NHS.
Professor Dame Anne Johnson, president of the Academy of Medical Sciences and Expert Advisory Group member, added: "We're not saying we're about to have the worst winter ever, we're saying we have got a bunch of uncertain things that could hit us in winter that we need to think about mitigating now."
She added: "I hope we will take forward some of these behavioural changes as a society. When you're sick, stay out of the way because that's actually when you're most infectious, get your test - if you have got COVID you need to continue with that careful self isolation."
Dame Anne said that the flu figures are "uncertain" and the 60,000 figure is an "an unlikely worst case scenarios", adding" flu is horribly unpredictable".
Professor Azra Ghani, Expert Advisory Group member, added: "We have never experienced this type of thing where society has really shut down and really reduced transmission to this extent. It's very difficult to know what impact this will have.
"It's really just a warning to say 'we can do something about this , this isn't an inevitable, we can put measures in place and reduce the impact'."
The report's authors think the flu season could come earlier than usual because of the lack of immunity but say this could actually be beneficial as there is more pressure on the NHS further into the winter.
Sir Patrick Vallance commissioned the report to examine the challenges facing the NHS this winter.
In addition to a deadly winter flu surge the study warned the health service is already under pressure and will struggle to cope with these additional winter challenges as it faced a shortage of beds and trained staff.
But the reports authors stressed the predictions are based on a worst case scenario with no interventions.
A faster vaccine rollout, the autumn booster campaign and increased testing capacity for COVID and flu will help significantly in reducing the impact of these extra pressures on the NHS.
Watch: What you need to know about COVID-19 variants