It’s now five years since the start of the COVID pandemic, but the contagious respiratory virus is still prevalent in the UK.
NHS England data shows hospitalisations with the virus rose by 15% in the last week of August, and confirmed cases in the seven days to 10 September increased by 7.6%.
If you do get COVID, then, you may wonder why some people seemingly in good health can be knocked flat, while others bounce back quickly.
Some studies are underway to explore how different factors, like the immune system, might explain differences in how people respond, but other factors can also affect how ill you get.
We spoke to a COVID expert to find out more.
Do you need to worry about new variants?
New variants of COVID, such as Stratus, are constantly emerging. But, according to David Matthews, Professor of Virology at the University of Bristol, this is nothing to be unduly concerned about.
“The virus is constantly evolving, and I would expect it to continue to evolve,” he tells Yahoo UK. “There are new variants, but there’s nothing truly novel happening at this point in time.”
He suggests that it appears COVID is beginning to show a “standard pattern” much like flu or RSV, “peaking in the winter and fading off over the summer.”
He adds: “There are levels of how well your immune system is trained to fight the virus. So when the virus first emerged back in 2020, nobody’s immune system had ever seen anything like it.
“So everyone’s immune system was learning from scratch how to defeat this thing. Whereas now, that’s not the case.”
Why does COVID affect people differently?
When it comes to why two people of general good health can have different experiences with the virus, Matthews says there are a few things at play. But a lot comes down to the amount of virus you’re exposed to at the start.
“You might catch it because somebody yesterday sneezed, and some of that landed on a keyboard, and then a day later, you touch that keyboard,” he explains. “The dose you get will be a small amount… enough perhaps to start the infection.”
On the other hand, he adds, “somebody might cough as they’re getting onto a bus, and then you walk into the aftermath of that cough and basically breathe it all in… you’ve got a much, much higher dose. That can mean the difference between feeling a bit sniffly to feeling really quite ill.”
He likens it to a military invasion: “If you have only one landing site, and you don’t land many troops. You’ve got a lot of work to do… If you have dozens of landing sites and thousands of troops on day one, then your invasion is going to be much easier, and it’s going to be much harder to push that back.”
As of September, COVID cases in the UK remain relatively low, although fewer people are testing. (Getty Images)
How can you reduce the chance of getting COVID?
There’s no guarantee you’ll stay free of COVID, which can cause a temperature, sore throat, runny nose, and other symptoms, but doing simple things can make a difference.
COVID boosters
Vaccination, Matthews stresses, is still one of the best tools for stacking the odds in your favour.
“One of the purposes of the yearly vaccines is to give your immune system a quick refresher, a quick retrain, so that it is as ready as it can be for when it does encounter the real thing,” he says.
“What the vaccine does, not only when you get it the first time, but every time you get a boost, is that it massively stacks the odds in your favour.”
While a vaccine doesn’t guarantee you won’t get COVID, the NHS states that it can reduce your risk of getting severe symptoms and help you recover more quickly if you do catch the virus.
Who can get the booster?
The UK’s vaccine advisers have updated their guidance on who should get a Covid jab this autumn, with the focus now on those most at risk of serious illness.
For autumn 2025, the booster will be offered to:
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Everyone aged 75 and over
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People living in care homes for older adults
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Anyone aged six months and over with a weakened immune system
That’s a change from last year’s rollout, which also covered 65 to 74-year-olds and all children and adults in clinical risk groups.
Wash your hands
When it comes to prevention, Matthews says washing your hands regularly is one of the most straightforward steps you can take.
He stresses you don’t need antibacterial gels to be effective. “The biggest effect you’re getting [by washing] is just getting the virus off your hands.”
Aimi Dickinson, Deputy Superintendent Pharmacist at Boots, adds: “Washing your hands remains one of the easiest and most effective ways to protect yourself and others from illnesses and viruses such as colds, flu and COVID-19. I encourage everyone to remember the good hygiene habits we learned so well during the pandemic to stay as healthy as we can this winter.
“Best practice is washing your hands using warm water and soap for at least 20 seconds or, if you do not have immediate access to soap and water, to use an alcohol-based hand sanitiser.”
Frequently washing your hands is still key to keeping COVID at bay. (Getty Images)
Who’s still at higher risk?
While the virus can hit anyone, Matthews reminds us that “anybody who’s at risk from things like flu, RSV will potentially be at risk from COVID.”
According to NHS guidance, people most at risk of becoming seriously ill from COVID-19 include those with:
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Weakened immune systems – for example, from conditions like Down’s syndrome, or certain autoimmune or inflammatory conditions like rheumatoid arthritis.
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Cancer and blood disorders – including people with blood cancers, sickle cell disease, or those undergoing cancer treatment.
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Organ or tissue damage – such as chronic kidney disease, severe liver disease, or those who’ve had an organ transplant.
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Serious neurological or lung conditions – including motor neurone disease, multiple sclerosis, Parkinson’s, some types of dementia, or long-term lung problems.
For the full list of conditions, the NHS advises checking its latest COVID guidance.
For people in these groups, Matthews stresses, keeping vaccinations up to date and practising good hygiene is especially important.
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