England's chief medical officer has issued a stark warning that the prevention and management of infections in older people is currently "hit and miss", demanding a more systematic approach to protect the UK's ageing population.
A Systemic Failure for an Ageing Society
In his annual report for 2025, Professor Chris Whitty contrasted the well-organised strategies for shielding children and young adults from disease with the inconsistent care often received by the elderly. He stressed that while tackling infections has driven extraordinary improvements in life expectancy over the last 150 years, far too little research has focused on the unique challenges faced by older adults.
Data from 2023 for England underscores the urgency. It reveals that the vast majority of deaths from infectious diseases were among older adults, with respiratory infections and Covid being the primary culprits. Deputy chief medical officer Dr Thomas Waite defended recent changes to Covid booster eligibility, while Whitty emphasised that the current priority is encouraging uptake of other vital jabs, including the new RSV vaccine.
Beyond Hospitalisation: The Hidden Toll on Quality of Life
Professor Whitty explained that the threat extends far beyond severe illness and hospitalisation. Even moderately serious infections like cellulitis can devastate an older person's quality of life, potentially trapping them at home and cutting them off from social contact.
The report outlines further grave risks, including an increased likelihood of stroke following bacterial or viral infections. Some evidence also points to a higher risk of heart attacks. Furthermore, infections can trigger delirium, and severe cases are associated with dementia, though it remains unclear if this link is causal or if infections simply accelerate its onset.
Individual Action and a Call for Research
Whitty outlined simple but effective steps individuals can take to protect themselves and others. These include meticulous handwashing, careful food preparation, and avoiding visits to vulnerable people while unwell.
On antibiotics, Whitty called for a balanced approach. While maintaining a "firm grip" on prescriptions is crucial to combat antimicrobial resistance, doctors should have a lower threshold for prescribing them to older patients due to their much higher risk of infections progressing to sepsis.
The report's focus on ageing was welcomed by immunology experts. Professor Arne Akbar, chair of the British Society for Immunology’s immune ageing network at UCL, said better infection management in later life holds huge potential to improve wellbeing and ease pressure on the NHS and social care.
While centred on elderly care, the report also sounded alarms on other fronts. It warned that the potential near-elimination of cervical cancer is threatened by slipping HPV vaccination rates. It also noted declining vaccine uptake among pregnant women and in childhood immunisation programmes, a trend especially acute in London and more deprived areas. Whitty rejected claims the UK is becoming vaccine-sceptical, attributing much of the drop to practical access issues.
The report further highlighted a rise in imported infections like malaria over the past decade, stressing the need to retain UK expertise in tropical diseases. Looking ahead, Whitty concluded that while the timing of future pandemics is unpredictable, their occurrence is not, urging sustained investment in preparedness.
