EXPERTS have warned that there is "a lot of uncertainty" over the impact of flu on the health service this winter.
Although the virus is widely expected to make a resurgence after virtually disappearing during the pandemic, signals from Australia suggest that the major strains in circulation may be less deadly compared to previous winters.
The vaccine is also believed to be a "good match".
However, scientists also cautioned that waning immunity could result in a flu season "as bad as some of the previous bad years".
ANALYSIS: What can Australia's experience tell us about what to expect?
Professor Sir Peter Horby, an expert in infectious diseases and director of the Pandemic Sciences Institute at Oxford University, said a lack of immunity due to prior exposure "means there may be slightly more transmission than usual and slightly more susceptibility to severe disease than usual".
He added: "There's certainly a lot of uncertainty but there is a possibility that we could have a worse season in terms of overall numbers of cases and potentially admissions to hospital.
"It may not be worse than previous years but there's the potential that it could be as bad as some of the previous bad years."
It comes as the latest data for Scotland shows that the current incidence rate, based on laboratory-confirmed cases, is low but around three times higher than normal for the time of year.
The number of cases detected last week - 183 - had barely changed from 187 in the previous week, however.
The number of hospital patients testing positive for flu - 88 in the week ending October 23 - compares to fewer than 10 at the same time last year but is "lower than that for the five previous seasons prior to the Covid-19 pandemic", according to Public Health Scotland.
READ MORE: NHS preparing for 'significant excess deaths' this winter
In Australia, the influenza season took off much earlier than normal and peaked in June.
In total, its surveillance programme has reported 225,332 cases and 308 deaths since April, with a median age of 82.
However, the case-fatality ratio - the number of deaths reported for every known infection - is around half what it was in 2017, when 745 Australians died.
Scientists said it is unclear whether this indicates a milder virus, behavioural changes, or a lag in identifying flu's impact - for example through excess mortality.
Dr John McCauley, who was until the end of September this year the director of the WHO Collaborating Centre for Influenza at the Francis Crick Institute, said colleagues in Australia had described the 2022 flu season as "moderate".
"Other indicators rather than just the numbers of cases were not particularly high," he said.
"The number of cases were higher. I don't know if that was due to testing - it wasn't over-testing, just more testing. But the number of deaths was low.
"Bear in mind though that counting excess deaths is not a trivial thing.
"It usually takes some months before you retrospectively work out how many winter deaths there were."
Dr McCauley added: "The feeling was that the elderly were doing some voluntary isolation off the back of corona, so they weren't really exposing themselves to the risk of infection so much."
READ MORE: Something strange has happened to cancer during the pandemic - but it's probably not what you expect
Prof Horby said the severity of any flu season is "very hard to predict".
He said: "Obviously it's the elderly who are at most risk of severe disease, and it may be that a smaller proportion [of elderly adults in Australia] were exposed than in previous years.
"It can also depend on levels of vaccine coverage, the match between the vaccine and the circulating strain, and how that strain relates to previous exposures.
"So it is very difficult to predict."
Why are you making commenting on The Herald only available to subscribers?
It should have been a safe space for informed debate, somewhere for readers to discuss issues around the biggest stories of the day, but all too often the below the line comments on most websites have become bogged down by off-topic discussions and abuse.
heraldscotland.com is tackling this problem by allowing only subscribers to comment.
We are doing this to improve the experience for our loyal readers and we believe it will reduce the ability of trolls and troublemakers, who occasionally find their way onto our site, to abuse our journalists and readers. We also hope it will help the comments section fulfil its promise as a part of Scotland's conversation with itself.
We are lucky at The Herald. We are read by an informed, educated readership who can add their knowledge and insights to our stories.
That is invaluable.
We are making the subscriber-only change to support our valued readers, who tell us they don't want the site cluttered up with irrelevant comments, untruths and abuse.
In the past, the journalist’s job was to collect and distribute information to the audience. Technology means that readers can shape a discussion. We look forward to hearing from you on heraldscotland.com
Comments & Moderation
Readers’ comments: You are personally liable for the content of any comments you upload to this website, so please act responsibly. We do not pre-moderate or monitor readers’ comments appearing on our websites, but we do post-moderate in response to complaints we receive or otherwise when a potential problem comes to our attention. You can make a complaint by using the ‘report this post’ link . We may then apply our discretion under the user terms to amend or delete comments.
Post moderation is undertaken full-time 9am-6pm on weekdays, and on a part-time basis outwith those hours.
Read the rules here