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 Gap in Care for the Elderly
In his annual report for 2025, Professor Chris Whitty contrasted the well-organised strategies for shielding children and young adults from infectious disease with the often inconsistent care offered to the elderly. He stressed that while tackling infections has driven 'extraordinary improvements in life expectancy over the last 150 years', far more research is urgently needed for the fastest-growing age group.
Data from 2023 in England underscores the severity of the issue: the vast majority of deaths from infectious diseases occurred in older adults, primarily due to respiratory infections or Covid-19. However, Whitty emphasised that the threat extends beyond hospitalisation and severe illness.
Beyond Hospital Wards: Quality of Life at Stake
'Even quite apparently moderately important diseases like cellulitis can lead to very significant quality of life issues for older people,' Whitty stated. He explained that such infections can trap individuals in their homes, cutting them off from social contact.
The report outlines further grave risks for older adults following infection, including an increased risk of stroke after bacterial or viral illnesses. Some evidence also points to a higher chance of heart attacks or other cardiac problems. Furthermore, infections can trigger delirium and are associated with dementia, though it remains unclear if this link is causal or if infections simply accelerate onset.
Personal and Prescription Measures
Whitty highlighted simple but effective actions individuals can take to protect themselves, including rigorous handwashing, careful food preparation, and avoiding visits from people who have recently been unwell.
On medical policy, he advocated for a lower threshold for prescribing antibiotics to older people, despite the need to maintain a 'firm grip' on usage to combat antimicrobial resistance. This is because the risks of a routine infection progressing to life-threatening sepsis are significantly higher in the elderly.
A Wider Public Health Challenge
The report's concerns are not limited to older age groups. It warns that the potential for near-elimination of cervical cancer is at risk if HPV vaccination rates are not maintained. It also notes worrying declines in vaccine uptake among pregnant women and in routine childhood immunisation, with the latter drop particularly acute in London and more deprived areas.
Whitty countered claims of rising vaccine scepticism, stating, 'Absolutely that is not true,' and attributing much of the childhood vaccine drift to practical access issues.
Professor Arne Akbar, Chair of the British Society for Immunology’s immune ageing network at UCL, welcomed the report's focus. He said improving infection management in older age held huge potential to enhance quality of life and relieve pressure on the NHS and social care systems.
Looking ahead, the report cautions that future pandemics are 'entirely predictable' in their occurrence, if not their timing. 'We need to keep our capacity to prevent and respond to infections up between events rather than wring our hands and wish we had done so when they occur,' Professor Whitty concluded.
