Covid-19, strep A and flu are all having a serious impact on UK health services

Wales is dealing with a "tripledemic" — rising rates of coronavirus, record levels of strep A/scarlet fever cases, and a winter flu season which has arrived earlier than usual.

The Welsh NHS Confederation has described demand on the system as "relentlessly high". Call volumes to the NHS Wales 111 helpline have increased by a record 300% And one Welsh health board — Betsi Cadwaladr in north Wales — has declared a critical incident and cancelled all but the most urgent operations, partly because of these three infectious illnesses spreading through communities.

The NHS has provided a list of the symptoms of each of the three illnesses. If you are worried that you or a loved one might have one of the infections, here are the symptoms you should know about:

Covid-19
a high temperature or shivering (chills) – a high temperature means you feel hot to touch on your chest or back (you do not need to measure your temperature)
a new, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours
a loss or change to your sense of smell or taste
shortness of breath
feeling tired or exhausted
an aching body
a headache
a sore throat
a blocked or runny nose
loss of appetite
diarrhoea
feeling sick or being sick.
The NHS describes the symptoms as "very similar to symptoms of other illnesses, such as colds and flu". If you have Covid symptoms and either have a high temperature or do not feel well enough to do normal activities or go to work (or in the case of children, their educational setting), then try to stay home and avoid contact with others. Get help from NHS 111 if you're worried about your symptoms or you're not sure what to do.

How long is it contagious?
You should: try to stay at home and avoid contact with other people for . avoiding meeting people at higher risk from COVID-19 for 10 days, especially if their immune system means they're at higher risk of serious illness from COVID-19, even if they've had a COVID-19 vaccine.

Strep A
flu-like symptoms, such as a high temperature, swollen glands or an aching body
sore throat (strep throat or tonsillitis)
a rash that feels rough, like sandpaper (scarlet fever)
scabs and sores (impetigo)
pain and swelling (cellulitis)
severe muscle aches
nausea and vomiting.
Most strep A infections are not serious and can be treated with antibiotics, but in rare cases they can cause serious problems. This is called invasive group A strep (iGAS). It is important to get an urgent GP appointment or get help from NHS 111 if:

your child is unwell and is getting worse
your child is feeding or eating much less than normal
your child has fewer wet nappies than usual or is peeing less than usual, or shows other signs of dehydration
your baby is under 3 months and has a temperature of 38C, or is 3 to 6 months and has a temperature of 39C or higher
your child is very tired or irritable.
The NHS says: "If your child does not seem to be seriously ill, you can usually look after them at home. They should feel better in a few days. If they're uncomfortable, you can give them children's paracetamol or children's ibuprofen. Check the leaflet to make sure the medicine is suitable for your child and to see how much to give them. A pharmacist can give you advice about how to ease your child's symptoms and whether you need to see a doctor."

The guidance adds: "If you or your child has a strep A infection, you should stay away from nursery, school or work for 24 hours after you start taking antibiotics. This will help stop the infection spreading to other people. Serious strep A infections (invasive group A strep, iGAS) need to be treated in hospital with antibiotics." Sign up for our Covid newsletter here

How long does strep throat last?
Strep throat typically resolves in three to five days if untreated. Despite the short duration, antibiotic treatment is recommended to reduce the risk of complications. Symptoms typically resolve within one to three days following the start of antibiotics.

Flu (influenza)
a sudden high temperature
an aching body
feeling tired or exhausted
a dry cough
a sore throat
a headache
difficulty sleeping
loss of appetite
diarrhoea or tummy pain
feeling sick and being sick.
The NHS adds that flu symptoms are similar for children, but they can also get pain in their ear and appear less active. Ask for an urgent GP appointment or get help from NHS 111 if you or your child have symptoms of flu and:

you're worried about your baby's or child's symptoms
you're 65 or over
you're pregnant
you have a long-term medical condition – for example, diabetes or a condition that affects your heart, lungs, kidneys, brain or nerves
you have a weakened immune system – for example, because of chemotherapy or HIV
your symptoms do not improve after 7 days.
If you want to know more about the impact the three infections are having on Wales, you can read more here.

How long does the flu last?
The symptoms of flu usually develop within 1 to 3 days of becoming infected. Most people will feel better within a week. However, you may have a lingering cough and still feel very tired for a further couple of weeks.

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