Oxfordshire's director of public health has warned that flu could have a greater impact than Covid this winter during a plea for people to get vaccinated against both.
Ansaf Azhar addressed the county's Health Improvement Partnership board with a health protection update this week.
He said the absence of Covid restrictions, which had also helped to quell flu over the past two winters, would contribute to pressure on the NHS and that "we have certainly seen evidence" of a flu "surge" in other parts of the world.
"We keep an eye on what is happening in the rest of the world and often we keep an eye on Australia where there has been a significant surge in flu," he said.
"The expectation is that we will see a surge in flu over here as well, particularly as we haven't been hit by flu over the past couple of years and the immunity will have worn off.
"In some ways, I am actually more concerned about the impact of flu.
"Vaccinations against flu are on offer, please go and get your vaccination. This is the time to do it before we see an uptick in case rates, protect yourselves, your families and vulnerable groups.
"We are at that point, the end of September going into the autumn season where we see respiratory illnesses going up. We are not going to see measures being introduced to curtail that, we can't be doing that so it is really important to take the protective measures that are offered to us."
Mr Azhar also confirmed that Covid cases are rising, particularly in children since they have returned to schools over the past month.
"One of the things I am keen not to do is give a running commentary about what Covid rates are," he said.
"The reality is we are going to have to live with this for a long time to come and we will see fluctuations during that.
"We know that case rates are expected to increase as we approach winter and we are certainly seeing signs of that.
"While we are not doing mass testing, we can see some of the trajectory, particularly from ages seven to 11, we are seeing an uptick now schools have started and that is not unexpected.
"The important thing I want to focus on is not about the data or the fluctuation in case rates that we're seeing, it is how we can protect ourselves.
"There is not much we can do about the fluctuation in case rates that we are seeing but there are things we can do to reduce the risk of transmission.
"We know the winter is going to be a difficult one this year, not just because of Covid but other respiratory illnesses, particularly flu.
"I think it is really important that we take up the offer of vaccination. Covid booster programmes have started, if you have been contacted, please, please take up the offer."