People who are infected with the flu and Covid-19 are twice as likely to die as those with just coronavirus, Public Health England has warned.

As the country braces itself for a demanding winter in which influenza and coronavirus will circulate at the same time, research from PHE has found that people with both conditions between January and April were at greater risk of severe illness.

It also found the majority of those cases involved older people, with over half dying.

PHE said the NHS was preparing to offer a free flu vaccination to a record 30 million people this winter as concerns over the impact of flu and Covid on an already strained health system increase.

For the first time, pharmacies can offer vaccinations to residents and care home staff which PHE said will “help increase uptake in the social care sector.”

PHE medical director Dr Yvonne Doyle said: “It is dangerous to dismiss influenza as ‘just’ the flu – it can be extremely serious and can lead to hospitalisation, permanent disability or even death.

“The flu vaccine is more important than ever to help reduce transmission of flu and protect the nation from the double threat of flu and Covid-19.”

Dr Nikita Kanani, medical director of primary care for NHS England and Improvement, said: “My frontline NHS colleagues across England are working harder than ever to prepare for winter, including expanding and adapting services to ensure people can get the care and vaccinations they need safely and conveniently.”