Four years into the Covid pandemic, the virus continues to evolve rapidly, affecting the UK population and healthcare system. Approximately 1.2 million people in England and Scotland are now estimated to have Covid; the latest significant strain is the JN1 variant of Omicron. Despite lower peaks than in previous years, the virus still causes multiple waves, exacerbated by reduced vaccination scope and emerging variants. Hospitalisations have declined, with fewer than 5,000 weekly admissions in England since early 2023, thanks to vaccine effectiveness. The anti-vax movement has influenced public perception, but vaccines have significantly reduced Covid mortality. Long Covid remains a concern, affecting almost two million people in the UK and adding financial strain to healthcare services. Excess deaths in 2023 were still above the five-year average, indicating ongoing challenges for the NHS, including treatment backlogs. The pandemic has underscored health inequalities and the importance of comprehensive public health strategies. Future measures include seasonal vaccines and improved indoor air quality to combat evolving variants.