As I write this, the most recent heatwave has finally ended. For many people, summer means getting outside and enjoying the sunshine. For people living with Long Covid, PoTS and other disabling conditions, extreme heat can mean something very different: hiding indoors, trying to keep cool and simply getting through the day.
But the weather is not the contradiction I want to talk about.
This summer, we have seen a series of reports, statements and decisions about Covid-19, Long Covid and healthcare worker safety that simply do not add up.
One in four UK healthcare workers is reported to have Long Covid.
Long-term sickness absence among nurses is rising. NHS staff are increasingly applying for early retirement. And the UK Covid-19 Inquiry has documented serious failures in the way healthcare workers were protected during the pandemic.
You might expect all this to lead to stronger infection prevention measures.
Instead, we are seeing Covid-19 protections are being downgraded.
How does that make sense?
A report from the NHS Race and Health Observatory states that 25% of UK healthcare workers have Long Covid, with nurses and allied health professionals twice as likely to develop it as doctors.
Think about that.
One in four.
Long Covid can leave healthcare workers struggling to remain in work or unable to work at all. At the same time, an RCNi investigation has highlighted increasing long-term sickness absence among NHS nurses, while more than 27,000 nurses and midwives left the profession last year (see: https://londondaily.com/numbers-of-nurses-and-midwives-leaving-nhs-highest-for-four-years).
The NHS has a workforce crisis.
Surely preventing avoidable illness among the staff we already have should be an urgent priority (as well as a moral imperative)?
The UK Covid-19 Inquiry has documented how healthcare workers were inadequately protected during the pandemic. Module 3 identified serious problems with infection prevention and control (more information available here); Module 4 added further evidence about the experiences of healthcare workers.
These findings should have triggered urgent action.
Instead, we seem determined to repeat the mistakes of the past.
The Department of Health and Social Care has told SHH-UK that NHS England agrees infection prevention strategies should be guided by the latest evidence and that the safety of NHS staff, patients and visitors remains a priority.
It also told us that the recommendations of the Covid Inquiry’s Module 3 report are being carefully considered.
But responsibility for the relevant decisions was pointed towards UKHSA – and we are still waiting for a response to the letter we, along with 29 other organisations, sent Professor Susan Hopkins in January 2026.
They have the evidence. Where is the action?
This is not a new argument.
In August 2022, concerns about respiratory protection were raised directly with two senior NHS England nursing and infection prevention leaders – one of whom is now Chief Nursing Officer (CNO) for England.
According to notes made following that meeting, the person responsible for national IPC guidance at the time argued that there was little point protecting healthcare workers from Covid-19 at work because they could become infected elsewhere.
SHH-UK has also repeatedly written to the four UK CNOs and met with them in December 2024 to present the evidence. (The report sent to the CNOs ahead of this meeting can be found here. Our latest letter to the CNOs is available here.)
We know that SARS-CoV-2 is airborne, we know about the impact of repeated infections, and we know about Long Covid.
So why are we still having essentially the same argument?
The latest contradiction is perhaps the most difficult to understand. NHS Scotland and NHS Wales have downgraded the danger posed by Covid-19 within their infection prevention guidance, with surgical masks recommended for staff protection in relevant circumstances (Figure 1).
Yet surgical masks and respirators are not interchangeable pieces of equipment.
Surgical masks are loose fitting. Respirators are designed to filter inhaled airborne particles and, when properly fitted, form a seal around the face.
And there is evidence supporting better protection from respirators.
A 2021 systematic review and meta-analysis involving 9,164 participants found N95 respirator use was associated with fewer viral infections among healthcare workers than surgical masks, including a substantial difference for SARS-CoV-1 and SARS-CoV-2 infection. Read the systematic review and meta-analysis
This major 2024 review, drawing on more than 100 published reviews and selected primary studies, concluded that masks reduce respiratory infection transmission when worn correctly and consistently, but that respirators are significantly more effective than medical or cloth masks. Read the narrative review and meta-analysis
And a major 2025 state-of-the-art review in The BMJ concluded that the evidence suggests respirators are more effective than masks in healthcare, particularly when worn continuously rather than only during selected procedures. The authors also highlight that healthcare environments can amplify outbreaks and that exposure is not restricted to so-called aerosol-generating procedures. Read the BMJ review on masks and respirators
So, who is actually responsible for ensuring healthcare workers are protected?
And, more importantly, when will somebody act?
In the words of an experienced health and safety consultant:
“The people responsible for these decisions are condemning future generations of healthcare workers to Long-Covid. Their incompetence and willingness to inflict harm on other human beings is nothing less than criminal.”
We know SARS-CoV-2 can spread through the air.
We know healthcare workers have been disproportionately affected by Long Covid.
We know experienced NHS staff are being lost to long-term sickness and early retirement.
We have an Inquiry documenting failures in infection prevention and control.
We have evidence supporting respirators as a way of reducing exposure to respiratory viruses.
Yet we are downgrading protection against Covid-19.
SARS-CoV-2 has not suddenly stopped being airborne.
A surgical mask has not suddenly become a respirator.
Long Covid has not disappeared.
And healthcare workers have not become expendable.
Healthcare workers cared for us through the pandemic.
Thousands are now living with its consequences.
We cannot claim that NHS staff are our greatest asset while accepting preventable infection as an inevitable part of their job.
We cannot talk about NHS workforce retention while failing to address a workplace hazard capable of removing staff from that workforce.
And we cannot say our policies are evidence-based while ignoring evidence that challenges them.
How many more nurses, doctors, allied health professionals, healthcare assistants and other staff have to become ill before preventing infection becomes the priority?
The evidence is there.
The harm is happening.
Enough reports. Enough contradictions. It is time to act.
A large US study of almost 2,000 children and adolescents found that those meeting the research threshold for probable Long COVID were more likely to experience difficulties with grades, attention and participation with friends.
Press release: One in four UK healthcare workers has Long Covid, yet Covid protections are being downgraded. SHH-UK calls for evidence-based prevention.
As Long Covid affects one in four UK healthcare workers, Covid protections are being downgraded. The evidence is clear. Why are we failing to act?
