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Content ArticleThe Covid-19 Inquiry published its third report and recommendations following its investigation into ‘the impact of the Covid-19 pandemic on the healthcare systems of the United Kingdom’ on Thursday 19 March 2026. It examines the governmental and societal response to Covid-19 as well as dissecting the impact that the pandemic had on healthcare systems, patients and healthcare workers. Recommendations There are many lessons to be learned from the experiences of the UK’s healthcare systems during the Covid-19 pandemic and many areas for improvement. The Inquiry has made 10 recommendations and considers them all to be necessary to prevent healthcare systems being overwhelmed in the next pandemic: Recommendation 1: Ensure that decision-making on infection prevention and control is underpinned by clear structures and a cautious approach to transmission risk The UK government must ensure that there is a body (equivalent to the UK Infection Prevention and Control Cell) in place ready to be convened at the outset of any future pandemic, to consider and draft infection prevention and control guidance for healthcare settings. This body must: have clear lines of responsibility and a clear, pre-defined role and remit during a pandemic have multidisciplinary membership, including experts in the science of viral transmission as well as those with clinical expertise ensure that its guidance accounts for the risk of all plausible routes of transmission until sufficient evidence emerges to rule out specific routes ensure that guidance clearly explains the underlying rationale for the precautions recommended. Separately, the Department of Health and Social Care, NHS National Services Scotland, Public Health Wales and the Public Health Agency (Northern Ireland) should review the national infection prevention and control manuals and any future guidance to ensure that the approach to identifying risk of transmission is not confined solely to specific procedures. Emphasis should be placed on a combination of risk factors, such as rates of transmissibility, environment, setting and procedure. Recommendation 2: Guidance for visiting restrictions The UK government, Scottish Government, Welsh Government and Northern Ireland Executive should publish guidance for the implementation of visiting restrictions in hospitals in the event of a future pandemic. The guidance should identify the circumstances in which visiting restrictions should be introduced, escalated, decreased and removed alongside the measures and exemptions at each level. The guidance should be led by the following core principles: Measures applied should be the least restrictive possible, both in terms of severity and the length of time for which they apply. Restrictions should be decided upon and applied at the most local level possible. Unless restrictions are applied at a specified level, trusts and health boards should take decisions on the severity of restrictions based on local risk assessments. Communications with the public must clearly explain the measures in place and the reasons why restrictions apply. The guidance should be reviewed every three years in line with the Inquiry’s Module 1 Report (Recommendation 4) Recommendation 3: Better preparation for fit-testing The UK government, Scottish Government, Welsh Government and Northern Ireland Executive should work with employers, including health boards and trusts, to review the availability of qualified fit testers and take steps to increase the number of fit testers accordingly. Availability should be reviewed every three years in line with the Inquiry’s Module 1 Report (Recommendation 4). The Health and Safety Executive and the Health and Safety Executive for Northern Ireland should update their guidance to employers to emphasise the need to ensure that sufficient fit-testing capacity is available. Recommendation 4: Improve data systems to identify individuals at high risk during a pandemic The UK government, Scottish Government, Welsh Government and Northern Ireland Executive must ensure that health data and digital systems have the capability to identify individuals at high risk of morbidity or mortality from a pandemic disease quickly and accurately in a future pandemic. This should include action to improve health data systems and patient record-keeping by: improving patient data by enabling more granular diagnostic coding ensuring that care records are compatible across primary and secondary care enabling secure data-sharing and linkage across multiple health datasets and systems for identifying individuals at high risk. Recommendation 5: Prepare to scale up urgent and emergency care capacity The UK government, Scottish Government, Welsh Government and Northern Ireland Executive, in conjunction with organisations responsible for delivering services, should plan for surge capacity in urgent and emergency care during a pandemic. Plans must ensure that there is sufficient workforce capacity and the ability to surge, including the number and type of staff required, recruitment and training provision. This should be completed as part of the whole-system civil emergency strategy recommended in the Inquiry’s Module 1 Report (Recommendation 4). Plans should be published and subject to review every three years. Recommendation 6: Prepare for and test the ability to scale up hospital capacity The UK government, Scottish Government, Welsh Government and Northern Ireland Executive should work with trusts and health boards to ensure that pandemic plans include practical steps to rapidly scale up hospital capacity to treat acutely unwell patients. This should include critical care services that can deliver multiple levels and types of organ support. It should also cover necessary equipment, supplies, space and staff, including redeployment and training. All trusts and health boards must keep an easily accessible, up-to-date record of the information needed to implement these plans in the hospital sites they operate. This should include technical aspects of critical care expansion such as power, ventilation, oxygen and waste management systems. Plans for expanding capacity should be published, subject to review every three years and tested as part of the pandemic response exercises recommended in the Inquiry’s Module 1 Report (Recommendation 6). Recommendation 7: A framework to guide the allocation of intensive care resources in the extreme event of saturation The UK government and devolved administrations should publish a UK-wide framework setting out ethical and operational principles to guide the allocation of adult intensive care resources in the extreme event that they are saturated during a pandemic. That framework must: be informed by comprehensive engagement with the public and developed in conjunction with professionals across healthcare, law and ethics, as well as with regulators of healthcare professionals set out clearly established triggers for its use, based at least in part on a UK-wide system that measures critical care capacity strain and facilitates mutual aid (such as the CRITCON tool used in England) establish clinicians’ legal and professional duties in applying the framework, which should be clearly explained to clinicians through guidance be regularly reviewed with reference to contemporary patient data during a pandemic, and any future use of it must be evaluated and reported on publicly. A plan and timeline for completing this work should be published within six months of this Report. Application of the framework should be tested as part of the pandemic response exercises recommended in the Inquiry’s Module 1 Report (Recommendation 6). Recommendation 8: Systematically recording and publishing healthcare worker deaths The UK government, Scottish Government, Welsh Government and Northern Ireland Executive should work with their respective public health agencies and healthcare employers to develop nation-specific mechanisms to collect, analyse and publish data systematically on the deaths of healthcare workers in the event of a pandemic outbreak. The UK Statistics Authority should work with data providers to ensure that the data are comparable across the four nations of the UK. Recommendation 9: A standardised process for advance care planning across the UK The UK government, Scottish Government, Welsh Government and Northern Ireland Executive, working with trusts and health boards, should establish and promote one standardised process across the UK (such as ReSPECT, the Recommended Summary Plan for Emergency Care and Treatment) for clinicians to ascertain and record their patients’ wishes and preferences for future care and treatment in order to inform individualised decision-making, including Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) notices. Recommendation 10: Psychological and emotional support for healthcare workers The UK government, Scottish Government, Welsh Government and Northern Ireland Executive, working with healthcare employers and professional bodies, should put in place plans to deliver effective support for healthcare workers at scale from the outset of a pandemic. Plans should cover the nature and level of support that will be provided during and after a pandemic. All four governments should develop a programme of peer support visits that can, from the outset of a pandemic, be targeted towards areas of acute hospitals under considerable strain. The purpose of the visits should be to support front-line staff, collect insights on the pressures that healthcare workers are facing and understand what further support they might need. See also: UK Covid-19 Inquiry Module 1: The resilience and preparedness of the United Kingdom Covid-19 Inquiry: Module 2, 2A, 2B, 2C Report – Core decision-making and political governance
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Content ArticleWith the UK Covid-19 Inquiry due to publish its report into the impact of the pandemic on healthcare systems this week, CATA (the Covid Airborne Transmission Alliance) has submitted its own reports to the Inquiry. These cover investigations that CATA carried out independently, based on Freedom of Information requests and other sources of information (see CATA's press release that explains the background to this initiative). David Osborn, a member of CATA's Executive Team, gave a brief overview of these reports in a presentation to the SHBN (the Safer Healthcare Biosafety Network). David Osborn SHBN Meeting 130326.mp4 David's presentation can also be downloaded from the PDF attachment below: 2026-03-13 SHBN Meeting.pdf CATA has released copies of their reports into the public domain although, due to Inquiry confidentiality rules, some material has had to be redacted. Links to CATA’s two reports: Changes in the Management of COVID-19 (March 2020) Independent Investigation into the conduct of the IPC Cell
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News Article
'I'm still haunted that he died alone': The last voices of the Covid inquiry
Patient Safety Learning posted a news article in News
Rivka Gottlieb said she still felt "haunted" by the fact that her father, Michael, died alone. He was a fit and active 73-year-old, she said, working part-time in a golf shop and teaching children at his local synagogue. Her story was one of the last to be told at the Covid inquiry, which heard its final evidence this week. In March 2020, Michael and Rivka's mother, Mili, were admitted to different wards of the Royal Free hospital, in north London, with Covid symptoms - just as the first lockdown was announced. "We were just expecting him to be given a bit of oxygen and then he'd be sent home," Rivka said. Michael deteriorated in hospital. His cough became so severe he had to send a WhatsApp message to tell her he was being put on a ventilator. Two weeks later, the family was told he would never recover and that doctors were going to reduce his life support. "It was a dark and terrifying time and difficult to get updates from the hospital. I feared the worst every time the phone rang," recalled Rivka. In the last week, the inquiry has heard more than eight hours of emotional testimony from bereaved relatives. The inquiry heard how families were "torn apart" by social distancing rules, which prevented them from being with their loved ones at the end of their lives. Others spoke about huge difficulties accessing information from care homes and hospitals. Families said they were often unable to ask questions about their relatives or felt the true situation was not properly explained to them. Read full story Source: BBC News, 6 March 2026 -
Content ArticleThe final module in the long-running Covid-19 inquiry has concluded, marking the end of public hearings that began almost three years ago. While other sections of the inquiry have focused on specific areas of the pandemic, such as the care sector, economy, vaccines and political decision-making, module 10 had a broader remit, looking at the overall impact on society and the legacy left behind. “This module is about making a permanent record of the impact of Covid-19, lest people forget, and about recommending improvements for the future,” said Heather Hallett, the inquiry chair, at its outset. This Guardian article highlights some of the key things we learned: Related reading on the hub: "Why should a vulnerable person be expected to tolerate lack of protections against Covid?" Respiratory protective equipment: An unequal solution for healthcare workers? A blog by David Osborn
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News ArticleSome people suffering from long Covid may experience symptoms similar to those seen in individuals with Alzheimer’s disease, according to new research. Recent findings from New York University Langone Health suggest that changes in the brain caused by Long Covid — symptoms of the illness that linger for more than three months, according to the CDC — may result in long-term fatigue, brain fog, dizziness, loss of smell or taste, depression, and other symptoms. Some 20 million Americans have been diagnosed with long Covid, according to Yale Medicine. “Our work suggests that long-term immune reactions caused in some cases after an initial COVID infection may come with swelling that damages a critical brain barrier in the choroid plexus,” senior study author Dr. Yulin Ge, a professor in the Department of Radiology at NYU Grossman School of Medicine, said in a statement. “It is currently unknown whether these changes are reversible. We are actively analyzing their follow-up data to address this question,” Dr Ge said. Senior study author Dr. Thomas Wisniewski of the NYU Grossman School of Medicine said in a statement that the team's next steps will be to monitor the patients to see if “the brain changes we identified can predict who will develop long-term cognitive issues.” Read full story Source: The Independent, 11 February 2026
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Content ArticleThis prospective, observational cohort study examined data from 13,647 adults participating in the Researching Covid to Enhance Recovery (RECOVER-Adult) study. It aimed to update the research index for classifying symptomatic Long Covid and five symptom subtypes that differ in associated demographic features and quality of life. The researchers believe this update may help researchers identify people with symptomatic Long Covid and its symptom subtypes. Refinement of the index will be needed as research advances and the understanding of Long Covid deepens. Listen to a short podcast about the update of the RECOVER-Adult study.
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Content ArticleAround 5–10% of people with Covid infections go on to experience Long Covid, with symptoms lasting three months or more. Researchers have proposed several biological mechanisms to explain Long Covid. However, in a perspective article published in the latest Medical Journal of Australia, the authors argue that much, if not all, Long Covid appears to be driven by the virus itself persisting in the body. Since relatively early in the pandemic, there has been a recognition that in some people, SARS-CoV-2 – or at least remnants of the virus – could stay in various tissues and organs for extended periods. This theory is known as “viral persistence”. While the long-term presence of residual viral fragments in some people’s bodies is now well established, what remains less certain is whether live virus itself, not just old bits of virus, is lingering – and if so, whether this is what causes long COVID. This distinction is crucial because live virus can be targeted by specific antiviral approaches in ways that “dead” viral fragments cannot. Viral persistence has two significant implications: when it occurs in some highly immunocompromised people, it is thought to be the source of new and substantially different-looking variants, such as JN.1 it has the potential to continue to cause symptoms in many people in the wider population long beyond the acute illness. In other words, long COVID could be caused by a long infection.
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Content Article
In this interview, David Osborn, chartered occupational safety and health practitioner and member of the Covid-19 Airborne Transmission Alliance (CATA), speaks to Lotty Tizzard, Digital Content Manager at Patient Safety Learning, about how CATA was established during the pandemic to advocate for adequate respiratory protection for NHS employees. David explains how CATA advocated for the government and heath service to recognise that Covid-19 is passed on by aerosol transmission (through microscopic particles in the air). He also outlines why surgical masks do not adequately protect people against catching airborne viruses and describes how inadequate respiratory protective equipment (RPE) contributed to thousands of NHS staff catching Covid-19 at work. As a result, many healthcare workers died and a large number still live with the ongoing symptoms of Long Covid. David describes CATA's involvement as a Core Participant in the Covid-19 Inquiry and outlines what he hopes will be done to ensure the UK is better prepared for future pandemics. Patient Safety Learning is also a member of CATA. Clarification David wishes to clarify a point raised in the interview: "When talking about the “IPC Cell” I said that they 'didn’t produce minutes'. In fact, notes or minutes were taken at all IPC Cell meetings. The point I was making is that they were not published ('produced' in the sense of being released into the public domain), when the minutes of most other groups such as SAGE and NERVTAG were published. The few IPC Cell minutes that have trickled into the public domain have mostly been as a result of Freedom of Information requests by a colleague and a few that I have managed to obtain myself. In some cases, public authorities have taken around 18 months to disclose documents, and it has required the intervention of the Information Commissioner's Office. I anticipate that more minutes will be disclosed for public scrutiny as time goes on." You can read more about CATA and the Covid-19 Inquiry in David's blogs and presentations on the hub: Respiratory protective equipment: An unequal solution for healthcare workers? A blog by David Osborn Healthcare workers with Long Covid: Group litigation – a blog from David Osborn Covid-19 : A risk assessment too far? A blog by David Osborn CATA and the UK Covid-19 Public Inquiry: Presentation from David Osborn Join the conversation Were you working in health and social care during the pandemic? We'd like to hear about your experience of health and safety at work. Were you provided with adequate PPE to carry out your job safely? Did you catch Covid-19 while at work? You can join the conversation by commenting below (you'll need to sign up first) or get in touch with us directly by emailing [email protected] -
Content Article
This is letter from #ThereForME calls for an inquiry into the persistent and historical gaps in care for those with ME and Long Covid. It is co-signed by 28 organisations and smaller initiatives and has been sent to the Chair of the Select Committee, Layla Moran MP. Patient Safety Learning are one of the signatories of this letter. The letter recommends that an inquiry is undertaken by the Health and Social Care Committee with a remit to investigate: Current gaps in care for ME and Long Covid, and their connections to historic approaches to infection-associated chronic conditions (including NHS care and research funding). Economic impacts, including the relationship between growing economic inactivity in the UK’s working age population and the lack of meaningful service provision for people with ME and Long Covid. Recommendations to strengthen future care and research for people with ME, Long Covid and other infection-associated chronic conditions - and how this can inform wider pandemic preparedness (including public health prevention strategies to mitigate the future health burden of infection-associated chronic conditions). Attitudes towards and assistance for patients with ME and Long Covid in society, including benefits provision, disability assistance, social care and guidance for settings including workplaces and education. -
News Article
Long Covid health staff 'abandoned and forgotten'
Patient Safety Learning posted a news article in News
Healthcare workers with Long Covid say the government needs to do more to support those left with life-changing disabilities since catching the virus. Nurse Rachel Hext, 37 from Paignton, insisted she caught Covid in her job as a nurse in a small community hospital in Devon. "We were clapped and called heroes, and now those of us who have been bereaved or disabled by it have been forgotten," she said. The government said it knew Long Covid could have a debilitating impact on people's physical and mental health, that there was a "range of support for staff" and it was funding research into it. Mrs Hext is one of a group of healthcare workers with long Covid who have taken their fight to the High Court to try to sue the NHS and other employers for compensation. The staff, from England and Wales, said they believed they first caught Covid at work during the pandemic and said they were not properly protected from the virus. She said: "I want acknowledgement and I want support for the people who need it. "Long Covid is absolutely life-changing. It's devastated us as a family." Read full story Source: BBC News, 20 March 2025 Related reading on the hub: "Forgotten heroes" – the sequel: a blog and resources from David Osborn The pandemic – questions around Government governance: a blog from David Osborn Healthcare workers with Long Covid: Group litigation -
News Article
Almost 1 in 10 may have Long Covid, research finds
Patient Safety Learning posted a news article in News
Almost one in 10 people in England think they could have long Covid, according to analysis of national data. University of Southampton researchers examined information collected by NHS England that showed 4.8% of people reported having the condition. The analysis of more than 750,000 responses to the GP Patient Survey also found that 9.1% of people believe they may have long Covid. Long Covid is a chronic condition induced by Covid-19 infection, with symptoms including fatigue, feeling short of breath, brain fog, and heart palpitations. The information also shows higher rates of long Covid in deprived areas and people with particular ethnic backgrounds, parents, carers and those with another long-term condition. Professor Nisreen Alwan, who co-authored the study, said the analysis "adds further evidence of the unfairness of long Covid", with people who are "already disadvantaged in society more likely to be affected". "It also shows us that many people aren't sure if they have it, and may need diagnosis, treatment and support." He said the condition was "still a very significant issue impacting individuals, families, the economy and wider society". "We need to do more to prevent it, diagnose it, and properly support people who are affected by it," he added. Read full story Source: BBC News, 18 March 2025 -
News Article
Huge fall in NHS Long Covid clinics, study finds
Patient Safety Learning posted a news article in News
New research has revealed the number of NHS clinics for people living with Long Covid has more than halved, from a peak of 120 services in 2022 to 46 today. Services for children and young people are also affected with 13 specialists hubs reduced to eight. The BBC also discovered the NHS in England no longer monitored the status of Long Covid clinics and stopped doing so nearly a year ago. Spokespeople for NHS England and the Department of Health confirmed they were no longer tracking how many Long Covid clinics were still operating. Birmingham-based charity Long Covid Support used Freedom of Information (FoI) requests to ask hospitals about what clinics they have for patients. Margaret O'Hara, from the group, said changes in the way clinics were funded inside the NHS had led to many services being merged or stopped altogether. She told the BBC many parts of the NHS were "struggling to cope" and the picture for patients was one of "utter confusion". After the initial infection with coronavirus, rather than getting better, patients are instead left dealing with any number of problems including fatigue, pain and breathing difficulties. For many, getting any sort of diagnosis let alone treatment in a specialist NHS clinic is a long and sometimes fruitless journey, according to the support group. In a survey of patients affected by the condition, a spokesperson for Long Covid Support said they found about half of those they talked to considered themselves disabled by the condition. A similar number of adults surveyed also said they were not followed up by a healthcare professional and still had ongoing symptoms, despite when the NHS discharged them from treatment. Read full story Source: BBC News, 17 March 2025 Further reading on the hub: "Why should a vulnerable person be expected to tolerate lack of protections against Covid?" -
News Article
Patients with Long Covid regain sense of smell and taste with pioneering surgery
Patient Safety Learning posted a news article in News
Doctors in London have successfully restored a sense of smell and taste in patients who lost it due to long Covid with pioneering surgery that expands their nasal airways to kickstart their recovery. Most patients diagnosed with Covid-19 recover fully. But the infectious disease can lead to serious long-term effects. About six in every 100 people who get Covid develop Long Covid, with millions of people affected globally, according to the World Health Organization. Losing a sense of smell and taste are among more than 200 different symptoms reported by people with Long Covid. Now surgeons at University College London Hospitals NHS Foundation Trust (UCLH) have cured a dozen patients, each of whom had suffered a profound loss of smell after a Covid infection. All had experienced the problem for more than two years and other treatments, such as smell training and corticosteroids, had failed. In a study aiming to find new ways to resolve the issue, surgeons tried a technique called functional septorhinoplasty (fSRP), which is typically used to correct any deviation of the nasal septum, increasing the size of nasal passageways. This boosts airflow into the olfactory region, at the roof of the nasal cavity, which controls smell. Doctors said the surgery enabled an increased amount of odorants – chemical compounds that have a smell – to reach the roof of the nose, where sense of smell is located. They believe that increasing the delivery of odorants to this area “kickstarts” smell recovery in patients who have lost their sense of smell to Long Covid. Prof Peter Andrews, a senior consultant surgeon in rhinology and facial plastic surgery who led the research, said surgery increased the airway by about 30%, so airflow also increased by about 30%. Read full story Source: The Guardian, 7 March 2025 -
News ArticleOn 20 March 2020, Rowan Brown started to feel a tickle at the back of her throat. Over the next few days, new symptoms began to emerge: difficulty breathing, some tiredness. By the following week, the UK had been put under lockdown in a last-minute attempt to contain the spread of SARS-CoV-2, or Covid-19. Brown didn’t know then she was at the beginning of a condition that did not yet have a name, but which has since become known as Long Covid. After two weeks, she had a Zoom with a friend, and at the end of the conversation it was as if all life force had drained out of her body. Her doctor advised her to stay in bed for two weeks. Those two weeks turned into three and a half months of extended Covid symptoms: nausea, fevers, night sweats, intense muscle and joint pain, allodynia (a heightened sensitivity to pain), hallucinations, visual disturbances. By the end of the three months, she had noted 32 different symptoms. “I didn’t recognise the way my body felt at all: my skin, my hair,” she remembers now. “It was like being taken over by a weird alien virus, which I guess is what happened.” Brown, 48, is one of 2 million people in the UK thought to be experiencing long Covid symptoms; according to a study published last summer, roughly 400 million people worldwide have been affected. Often, long Covid patients experience mild primary infections, are never admitted to hospital and only realise there is a problem later, when the symptoms persist well beyond the usual two weeks. Some make a full recovery, some see improvements over time; others, like Brown, have seen little progress since being infected five years ago. One of the main challenges in diagnosing and treating long Covid is its unpredictability: research studies have linked it to more than 200 symptoms affecting every part of the body. Many patients go on to develop complications such as postural orthostatic tachycardia syndrome (POTS) and fibromyalgia, a chronic pain disorder; 59% of patients show signs of organ damage. The unwillingness to discuss chronic illness is especially concerning when combined with the scepticism faced by Long Covid patients, who have to advocate for themselves so that medical professionals, employers and loved ones understand the gravity of their illness. All of this conspires to make Long Covid patients feel invisible, voiceless and forgotten. Read full story Source: The Guardian, 2 March 2025 Further reading on the hub: Exploring the barriers that impact access to NHS care for people with ME and Long Covid Building an NHS that’s there for Long Covid and ME Top picks: 12 research papers on Long Covid It's time to confront Long Covid: An interview with Clare Rayner on why we must keep pushing for research, treatment and prevention Healthcare workers with Long Covid: Group litigation – a blog from David Osborn
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Community Post
Covid-19: What is your Trust or GP practice doing to make you feel safe?
Patient Safety Learning posted a topic in Coronavirus (COVID-19)
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In a new blog on the hub, Laura Evans discusses the lack of protection against Covid-19 for vulnerable patients when going for a GP appointment or into hospital and shares her personal experience of being dismissed when asking for basic patient safety measures to be put in place. We'd like to hear your experiences. Are you a vulnerable patient? What is your Trust or GP practice doing to make you feel safe? Please comment below (sign up first for free) or you can email us at [email protected]. -
Content ArticleThis study in the Journal of Medical Virology aimed to assess the extent and the disparity in excess acute myocardial infarction (AMI)-associated mortality during the pandemic, focusing on the outbreak of the Omicron strain. Using data from the US Centers for Disease Control and Prevention's (CDC's) National Vital Statistics System, the authors found that excess death, defined as the difference between the observed and the predicted mortality rates, was most pronounced for the 25–44 years age group. Excess deaths ranged from 23%–34% for the youngest compared to 13%–18% for the oldest age groups. The trend of mortality suggests that age and sex disparities have persisted even through the Omicron surge, with excess AMI-associated mortality being most pronounced in younger-aged adults.
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Content ArticleThe aim of the Long Covid webinar held on 5 July 2023 was to discuss where we are now with Long Covid clinics and research. The presentation videos from the webinar can be accessed from the link below.
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Content ArticleIn a new Lancet Respiratory Medicine Series about Long Covid, Sally J Singh and colleagues discuss the origins of respiratory sequelae and consider the promise of adapted pulmonary rehabilitation programmes and physiotherapy techniques for breathing management. Pratik Pandharipande and colleagues review the epidemiology and pathophysiology of neuropsychological sequelae of COVID-19-related critical illness, highlighting the combined threat of long COVID and post-intensive care syndrome (PICS), and outline potential mitigation strategies. Finally, Matteo Parotto and colleagues discuss pathophysiological mechanisms of diverse, multisystem sequelae in adult survivors of critical illness, including longitudinal effects of endothelial and immune system dysfunction, and consider the challenges of providing appropriate care and support for patients.
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Content Article
As reported recently, the Scottish Healthcare Workers Coalition called upon the Scottish Government to reinstate 'universal masking' in health and social care settings. In this statement written in support of their campaign, an occupational safety and health practitioner, David Osborn, explains the legal requirements for risk assessments that the Government ought to have undertaken before reaching such a decision that exposes healthcare staff to the life-changing consequences associated with repeat Covid-19 infections. He also explains the legal duty of the Government to consult with workers before implementing changes that may affect their health and safety. Neither duty (risk assessment nor prior consultation with workers) appears to have been well met, putting the Scottish Government and Health Boards in breach of UK-wide health and safety law. The decision by the Scottish Government to withdraw the coronavirus guidance for extended use of facemasks across health and social care is clearly a matter that has significant implications for the safety of health and social care workers. It is a legal requirement under the Health and Safety at Work Act etc 1974 that employers (including Governments and their Health Boards) must do at least two things before implementing a change that may materially and substantially impact workers’ health and safety at work: They must conduct a suitable and sufficient risk assessment of the proposed actions; and They must consult with all employees or their elected representatives concerning the proposed change. 1. Risk assessment To be “suitable and sufficient” the risk assessment for the abandonment of universal masking should have considered several factors such as: The fact that variants of the SARS-CoV-2 virus continue to evolve which are becoming more immune resistant and subject to vaccine escape. The opportunity for viruses to mutate in this way depends upon the sheer number of viruses in circulation within the population. The greater the number, then statistically the more likely it is that a variant could evolve with potential to partially or wholly defeat our current vaccines and greatly impair the nation’s recovery from the pandemic. It just takes for one single virus to mutate in a certain catastrophic way for this to happen – as will have been the case in Wuhan in 2019. Any responsible Government and Health Board should take all reasonably practicable steps to reduce the number of viruses circulating in the population, particularly in health and social care premises. The Scottish Government appears blind to this simple but important duty that it owes to the Scottish people and its healthcare workers in particular. Evidence is emerging that cases of SARS-CoV-2 reinfection and associated hospitalisations and deaths have increased in relative frequency as new Omicron lineages have emerged with enhanced transmissibility or immune escape characteristics. The evidence also suggests that the time interval between repeat infections is decreasing, particularly (and rather peculiarly) amongst individuals who have previously been infected with the Alpha (‘Kent’) variant which arose during the second wave (winter 2020-21). Many healthcare workers will have been infected during that period. The consequence is that these workers are (a) that these infections may recur more frequently and (b) are at greater risk from these repeat infections. It has long been established that each time a person is infected or reinfected with the SARS-CoV-2 virus they have a risk of developing Long Covid, which can have severe detrimental effect on their health and quality of life – sometimes causing debilitating, irreversible, long-term health conditions. The more times they become reinfected, the worse these conditions may be and the longer they may last. By law, the risk assessment must be recorded (on paper or electronically) and be made available to employees and their representatives immediately upon request. I therefore call upon the Scottish Government to confirm whether or not such a risk assessment was undertaken before the decision was taken to abandon universal masking. If one was done, then the Government and the Health Boards should publish it so that interested parties, such as the Coalition, can determine whether it has properly considered all relevant factors that have a direct bearing on the increased risk of healthcare worker infection and how they plan to mitigate that risk. If no such risk assessment was done, either by the Government centrally or by its Health Boards, then they have acted recklessly and unlawfully. 2. Consultation For clarity, the “consultation”, which is required by the Safety Representatives and Safety Committees Regulations 1977 and the Health and Safety (Consultation with Employees) Regulations 1996, has a very clear meaning. It means: a) providing employees, or their safety representatives, with all relevant information relating to any proposed change in health and safety arrangements (including giving them sight of any risk assessments) before that change is implemented; b) allowing the employees and their representatives sufficient time to discuss amongst themselves and seek any further advice they may need to inform an opinion about the change; c) the employer must then take account any the feedback that it receives. These are serious matters. The UK Government and the devolved administrations, through inept planning for pandemics and the issue of seriously flawed guidance, failed to provide health and social care workers with the necessary PPE to prevent them inhaling airborne virus whilst they cared for highly infectious patients. It is quite understandable that our brave healthcare workers are now so aggrieved by the Government’s decision. These are the same people for whom we, the public, stood and clapped so proudly at our doorsteps during those dark days. The chaotic state of the UK’s planning and preparedness for pandemics has been laid bare at the UK Covid-19 Public Inquiry. During future sessions, the Inquiry will receive evidence concerning the deception which was wrought upon healthcare workers that the flimsy paper masks they were given would keep them safe from the disease when health and safety law requires proper tested and certified respirators to be used (such as FFP3 and equivalent) when workers are exposed to dangerous microbiological hazards in their workplace. Current World Health Organization guidance still advocates that universal masking policies in health and social care premises do still have their place in Governments’ armoury of defence measures to keep healthcare workers safe. Given all that they have already been through, combined with the ongoing suffering that many of them are experiencing from the disease they have contracted whilst caring for us, surely it is now time for the Scottish Government to pay greater consideration and respect for their health and safety. Some commentators may view the abandonment of universal masking as the Government playing “Russian Roulette” with their health by "letting the virus rip" – as sadly it is likely to do as the autumn and winter seasons approach. -
Content Article
UK Covid-19 Inquiry - Every Story Matters (June 2023)
Patient-Safety-Learning posted an article in Covid-19 Inquiry
The UK Covid-19 Inquiry is the independent public inquiry set up to examine the UK’s response to and impact of the Covid-19 pandemic, and learn lessons for the future. In order to fully understand the impact of the pandemic on the UK population, the Inquiry is inviting the public to share their experiences of the pandemic by launching Every Story Matters. It will inform the Inquiry’s work by gathering pandemic experiences which can be brought together and represent the whole of the UK, including those seldom heard. The output of Every Story Matters will be a unique, comprehensive account of the UK population’s experiences of the pandemic, to be submitted to the Inquiry’s legal process as evidence. Share your story here. Every Story Matters provide a toolkit that contains information and creative assets that can be used to encourage participation in Every Story Matters. Every Story Matters aims to provide inclusive methods for people to talk about their experience of the pandemic, so anyone that wants to share their story feels heard, valued, and can contribute to the Inquiry. tips on engaging people to take part in Every Story Matters print campaign assets to download online campaign assets to download information on how to use campaign assets information on accessible engagement options. -
Content ArticleA significant number of doctors and other healthcare workers have developed post-acute COVID, including a large number who developed it as a result of workplace exposure to Covid-19. This paper examines the impact post-acute Covid symptoms have had on the medical workforce, personally and professionally. It provides a unique and valuable insight into the experience of UK doctors suffering from post-acute Covid. It has been informed by a UK survey of over 600 doctors suffering from the continuing effects of an infection with Covid-19, as well as wider research of the issues. The survey was undertaken by the British Medical Association (BMA) in partnership with Long COVID Doctors for Action. This is the first comprehensive survey of doctors with post-acute Covid health complications. This paper should inform the support needed by current sufferers of post-acute COVID in the NHS workforce, and help protect services and patients now and in the future. Recommendations The Department of Work and Pensions must act without delay on current IIAC (Industrial Injuries Advisory Council) recommendations for the specific circumstances where Long COVID should be recognised as an occupational disease for healthcare workers. Alongside this, there must be investment in research to support the additional designation as an occupational disease of the broader range of post-acute COVID symptoms this report shows are highly prevalent among sufferers. UK Government must urgently develop a package of financial support for doctors and healthcare workers with post-acute COVID. Health and Safety Executive must provide clear guidance to health service employers on the legal requirements to carry out risk assessments and report instances of infection under RIDDOR (Reporting of Injuries, Diseases and Dangerous Occurrences Regulations). The Department of Health and Social Care must ensure funding is allocated for appropriate PPE (Personal Protective Equipment) and RPE (Respiratory Protective Equipment) in health and care services to ensure staff are protected. UK health services must increase access and improve waiting times to post-acute COVID care such as NHS COVID clinics. UK health services must ensure care for those with post-acute COVID, such as that delivered through NHS COVID clinics, is multidisciplinary and offers access to both physical and mental healthcare. Health education bodies across the UK must fund increased occupational medicine training posts. UK health service employers must prioritise timely access to occupational health services and assessments for staff with post-acute COVID. UK health service employers must promote greater awareness amongst managers of the needs of staff with post-acute COVID and support measures required. UK governments and health systems must ensure health service estates are safe for staff and that the risk of infection from infectious diseases, like COVID-19, is reduced, including ensuring improved and appropriate ventilation.
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Content ArticleIn this episode of the Medicine and the Machine podcast, Scottish GP Gavin Francis talks about the need to reconsider the importance of convalescence. He discusses the role of GPs in supporting patients through recovery after a hospital admission or period of illness and talks about a lack of awareness of the principles of convalescence amongst patients.
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Content ArticleA NIHR-funded study has reached an agreement amongst researchers and patients on how best to measure improvement in Long Covid. Researchers have identified a Core Outcome Measure Set (COMS). This is designed to help researchers and clinicians measure the severity and impact of Long COVID. COMS specify key things that should be measured in all patients. This improves how data can be compared and summarised. Researchers say this will speed up the development of treatments for Long Covid. The research is published in Lancet Respiratory Medicine. It was co-led by the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London and in collaboration with the World Health Organization (WHO). The research included close collaboration with Long Covid patients and organisations. Symptoms that persist or develop after Covid-19 are known as Long Covid. They are also described by other names such as post Covid-19 condition, post acute sequelae of Covid-19 (PASC) or post-Covid syndrome. Common symptoms include: fatigue shortness of breath pain exercise intolerance cognitive dysfunction (brain fog). But, patients can experience a wide range of other symptoms across all bodily systems. This makes it hard to identify the key symptoms and decide how to measure them. The COMS agreed in this study will help solve this challenge.
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Content ArticleIn this video, the Long Covid Groups' KC Anthony Metzer questions Professor Kamlesh Khunti to find out if he agrees that Long Covid should be cited as a reason not to allow Covid-19 to spread unchecked via non-pharmaceutical interventions (NPIs). Professor Khunti is a member of SAGE and former Chair of the National Long Covid Research Working Group.
