With the official advice from the NHS saying that Covid-19 is mainly spread by ‘droplet and touch’ but the World Health Organisation saying the primary spread is ‘airborne’, the message to staff and patients is confused, leading to a lack of protective measures, putting staff and patients at risk.
The NHS: failing to protect people
As pressures in the NHS continue, with increasing admissions for infectious viruses, there are calls to improve the infection, prevention and control (IPC) measures within the NHS and social care.
That’s because flu, Covid, RSV, and norovirus (droplets can be airborne when a patient vomits) can be deadly for patients who are immunosuppressed, and those with conditions like cancer who, due to treatment, are more prone to infection.
But confusion has set in within the NHS IPC department saying that Covid is mainly spread by ‘droplet and touch,’ and others including the WHO saying it is primarily ‘airborne spread.’
In practice this now means the onus is on vulnerable patients to ask staff to wear a mask, with some patients unaware or unable to make this request. To complicate this further, not all staff are complying with this request. Other staff agree, but their masks won’t give suitable protection.
For Janice, this became a problem when her mum aged 86, who has a neuromuscular degenerative condition, injured her head in a fall. An ambulance was called and Janice said:
My husband and I waited for them at the door, both of us in masks. But they turned-up mask free and refused to put one on. I couldn’t believe it! We had brand new unopened FFP3 masks in stock, but they refused to take them saying they hadn’t been fit tested and trained to wear them. They also said Covid was over!
Eventually, Janice said they put on their own blue surgical masks, that were ‘baggy’ and offered little protection
So, why do we have two different views on how Covid is spread?
Confused messaging and understanding
Experts at the Covid-19 Inquiry have testified that the primary route of transmission for Covid is airborne. This is often called ‘aerosol spread’.
But the current Head of IPC for NHS England, Dr Lisa Ritchie in the current document ‘How to avoid catching COVID-19 infection’ gives the following advice:
When someone with COVID-19 breathes, speaks, coughs or sneezes, they release small droplets containing the virus. You can catch it by breathing in these droplets, or by touching surfaces covered in them and then touching your eyes, nose or mouth.
In his extensive written evidence, Professor Clive Beggs discussed the historical controversy surrounding airborne versus droplet-borne diseases:
During the pandemic the World Health Organisation (WHO) and many other professional institutions relied on(these) flawed assumptions, despite some dissenting pre-pandemic evidence.
Eventually the scientific evidence for airborne transmission of Covid-19 from studies using multiple types of methodology became overwhelming and the WHO acknowledged its significance with a change in official terminology adopted in 2024, reclassifying SARS-COV-2 as a pathogen that is ‘transmitted through the air.
If the World Health Organisation has updated their official terminology to match the ‘overwhelming’ scientific evidence, why has the NHS IPC Department not followed suit?
One answer might be because a primary mode of transmission that is airborne has major cost implications for the whole of the NHS and social care, with poorly ventilated, or crowded indoor spaces a particular risk regarding the spread of these pathogens
But to protect those who use and work in the NHS and/or social care sectors the government needs to put in place these IPC measures. This would also help to protect against flu, RSV, tuberculosis, and measles which are also on the rise.
The measures that need to be implemented include improved ventilation to bring in fresh air. High Efficiency Particulate Air (HEPA) filters to ‘clean’ the air and remove any viruses. Plus, effective PPE for everyone, with FFP2 and FFP3 masks being more effective to prevent the spread of airborne viruses. The blue surgical masks worn reluctantly by the paramedics Janice encountered don’t offer the protection required.
The NHS must do better
With no progress on protecting staff and patients, a petition has been set up by Janet Newsham the coordinator of Greater Manchester’s Hazards Centre and Chair of the UK Hazards Campaign, to address this. You can sign the petition here.
Newsham said:
There are many airborne risks especially in healthcare settings which are ongoing and should and can be prevented, reducing the risks for patients, visitors and staff.
In terms of what the public could do to apply pressure on the government, Newsham said:
The UK government and parliament petition calling for these measures is one way that the public can let the government know that they want to be protected from airborne infections while accessing healthcare.
The All-Party Parliamentary Group for Long Covid has now been set up and separately to this group, a letter has been sent to the Chair of the Covid-19 Inquiry inviting her to make urgent interim recommendations to make healthcare settings safe. But a reply was received on 27 January 2025 in which the Right Honourable Baroness Hallett declined to make any recommendations in module three of the Inquiry.
As the Covid-19 Inquiry turns to reflect on matters such as the procurement and quality of PPE, it is frankly shocking that in 2025, the protection of staff and patients is still an issue causing concern.
The confusing message from the NHS IPC department and continued lack of protective measures puts all those who use and work in the NHS and social care at risk, particularly those who are vulnerable due to weakened immune systems.
Featured image via the Canary
