UK frontline doctors, like the rest of our NHS colleagues, stepped up to provide medical care to patients with Covid-19 from the start of the pandemic, long before any available Covid vaccines. Most were not furloughed nor able to stay home, but continued to provide healthcare, at considerable risk to themselves.
Now, like tens of thousands of other healthcare workers, we have a chronic illness and disability - long Covid - as a result of infection acquired in the workplace. It now appears that workers who risked their lives to provide essential medical care are facing not only chronic illness and organ damage, but also potentially financial destitution. It is morally indefensible that healthcare workers in this position are now being abandoned.
Long Covid is a debilitating, chronic physical illness affecting multiple organs, occurring in individuals after infection with Sars-CoV-2. It manifests with a myriad of potential complications, including damage to the heart, lungs or brain; disorders of the nervous system; blood clots; impaired memory; and disabling levels of fatigue. The number of people living with long Covid in the UK is now estimated at approximately 2 million.
The rate of Covid-19 caused by workplace exposure is around four times higher in health and social care workers compared to workers across all industries. Moreover, health and social care workers are seven times more likely to have had severe Covid-19 than other workers. At least 199,000 NHS workers are currently living with long Covid. This is in addition to more than 2,100 health and social care workers who have lost their lives due to Covid-19.
This degree of workplace-acquired long Covid demonstrates failures in personal protective equipment (PPE) policy to adequately protect staff. Much of this viral exposure occurred in the context of inadequate PPE, or, in some cases, no PPE at all.
What’s more, there is, so far, no available cure or disease-modifying medical treatment for long Covid. Despite obtaining this illness in service to the NHS, we have been left without adequate care from the NHS. We are left to languish and told simply to “wait and see”. Well, while we wait in hope of spontaneous recovery, many healthcare workers, not in substantive employment with the NHS, have already lost their jobs. We have heard reports of colleagues in this situation – including primary care and locum staff – losing their homes, and having to declare bankruptcy. Other healthcare workers, those in direct long-term employment with the NHS, have had better employment protection – until now.
Across the UK, Covid absence policies have recently been updated, meaning that NHS workers who are sick with long Covid are now vulnerable to disciplinary absence procedures, and loss of employment, career and income. Although the nations of the UK vary in the specific details of these policy changes, it is clear “special Covid leave” is due to end imminently for UK NHS workers with chronic Covid-related illness. In other words, financial support for NHS staff who are unwell with long Covid will end, and staff who are currently absent with long Covid will soon face formal absence processes. This replacement of “special leave” with normal sickness processes has the potential to quickly escalate to dismissal. We are already hearing stories of colleagues whose employers are preparing disciplinary procedures.
The NHS is already in the midst of a staffing crisis. Figures show the number of unfilled posts across health services in England recently stood at 110,192, including a shortage of 39,652 nurses and 8,158 doctors. It is therefore shortsighted to stop supporting NHS workers unwell with long Covid. The loss of these workers from the profession will be a huge brain drain and loss to the NHS. We are a skilled workforce, and not easily replaced.
We welcome the recent statement released by the British Medical Association (BMA), condemning the change in employment policy for NHS workers with long Covid as “completely unacceptable”. But words are not enough. We must question how matters have been allowed to get this far. The BMA must step up and prevent the huge damage that will be done to individuals, to our profession, and to the NHS, through the dismissal and loss of career of doctors and other healthcare workers with long Covid. Together with a group of more than 200 other doctors, we have written an open letter to the BMA, calling upon them to take effective action. We need the group to better advocate for its members who now face the threat of dismissal and loss of career and future earnings.
We strongly hope that the BMA can fulfil its role as our advocacy group to exert influence, to turn the tide on government policy, and ensure ongoing support for doctors and other healthcare workers with long Covid as has happened in other European countries.
Meanwhile, as tens of thousands of us NHS workers face this precarious and frightening situation, we cannot help but feel we have been treated as though we are expendable, and are now being abandoned. Somehow the faint memory of people clapping and banging pots and pans on Thursdays evenings doesn’t quite make up for it.
Kelly Fearnley is a foundation doctor at Bradford Royal Infirmary. Shaun Peter Qureshi is a specialist registrar in palliative medicine in Glasgow
