A recent episode of the hospital drama Casualty misrepresented the very serious risks that Covid still poses. Jane Stevenson wrote to the BBC to explain just how wrong they’d got it.

On Saturday 9 March, an episode of Casualty was broadcast, “Trauma”, which created a lot of upset. After reading a robust Twitter/X post by Clinically Vulnerable Families, I watched the episode myself. I am writing to complain that a storyline in this episode amplified Covid misinformation and missed out some crucial context.

The storyline involved Aisling, who has overdosed on her anti-anxiety medication. Aisling was wearing an FFP2 respirator mask. The ambulance crew asks if she wants to take off the mask, reassuring her that they are vaccinated.

During handover at the hospital, we learn that Aisling has been living in isolation for a long time and is described as having “post-Covid anxiety”. Later, a medic says to her: “The risks to you from Covid are smaller than the situation you are actually in.” The medic, in reference to Aisling’s anxiety, says there is “no magic cure,” though she wishes there were.

I’m sure this storyline looked completely valid and innocent, but from the perspective of those of us who, with good reason, wish to avoid repeat Covid infections, it was far from harmless.

Aisling’s condition is labelled as “post-Covid anxiety”. We are indeed post- the acute stage of the pandemic, but we are not post-Covid. At the time of broadcast, one in 143 people in England had Covid. As the disability support organisation BuDs UK notes, this would typically equate to two people in a busy supermarket.

NHS data shows that 1,818 beds were occupied by confirmed Covid patients in England on 29 February. In the UK, 3,024 people lost their lives to Covid in the first eight weeks of 2024. So Covid is still circulating – and people using indoor public spaces, such as hospitals face a significant chance of encountering the virus.

One of the reassurances given to Aisling was that the medics were vaccinated, implying it was safe for her to remove her mask. This is a false reassurance. Current vaccines are not sterilising, meaning that even though vaccination helps reduce infection and harm from the virus, you can still catch and spread it. Additionally, since last autumn,12 million fewer people were eligible for boosters compared to the previous year, and this spring eligibility has been restricted further. So a patient in another bay, or indeed a member of staff, could have Covid and – as Covid is airborne – Aisling would have been at risk in a crowded, poorly ventilated Emergency Department.

With an Office of National Statistics (ONS) survey showing that people with underlying conditions have an 8.5x increased risk of mortality and 5.2x increased risk of Long Covid, it’s not surprising that any clinically vulnerable person watching would likely not sit comfortably with the strong implication made in these Casualty scenes: that Covid is nothing to worry about. This is particularly true in an era of reduced mitigations, including less testing and isolation (even for NHS staff who have respiratory symptoms), fewer people eligible for vaccines and the removal of mask mandates in hospitals.

Indeed, there are many people other than the clinically extremely vulnerable (CEV) who are not willingly consenting to being repeatedly exposed to Covid. Swimming against the tide is not easy. People who are Covid-cautious are often labelled as anxious, with common responses being along the lines: “We have all the vaccines and treatments; catching it builds immunity; it only badly affects the elderly and frail, right?”

Sorry to break the news, but the opposite to those common assertions is true.

Sadly, there is growing evidence from multiple studies that Covid is a multi-system, multi-organ disease that can leave long-lasting effects in a significant proportion of people who are infected, even if their initial symptoms are mild, even if they are vaccinated and even if they have been infected before.

The list of systems potentially affected, and the pathological impacts on these, might be eye-opening for some. It includes cardiovascular, gastrointestinal and neurological systems and health impacts ranging from extreme fatigue to coagulation disorders and diabetes. Covid is not just a disease of the respiratory system. Scientists are calling for better vaccines and other pharmaceutical and nonpharmaceutical interventions because many are very worried about the emerging picture.

What’s more, further evidence is emerging that your risk of Long Covid actually increases with reinfection. One sobering figure comes from a recent Canadian study in which 38 per cent of Canadian adults reporting three or more Covid infections had experienced Long Covid symptoms.

At last count, there were an estimated 1.9 million people in the UK with Long Covid. In a recent BBC interview, Senior Consultant Cardiologist Dr Rae Duncan said: “Although there may be groups that are more at risk, it does not mean that if you are young and healthy you have no risk and you are not going to get Long Covid.”

Earlier this year, Dr Al-Aly, Director of the Clinical Epidemiology Center and Chief of Research and Development at the Veterans Affairs St. Louis Health Care System in Missouri, told Time magazine that he “wished we lived in a world where getting repeat infections doesn’t matter, but the reality is that’s not the case.” It was a message he repeated In his testimony to the US Senate in January: “You can still get Long Covid after reinfection and not enough people know about this.”

Why do not enough people know about this? I think the responsibility lies in the hands of governments and public health institutions, but large mainstream media corporations must take a share of this too. This is why Casualty, which is respected for its attention to detail, has a responsibility not to downplay the risks of Covid and spread comforting misinformation.

If you go on social media, under any high-profile post about the need for mitigations to stem the spread of Covid, there will be lots of troll accounts saying that the person posting is unnecessarily anxious and wants us locked down forever. The opposite is true. The Covid-aware are having isolation imposed on them and want to have their human rights restored.

Since Boris Johnson announced “Freedom Day” on 19 July 2021, millions of CEV people and their families have been left with increasingly fewer protections while everyone else is led to believe it is safe to return to 2019 protocols. One of the few mitigations we have left, to create some freedom for ourselves, is to wear a respirator mask (FFP2 or FFP3). Aisling’s story portrayed mask-wearing as just another symptom of anxiety.

On Twitter/X, Dr Rebecca Healey summed up perfectly what was wrong about this portrayal:

“Wearing an FFP2/3, during an ongoing airborne SARS2 pandemic, in areas with potential exposure (i.e. indoors poorly ventilated), is simply good sense. The people doing this are usually those informed of the science beyond the acute picture. Or those more vulnerable to severe acute disease themselves. This is not anxiety.

“It is arguable that in this situation, anxiety may well result from being surrounded by a public who are themselves overwhelmingly uninformed, and who actively participate in stigmatisation of appropriate health behaviours.”

If you are going to touch on the isolation brought about by Covid, at least touch on the truth that, the virus itself, the reduction in mitigations plus the mass denial and minimisation are creating the isolation. Instead, your storyline amplified the meme that it is the individual’s anxiety that‘s the problem.

There are powerful people behind the minimisation of Covid. The emerging evidence of the long-term damage caused by the virus is largely ignored and people are being encouraged to think Covid is over. This has become another front in the culture war, and ordinary people are suffering as a result.

The BBC has a choice: whether to amplify this minimisation or stand with those at the front line whose lives are being affected, even put at risk, particularly in health care settings.

As an example, I will leave you with this heart-breaking testimony from an old school friend whose daughter was recently admitted to hospital with severe asthma.

“After seeing my husband and I both wearing FFP3 masks on his first rounds visit, the ward doctor condescendingly asked if I would like him to wear a mask too. When I gratefully replied that I would, he reluctantly went and found one for that first visit.

“But then we saw him tons of times after that, and he never wore a mask again, even when he was in extremely close contact with my daughter to listen through his stethoscope. There was a steady stream of new people coming in and out of our room – none of them wearing a mask. It was a continual tidal wave of risk.

“I had to decide every time whether to discuss mask-wearing. It felt like it would get them out quicker if I said nothing at all.

“In the end, I reluctantly admitted defeat and stopped asking. It just felt so awkward to have to keep requesting it and the reaction to my request wasn’t always very nice. I was surviving on very little sleep and the whole situation was utterly exhausting. It felt like a never-ending battle that I could never win.

“My daughter was so poorly, we had bigger issues to deal with at that time but, of course, if she ended up with a secondary infection, it could have been disastrous.”

Just as there are no “magic cures” for anxiety, there are none for restoration of freedom in an ongoing pandemic. There are answers though – but they are not minimisation, denial and propaganda.