A Comprehensive Beginners Guide to the Ongoing COVID-19 Pandemic (UK Edition) … or Why and How to Minimise Reinfection

Is the ongoing debate on COVID-19 a conspiracy theory?

No, it isn’t. Everything explained here is supported by peer-reviewed scientific research published in reputable journals. The problem is that UK government and public health policy has diverged from the science in favour of short-term economic gains. However, this is not a sustainable solution.

Sources are provided for every single claim made here so they can easily be verified.

But hasn’t COVID gone away?

Not at all. COVID-19 continues to spread, and each infection carries the risk of Long COVID, which can cause lasting organ damage, cognitive impairment, and chronic illness¹.

In absence of valid and accurate official data, there are clues suggesting that there are still many people being infected with COVID:

• The World Health Organisation still considers COVID a pandemic, it has simply ended the emergency phase^2,3.
• The Winter Coronavirus Infection Survey estimated that at the end of December 2023, around 1 in 24 people were infected with COVID*⁴. 
• The ZOE COVID Study, a private study which ran until September 2023, showed that even during times of the lowest transmission, approximately 500,000 people in the UK were infected at any one time¹¹. The current UK population is around 67 million people^5.
• Other countries continue to collect wastewater data and show repeated peaks of infection in all seasons throughout the year- including Scotland, the Netherlands, the USA and Canada^6,7,8,9.
• In 2022, more people were hospitalised with COVID in the UK than in 2020 or 2021. Due to significantly reduced testing, numbers for 2023 are unreliable; however, lack of any mitigations means it is likely the true figure for 2023 is similarly high¹⁰.

Official case numbers can appear low due to the following:

• Testing is no longer encouraged¹¹.
• Free tests are not available to the majority of the population¹¹.
• There is no way to report positive results from privately purchased tests¹¹.
• Hospitals no longer routinely screen for COVID, even in symptomatic patients¹².
• Lateral flow tests have a high false negative rate compared to PCR tests, meaning a lot of infections are not detected. This is further exacerbated by not swabbing the throat and only testing on the first day of symptoms, given viral load peaks between days 3–4^13-16.
• In England, Wales and Northern Ireland, wastewater is no longer monitored for COVID to check for disease prevalence^17,18,19.

Limitations with official case numbers make it difficult to know exactly how many infections are happening. Other factors contributing to the appearance that COVID-19 is no longer a problem include:

• Excess death data now includes the years 2020–2023 to generate the baseline number of expected deaths, therefore meaning that far more deaths are expected each year than before the pandemic. This hides the true number of excess deaths.^22,23.

Don’t previous infections and the vaccine make me immune to COVID?

Sadly, no. Previous infections and vaccination provide some protection (“immunity”) against hospitalisation and death, but immunity against infection can wane rapidly²⁴.

Studies show:

• Any immune protection against reinfection wanes rapidly after the initial infection. Reinfections are common and there are records of it happening in as little as 16 days^25,26
• New variants evade prior immunity from vaccinations and infection^27,28.
• Vaccines provide limited protection against infection and effects wane rapidly, this is compounded by fewer and fewer people being offered booster doses²⁹.
• Herd immunity with COVID-19 is not possible^30,31.

But isn’t COVID mild now anyway?

No. COVID has often wrongly been compared to the common cold or flu but is much more than a simple  respiratory illness. SARS-CoV-2, the virus that causes COVID, is a virus which simply uses the respiratory tract to enter the bloodstream where it causes systemic inflammation and attacks blood vessels throughout the body³². 

The disease that SARS-CoV-2 causes can be divided into acute and chronic phases. Vaccines mean that the acute phase can seem milder in most people; however, they provide limited protection from chronic illness and organ damage^33,34. 

As we learn more about the chronic phase, SARS-CoV-2 appears more similar to HIV, Epstein-Barr virus, syphilis, herpes and hepatitis B and C, illnesses which may cause initial flu-like symptoms but for which most concern lies in their long-term harm. Both the acute and chronic phases of COVID can be symptomatic or asymptomatic, but lack of symptoms does not mean there is a lack of internal damage.

Studies show that COVID infection:

• Results in ongoing symptoms in at least 10-20% of infections, which can be disabling^35,36.
• Increases risk of cardiovascular illness for at least a year following mild infection, resulting in increased blood clots, heart attacks, strokes and pulmonary embolisms^37,38,39.
• Increases heart attack risk by 3–8x⁴⁰ (in comparison, smoking increases heart attack risk by 2–4x yet indoor smoking is banned⁴¹).
• Leads to reduced global brain size and grey matter loss in 100% of patients with mild illness, compared with controls, as shown by MRI⁴².
• Causes cognitive impairment and reduced IQ compared to non-infected individuals —including 2–3x more cognitive impairment in healthcare workers following infection—with potential implications for healthcare delivery^43,44,45.
• Increases risk of many autoimmune diseases, with one study finding an overall increased risk of 43%^46,47.
• Increases risk of newly acquired Alzheimer’s and Parkinson’s diseases and accelerates existing disease^48-53.
• Causes autonomic nervous system dysfunction^54-58.
• Causes reduced sperm count, decreased sperm motility and increased risk of erectile dysfunction^59-69.
• Causes immune dysfunction, including reduction in T, B, NK and dendritic cells^70-81.
• Is associated with increased severity of RSV and Group A Strep infections both during COVID-19 infection and for at least one year post infection^82,83,84.
• Induces gene expression associated with cancer formation and may be accelerating existing cancers^85-91.
• Occurring initially during pregnancy results in twice the risk of a neurodevelopmental diagnosis at 1 year, as well as reduced lung volume and potential intestinal inflammation in baby^92,93,94.
• Occurring initially during pregnancy causes an increased risk of miscarriage, pre-term and stillbirth as well as increased maternal morbidity and mortality^95-99.
• In infants results in significantly poorer psychomotor development and higher rates of mildly delayed performances at 18–24 months¹⁰⁰.
• Results in subclinical heart and lung damage in children who have seemingly recovered^101,102.
• Results in increased risks of epilepsy, encephalitis, and nerve disorders in children for at least 2 years after infection¹⁰³.
• Accelerates biological ageing on a cellular level¹⁰⁴.
• Can result in viral persistence for months and, in some cases, years after initial infection even in patients without Long COVID symptoms such as fatigue, breathlessness and cognitive deficits. Persistent virus has been found in the brain, penis, testes, eyes, breast, appendix, gut, and muscle tissue^105-112. 

The possibility of chronic illness from SARS-CoV-2 was not unpredictable, as many infected with SARS-CoV-1 during the SARS epidemic of 2003 continue to have ongoing impacts many years later^113,114. Studies show that risks of long covid symptoms and multisystemic damage are cumulative with each infection^115,119.

The number of papers showing the long-term risks of COVID infections continues to increase into 2025, and it is becoming increasingly apparent that repeated infections are unsustainable and incompatible with a healthy, long life. 

Surely if all this was happening, I would see it around me?

There are frequent reports and news articles showing the effects of the ongoing pandemic, but many fail to mention COVID as a major cause of what they report, or make unsubstantiated claims about other causes, such as lockdowns. In some cases, data is only available from countries outside the UK, but as COVID has spread globally, it is likely that the same is happening in the UK but without being documented or reported on.

• Since 2021, UK news outlets have been reporting people experiencing “brutal” and “super” cold symptoms, with prolonged illness and back-to-back infections^120-123. This correlates with COVID-induced immune dysfunction, though this explanation is rarely given.
• Incidence of infections most commonly seen in immunosuppressed people has increased since 2020- including increases in Tuberculosis, Shingles and the invasive fungal infection Candida auris^124-131.
• Excess deaths from heart attacks are ongoing, with the greatest excess in 25–44-year-olds, estimated at 23–34% excess deaths in this age range (for every 100 people expected to die from a heart attack, 123–134 are actually dying)¹³². 
• UK insurance companies report a sudden rise in life insurance claims for people in their 40s¹³³.
• In Germany a news source reports that record sickness rates last year caused a recession when the economy would otherwise have grown¹³⁴.
• The Health Foundation reports that there is an upward trajectory of people not working due to ill health in the UK which is causing significant economic consequences¹³⁵.
• The number of people on long term sick leave in the UK has hit a 30-year high¹³⁶.
• NHS waiting lists have hit a record high¹³⁶.
• Hospital trusts across the country are repeatedly declaring critical incidents due to significant and sustained pressures^137-140.
• Schools are seeing consistently higher rates of chronic absenteeism than before 2020 in the UK and US^141,142,143.
• A news article by Infection Control Today suggests that recent marked increases in violent crime and aggression in the US and Canada may be attributable to COVID-induced brain damage¹⁴⁴. 
• Record numbers of performers are cancelling shows and tours due to serious illness–COVID itself is rarely named as the cause as show cancellation policies usually exclude COVID-related cancellations^145-150. 
• A report from Singapore’s Minister for Health states that all “non-COVID” excess deaths could be linked to prior COVID infection, according to a new study in the country^151,152.
• A Spanish university found that students infected with COVID were nearly half as likely to achieve outstanding academic results compared to their uninfected peers¹⁵³.
• Doctors are reporting on social media that they are seeing increasing numbers of cardiac issues, strokes, blood clotting issues, new autoimmune disease, and psychiatric symptoms after COVID infections^154,155.
• There has been a significant rise in children and teens diagnosed with type 1 diabetes, an autoimmune disease, since the pandemic began. One recent study found COVID infection results in 6x the risk of type 1 diabetes in children^156,157,158.
• When last reported in March 2024, there were 2 million people reporting Long COVID symptoms in the UK, including 111,000 children¹⁵⁹. This is nearly double the 62,000 children reporting Long COVID symptoms in March 2023¹⁶⁰.

What about immunity debt?

Immunity debt is the misguided concept that due to COVID precautions reducing numbers of other common infections in 2020 and 2021, people are now becoming ill more often and more severely as they catch them again^161,162. “Immunity debt” is not an established phrase used in epidemiology and was first used only in 2021¹⁶³.

It is true that lack of exposure could lead to greater numbers of infections, as three years’ worth of newly susceptible people (babies and the newly frail/immunocompromised) would all become exposed to common illnesses in 2022. However, this would not lead to more severe or prolonged infections^161,162. Epidemiologists and immunologists instead attribute this to COVID weakening our immune systems¹⁶².

There is no evidence to suggest that delaying infections results in more severe infection. In very young children, it can even be beneficial to delay infection until their immune system is fully developed. The immune system is not a muscle and does not need to be used constantly to be kept in shape. If anything, frequent infections can lead to malfunction^161,162,163.

If immunity debt existed:

• A debt would also have been created by cleaning the water, developing sewers, and handwashing.
• People who go to space, or live on bases in the arctic, would develop an immunity debt from being isolated for years at a time.
• Children born after 2021, when lockdowns ceased, would not also be experiencing more severe and prolonged illness symptoms.
• The debt would have been paid in 2022, yet in 2023 severe and prolonged viral illness symptoms continue to affect the population. 

I always wash my hands, won’t that protect me?

No, COVID is predominantly airborne.

• COVID is exhaled with normal breathing and talking and moves through the air like secondhand smoke^164,165,166.
• COVID can linger in poorly ventilated rooms for hours after an infected person has left^164,165. 
• The majority of infections are from inhalation of the virus^164,165,166. 
• Despite hand washing being important to reduce transmission of some other illnesses, there is no evidence to show that handwashing significantly reduces transmission of airborne diseases such as COVID¹⁶⁷.

Do masks work? 

Yes.  Studies show that masks are effective in reducing the transmission on COVID-19, both on an individual level and in the community as a whole. However, not all masks provide the same level of protection. Whilst cloth and surgical masks do somewhat reduce transmission, respirator masks are far more effective ^176-179.

But if masks really work, why aren’t they still in hospitals?

Once again, the removal of COVID protections in hospitals comes despite calls from healthcare workers, healthcare charities, scientists, and clinically vulnerable patients for them to remain^180-187. There is an abundance of evidence to show masks reduce transmission^176,177. 

In the UK most hospitals have completely removed mask mandates, as well as stopping regular staff testing and permitting staff to return to work after infection without a negative test. This is despite the persistent World Health Organisation guidance that:

• [You should] wear a properly fitted mask when physical distancing is not possible and in poorly ventilated settings¹⁸⁸.
• [You should] stay home and self-isolate for ten days from symptom onset, plus three days after symptoms cease¹⁸⁸.
• If you need to leave your house or have someone near you, wear a properly fitted mask to avoid infecting others¹⁸⁸.
• Universal masking should be used in healthcare facilities where there is community transmission of COVID^189,190,191.

Occasionally, during significant and sustained pressures, temporary mask mandates do return in some hospital areas, indicating an understanding that these do reduce infection. However, this limited action does little to protect against year-round infections. It would be unthinkable to only mandate healthcare workers to wash hands during surges in norovirus or MRSA – why are mask mandates any different?

Data and studies show that current lack of COVID protections in healthcare is causing avoidable harm:

• At least 14,000 patients have already died from hospital-acquired COVID-19 – the true number is likely much higher as less than half of NHS Trusts responded to this Freedom of Information request¹⁹².
• A study in a London teaching hospital found that mortality rate of hospital-acquired COVID-19 was 13% (9% direct cause, 4% contributing factor)¹⁹³.
• Hospital acquired COVID infections result in increased length of inpatient stays, increased rates of complications and increased post-operative mortality^194-197.
• Incidence of other hospital-acquired infections seems to be increased in patients already infected with COVID-19, likely due to virus’ impacts on the immune system^198,199.
• Approximately 50% of patients in hospital with COVID in Wales acquired it whilst in hospital for another reason²⁰⁰.
  • Data for hospital-acquired COVID in England is no longer collected, but with COVID protections lacking in both countries rates are likely similar.
• 91% of clinically vulnerable people say they have or would delay/cancel medical appointments due to high COVID-19 risks caused by lack of mask mandates, lack of testing and high community levels²⁰¹.
• Staff COVID infections result in increased absences, worsening staff shortages^{202, 203, 204}.
• A recent study from October 2024 found 33.6% of UK healthcare workers report symptoms consistent with Long COVID²⁰⁵

The truth is that hospitals have a long history of unnecessary delays to implementing infection control. After Semmelweis proved that handwashing reduced mortality in childbirth, this measure remained controversial and for a time the Vienna hospital where he had worked abandoned mandatory handwashing. Similarly, prior to the AIDS pandemic in the early 1980s, gloves were not commonly worn to prevent contact with infectious body fluids. When first introduced the healthcare community were sceptical and offered some resistance, but nowadays they are simply a part of universal precautions that we don’t think twice about^206,207.

Can’t I just stay away from people who are obviously ill?

Sadly, no. People can be infected with and transmit COVID before they develop symptoms, or without developing symptoms at all. It is thought that around 30-40% of people are pre- or asymptomatic while infectious, and around 60% of infections are acquired from people without current symptoms^208,209.

The majority of people will make attempts to conceal illness to avoid negative social outcomes and complete work-related achievements. One study found that 75% of people admitted to concealing symptoms, putting others at risk of infection²¹⁰.

Hasn’t the government and public health always worked to protect our health?

The lack of up-to-date COVID data and transparency on long-term effects means that everyone’s health is put at risk. However, this risk is even greater than average in vulnerable and minority groups, who are suffering the brunt of the ongoing pandemic mismanagement.

• Homeless people are at increased risk of reinfection and are  more likely to have comorbidities that increase risk of morbidity and mortality^211,212. 
• People of colour are at increased risk of acute morbidity and mortality^213,214,215.
• LGBT people are significantly more likely to report long covid^216,217,218.
• People from a low socioeconomic background and those who work manual jobs, are more likely to die or get long covid^214,215,219.
• Disabled people and those with pre-existing health conditions are more likely to die from initial infection and more likely to report long covid^214,215.

Additionally, a recent Freedom of Information request to the UKHSA has shown that current guidance for children with COVID to isolate for only 3 days is not based on evidence – in fact the paper provided as support for this policy concluded that children are most infectious within the first 5 days²²⁰.

If all this is true, aren’t there people trying to raise the alarm?

Yes, communities of people around the world consisting of doctors, scientists, engineers, and non-experts are trying to inform people about the ongoing COVID pandemic.

Organisations and resources that have been created include:

• The World Health Network – a global network of experts and advocates with the aim of ending the pandemic as a global health threat²²¹.
• The John Snow Project – provides reliable, honest information on COVID-19 from public health, clinical, and research experts²²².
• The COVID-19 Safety Pledge – Encourages and promotes organisations who have signed the COVID-19 Safety Pledge. This means they pledge to protect workers, service users and customers from COVID-19 through risk assessments to reduce transmission and support for employees to self-isolate. This organisation also runs a Campaign for Safe Healthcare²²³.
• COVIDhealthimpacts.co.uk – provides peer-reviewed COVID-19 research, summarized briefly in one place. Language aimed to best communicate with all people, regardless of whether they have a scientific background²²⁴.
• Clean Air Stars – provide guides for businesses on how to clean the air and promote businesses with cleaner air in their directory²²⁵.
• Clean Air Crew – A sourced collection of tips and tools for navigating an airborne pandemic. Focuses on clean air, better masks and school safety²²⁶.
• Country-wide mask blocs, including London, Brighton, Norwich, Manchester, Lincoln, Edinburgh and Glasgow – Provide free, high quality masks to those in need^227-233. 
• COVID Action Map – an interactive map of COVID action groups worldwide, including mask blocs, virtual networks, advocacy organisations, clean air organisations and community events²³⁴.
• Protect the Heart of the Arts – grassroots advocacy campaign to sound the alarm on the Long COVID emergency in the performing arts community. They advocate for layered mitigations in venues, like clean air and masking, so that performers, crew, venue staff and patrons can safely attend²³⁵.

There many healthcare workers trying to raise the alarm, in the UK these include:

• Dr Claire Taylor – specialist in Long COVID²³⁶.
• Dr Rae Duncan – consultant Cardiologist and Long COVID Researcher²³⁷
• Prof Nisreen Alwan – public Health Professor MBE²³⁸
• Dr Deepti Gurdasani – clinical epidemiologist and statistical geneticist. She recently moved to Australia in the hopes of better COVID safety but still uses social media to speak about conditions in the UK²³⁹.
• Prof Tom Lawton – consultant in critical care²⁴⁰.
• Dr David Tomlinson – consultant cardiologist²⁴¹.
• Prof Trisha Greenhalgh – professor of primary healthcare²⁴².
• Dr Binita Kane – pulmonologist with interest in Long COVID²⁴³.
• Dr Helen Salisbury – general practitioner²⁴⁴.
• Dr Jonathan Fluxman – general practitioner²⁴⁵.

UK charities and groups advocating for COVID protections include:

• Clinically Vulnerable Families²⁴⁶
• Long COVID Support²⁴⁷
• Long COVID Kids²⁴⁸
• Long COVID SOS²⁴⁹
• Long COVID Doctors 4 Action²⁵⁰
• Long COVID Nurses and Midwives UK²⁵¹
• Doctors in Unite²⁵²
• COVID-19 Bereaved Families for Justice UK²⁵³
• Hazards Campaign²⁵⁴
• COVID Action UK²⁵⁵

However, these voices are overpowered by the mainstream media, who continue to insist that COVID is mild, that the pandemic is over and to mock and belittle those who continue to try to avoid infection.

What can I do to protect myself and others?

Minimise Infections! New infections bear new risks… 

• Wear a well-fitted FFP2/3 respirator mask indoors and in outdoor crowds. These are designed to filter airborne viruses, unlike surgical or cloth masks^256,257.
• Test regularly, especially before gatherings. Doing so regularly can help reduce your risk of transmitting the virus, but be aware that a negative test does not guarantee that you are free from COVID²⁵⁸.
• Be aware that the full range of COVID symptoms includes muscle pains, sore throat, diarrhoea, vomiting, rashes and conjunctivitis; and that fever, loss of smell and a dry cough are not always present^259,260,261.
• Move activities outside if possible and increase indoor ventilation by by opening doors and windows and try to limit time indoors in busy spaces^262,263. 
• Seek out venues with air filtration – filters such as HEPA filters can be used to physically remove viral particles from the air and significantly reduce risk of infection^262,263,264.
• It is possible to use nasal sprays such as Boots Dual Defence/Viraleze and CPC mouthwashes as a complement to masking. While the evidence is limited, so don’t rely on these to prevent infection, they may provide an extra layer of protection²⁶⁵.
• Spread the word – if public health and the government won’t save us, we need to save ourselves.
  • Be visible on social media wearing a mask and practising COVID mitigation.
  • Share posts and articles on social media which accurately warn of COVID risks.
  • Sign and share petitions for universal masking in healthcare and on public transport.
  • Amplify the voices of charities/organisations fighting for COVID protections. 

If you are infected:

• Isolate for at least 10 days and until you test negative^188,266.
• If you must go out anywhere, wear a high quality, well fitted mask^188,266.
• Inform those you have recently been in contact with that you have tested positive, and they may have been exposed to COVID^188,266.
• Rest as much as possible – this can help to reduce risk of developing Long COVID⁵⁴.
• Try to isolate from others within the household. Wear a mask, run air filters, and open windows. It is possible to stop household transmission²⁶⁷.
• Try to isolate from pets as much as possible as they can also catch COVID. Studies show that in some cases this can cause multiorgan damage, including brain damage in dogs and cats, and in rare cases death^267-271. 
• Be vigilant to signs and symptoms of Long COVID, which may develop weeks to months after the initial infection²⁷².

If you have read this far, thank you. I understand that it may seem like the easiest thing to do is bury your head in the sand. Especially if you have already had COVID, it can be scary to think of the damage that might have already been done. But it is possible to prevent transmission and limit any further damage. Avoiding further reinfection can go a long way toward protecting your health, and the health of those you are close with. Our government and public health are not coming to save us – it is up to us to protect our communities. Every infection prevented is health, and potentially a life, saved.

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