Today is Long Covid Awareness day. It is strange that such a day should be necessary, given how many people’s lives Covid and Long Covid have touched in this country and around the world. Yet it is very necessary as the prevailing public discourse is that Covid is over, and it was never much of a problem to start with. Yet it still kills every week throughout the year, and an estimated 2 million people have Long Covid, affecting their health, and the country’s economy.

The ongoing Covid pandemic is a catastrophic example of the failures of the UK’s public health system. (I refer here primarily to English experience. The devolved administrations have done better than England, but are still affected to a large and tragic extent by the factors discussed below.) Covid requires both treatment and prevention, both medical and public health intervention, and both short and long term strategies with public, professional and political support.

The NHS did immensely well and the government moderately well in the initial phases; the public in general also did well in dealing with the restrictions and exigencies of lockdown. But there were clearly right from the beginning several negatives, which broadly compromised the capacity of public health approaches to be as effective as they could, and have badly compromised government action and professional and public response in the years since the emergency phase:

a) the instinctive reaction of our right wing governments that private provision must be better than public, so wasting billions of taxpayers’ pounds employing immensely expensive private firms to set up a ramshackle test and trace system rather than using existing public health capacity.

b) corruption in government, making sure for instance that funds for the provision of PPE went to their friends rather than to companies with proven track records in such provision.

c) vociferous anti-science and anti-clear thinking conspiracists given far too much air time on both social and traditional media.

d) a kind of neoliberal reductionism in which marginal increases in economic activity like enabling people to go to pubs again are valued far more than keeping people healthy; and school attendance is valued far more highly than reducing transmission – which has resulted in current high rates of absence of both children and teachers through sickness.

e) a refusal from government to take simple steps that might reduce transmission, such as ensuring air filtration in all classrooms and other public spaces which could easily and relatively cheaply have been done in the last four years.

f) short term and blinkered thinking in government and in public debate, in which the most important, and sometimes, the only important metric is death rates, leading us to ignore the creeping epidemic of long term illness and other forms of severe damage which Covid is wreaking on millions of people. We seem to be terrible at assessing long term risk: the fact that we got over a bout of Covid means we ignore the mountain of evidence that it will have done damage to one or more of our organs, which we will regret in ten or fifteen years time.