The following asks were developed through co-production with participants at an online public event hosted by
Covid Action Scotland on 19^th July 2025.

ASK 1: Acknowledge that Covid-19 reinfections cause serious long-term effects on health and advise the population on the need and means to minimise infection risks

There is an ever-increasing body of evidence that repeated reinfection with Covid-19 increases the likelihood of long-term damage to health, including Long Covid. It’s therefore unsurprising that tracking the incidence of many different illnesses, NHS pressures, labour market inactivity and school absences due to sickness, disability benefit expenditure, etc, etc, all show a step-change compared to the pre-pandemic period, with similar trajectories soaring upwards (see for example here, here, and here.

The next Parliament and Government need to ensure that there is strong public health information about the risks and effects of repeat Covid infections and about effective mitigations, so people are empowered to manage and mitigate their individual risk where they can, and are protected from airborne infections where public, collective action is required.

Ask 2: Require and invest in clean indoor air

Clean indoor air, i.e. good ventilation coupled with air-filtering, will stem the spread of all airborne viruses, including Covid-19 but also flu, RSV and Norovirus. It would significantly improve public health and thus reduce pressure on the NHS, labour market inactivity due to sickness, work and school sickness absence rates, and future disability benefit expenditure, it would be to address unsafe, unhealthy indoor air.

At a minimum, CO2 monitoring should be required in healthcare settings, in care homes and in schools, nurseries and other educational settings. If ventilation alone is not enough to keep CO2 within safe limits (i.e.< 800 ppm) then air filters should be required to be installed and consistently used. Investments in air filters in schools or hospitals and would more than pay for themselves by reducing staff sickness and the need for supply/bank/agency staff.

Ask 3: Commit to stopping hospital and other healthcare-acquired infections

Lack of action on healthy indoor air, very little mask-wearing, no routine testing for often asymptomatic Covid-19, the fact people will be there precisely because they’re ill with airborne infection, all add up to making hospitals and healthcare settings among the most risky places to be. Wales is the only UK country that tracks hospital-acquired (‘nosocomial’) Covid-19 infection. Typically, around 75-85% of inpatient Covid cases in Wales are the result of hospital-acquired SARS-CoV-2 infection. There are no reasons as to why the situation should be different in Scotland (where monitoring of such infections stopped in early 2023) than they are in Wales.

Nobody should suffer harm because they seek healthcare. Hospital in-patients are by definition vulnerable. Nosocomial infections cause deaths, long-term deterioration, for example of elderly patients who may already be frail or be suffering from dementia, and prolonged hospital stay. Effective, well-proven measures for preventing such infections must be taken. Those including air filters and wearing of FFP2/FFP3 masks, as well as routine testing of staff and of in-patients.

Ask 4: Increase infection monitoring and support testing

Testing is crucial for data collection. Without it how can you reliably know what the prevalence is, and take preventative action? How can you identify and treat illness appropriately, and protect others? How can you track whether subsequent bodily damage, illnesses and deaths originate with Covid infection?
 
We welcome the fact that the Scottish government continues to fund wastewater monitoring of Covid, but, while this must continue, it is not enough. We believe that free lateral flow tests should be available to all. Routine Covid testing of all hospital in-patients and of all residents in care homes should be reintroduced as top priorities.

We welcome the fact that the Scottish government continues to fund wastewater monitoring of Covid, but, while this must continue, it is not enough. We believe that free lateral flow tests should be available to all. Routine Covid testing of all hospital in-patients and of all residents in care homes should be reintroduced as top priorities. Mandatory testing of hospital patients prior to discharge to care homes needs to be reintroduced. Routine testing of healthcare and social care workers should also be reintroduced, especially during and after any viral symptoms.

Ask 5: Commit to an independent Scottish approach to vaccines, based on science

Scotland has devolved power over healthcare. It is under no obligation to follow advice by the Joint Committee on Vaccination and Immunisatoin (JCVI). To do so is a political choice. As such, Scottish Government, whose advice is far more restrictive than that of, for example, the World Health Organisation or the CDC in the United States, even under the Trump administration.

We believe that free COVID-19 vaccines should be available to anybody from 6 months onwards. At a very minimum, the World Health Organisation’s recommendations must be implemented, which say that people at high clinical risks, including during pregnancy, and anybody age 50+ should be offered and recommended regular vaccine boosters.

Ask 6: Commit to support and treatment for people with Long Covid

People are continuing to get Long Covid due to the fact that any attempt to prevent infection spread has been abandoned. Long Covid is typically a chronic illness of multi-system damage and dysregulation. There is evidence that Long Covid has overtaken asthma in the UK as the most common chronic childhood illness. The
Scottish Government has committed £4.5mn recurrent funding per year for Boards to deliver services for Long Covid and ME. This is welcome. However, even based on figures available (which are likely to be a significant under-estimate), that works out as around just £7 per person. There must be new, long-term and increased funding for Long Covid clinics and effective treatments for conditions associated with Long Covid must be made available to all who might benefit.