Intended for healthcare professionals

Letters Chief coroner’s guidance on covid-19 deaths

Chief coroner’s guidance on covid-19 deaths: workers outside the NHS are also vulnerable to risk

BMJ 2020; 369 doi: (Published 02 June 2020) Cite this as: BMJ 2020;369:m2179
  1. Andrew E Watterson, professor
  1. Occupational and Environmental Health Research Group, Public Health and Population Health Research Group, Faculty of Health, University of Stirling, Stirling FK9 4LA, UK
  1. aew1{at}

The BMJ rightly questioned the decision that coroners need not investigate NHS England personal protective equipment (PPE) failures in staff deaths from covid-19.1 This rings alarm bells for workers beyond the NHS who may have been exposed to SARS-CoV-2 without appropriate PPE. The medical press will hopefully speak up for these often very vulnerable workers.

SARS-CoV-2 occupational hazards in the UK emerged for many workers beyond health and social care at almost the same time but produced different levels of awareness, investigation, and action. Hence, covid-19 risk recognition and possible morbidity and mortality of workers has come in waves. The first wave, with a surprisingly belated and only partial recognition of the threats, contained those treating or in contact with covid-19—doctors, nurses, other health professionals, cleaners, and emergency and essential workers. Major PPE and testing problems compounded their risks.

The second wave contained social care and home care workers who faced even greater PPE and testing problems. The third wave contained key transport, service sector, and other workers. The fourth wave will include more construction and manufacturing workers.

Covid-19’s recognition as an “occupational disease” is likely to be highly problematic for all workers and, in the later waves, health and safety risks are less obvious. This is a neglected global research and publication field. Very few scoping reviews on covid-19 mention safety for grocery store staff, public transport workers, or taxi drivers, and little information is currently available on key and essential workers.2 Trade unions and non-governmental organisations have regularly raised the lack of PPE and health and safety precautions for these third and fourth wave workers.34 It is to be hoped covid-19 deaths and illnesses in these workers, however, will be fully documented and recognised.


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