As the UK COVID-19 Inquiry releases its Module 2 report on political governance and core decision-making, the COVID Airborne Transmission Alliance (CATA) has warned Chair Baroness Hallett that NHS workers remain at risk from airborne diseases. The alliance, representing tens of thousands of healthcare professionals, fears the government will again fail to act on lessons about airborne transmission.

Inquiry findings on airborne spread

The Module 2 report, published on 20th November 2025, criticises the UK’s early pandemic response as too little, too late. It highlights evidence emerging in March 2020 showing that COVID-19 spread through airborne aerosols. Public guidance on ventilation appeared months later and NHS protocols remained inconsistent, leaving frontline staff exposed in poorly ventilated environments.

These findings mirror CATA’s concerns as a participant in Module 3, which examined healthcare impacts.

Long-term burden and failures in preparedness

Ms Kamini Gadhok MBE, Vice-Chair of CATA, says: “The country has invested millions of pounds into the inquiry and a huge amount of faith into the process to help us learn lessons. COVID-19 has caused over 250,000 deaths and scientists’ understanding of the wide variety of long-term health consequences is advancing rapidly. There is a realisation that the burden of long-COVID on the nation’s healthcare systems will be far greater than was realised in the early days of the pandemic.”

CATA was formed in 2023 from earlier groups such as the Aerosol Generating Procedures Alliance and the COVID Airborne Protection Alliance. Its membership includes the Royal College of Speech and Language Therapists and the British Association for Parenteral and Enteral Nutrition.

The alliance argues that government responses to previous recommendations on pandemic preparedness have stalled. Safety expert David Osborn says: “The Government outlined an ambitious strategy and launched a plethora of documents and initiatives. However, it has been short on delivery. There is no monitoring or real plan to control any airborne diseases in healthcare settings and it’s costing the UK taxpayer billions and making hospitals the best place to go to catch COVID-19, or flu, or potentially even TB, Scarlet Fever or Measles.”

Osborn continues to uncover withheld scientific advice through Freedom of Information requests, which CATA plans to provide to the inquiry.

Biological security system under strain

CATA cites an independent Centre for Long-Term Resilience review of the UK’s Biological Security Strategy, published in August 2024. The review highlighted UK Health Security Agency (UKHSA) weaknesses, including underspending, administrative delays and missed targets in biological surveillance. Baroness Hallett has previously called surveillance as the country’s best defence against future pandemics.

Dr Barry Jones, chair of the alliance, says: “It is not surprising that UKHSA has failed its examination on pandemic planning, given the designated lead officer role for pandemics, the Director General for Strategy, Policy and Programmes appears to have been vacant for most of the year. The absence of progress in this area might be expected under the leadership of the new chief of UKHSA, Professor Susan Hopkins. She was one of the lead advisers during the COVID-19 pandemic, during which the UK had the second largest death toll for healthcare workers in the developed world.”

Professor Hopkins, appointed UKHSA chief in September 2025, previously served as its first chief medical advisor.

Continued pressure from long COVID

Module 2 also describes how delayed recognition of airborne transmission fuelled political fragmentation and inconsistent NHS protection measures. Ventilation guidance was incorporated into public messaging only by summer 2020, despite international evidence, including from the World Health Organisation.

This legacy continues. Long COVID affected an estimated 1.9 million people in the UK by mid-2025, contributing to fatigue, breathlessness and cognitive difficulties.

Concerns over government understanding of airborne risks

CATA has also criticised correspondence from Minister for Public Health Ashley Dalton, saying it reflects misunderstandings of airborne transmission and of obligations under the WHO Pandemic Accord signed in May 2025.

Professor Kevin Bampton, CEO of the British Occupational Hygiene Society (BOHS), says: “If Lady Hallett is hoping for decisive and informed leadership from the government, she is likely to be disappointed. In correspondence with CATA, the Minister responsible, Ashley Dalton seems utterly confused about the science and law published by public bodies. This is despite clear obligations set out by the WHO on the control of the virus and signing the WHO Pandemic Accord.”

BOHS issued detailed PPE guidance in July 2025 under Control of Substances Hazardous to Health regulations. It explains that:

• Fluid-resistant surgical masks provide source control but limited inhalation protection.
• Filtering respirators such as FFP3 filter 99% of aerosols and protect the wearer when properly fit-tested.
• Respirators are required in settings where ventilation is inadequate.
• Valved respirators may reduce source control.

Gaps in government planning

The Department of Health and Social Care’s revised Pandemic Preparedness Strategy is still unpublished. Officials attribute delays to Exercise Pegasus, a national simulation held from September – November 2025 during peak holiday periods.

Dr Barry Jones says: “Exercise Pegasus is welcome and hopefully it will inform practice, unlike previous exercises before the pandemic. However, what has been delivered is a poor relation to a similar exercise run in the Netherlands.”

The Dutch “Disease X” simulations in 2025 featured interdisciplinary planning and stronger attention to zoonotic threats.

Jones adds: “Not all the key stakeholders (including inquiry-appointed IPC experts) were invited to participate or observe. This is an area where the country needs openness and transparency, which was in such short supply when it was needed during the height of the pandemic. The lack of such involvement renders the exercise not fit for purpose.”

Reliance on vaccines over ventilation

CATA argues the government continues to rely primarily on vaccines, which reduce severity but not infectiousness. The alliance warns this leaves vulnerable patients exposed and undermines staff confidence in employer protections.

Call for accountability

As airborne transmission risks persist in under-resourced NHS settings, CATA urges Baroness Hallett to use the inquiry’s findings to secure stronger accountability. Without urgent reforms, the alliance warns the UK remains vulnerable to respiratory threats and risks losing the opportunity to learn from the pandemic.