Reaffirming health and safety precautionary principles for COVID-19 in the UK.

In their case for a sustainable UK strategy for COVID-19, Deepti Gurdasani and colleagues recommend “restoration of an adequate health and safety inspectorate”. We do not believe that the UK Health and Safety Executive (HSE) should, like Public Health England, be made a scapegoat for lack of ministerial direction but rather that the HSE should be restored the wherewithal to fulfil its mandate.

The HSE needs to step up in this pandemic, independently of political influence, and to firmly enforce occupational hygiene measures for source control, including regular staff testing, segregation, and ventilation. Moreover, the HSE should apply precautionary principles with regards to the proliferating evidence for aerosol transmission of severe acute respiratory syndrome coronavirus 2.

The HSE should recognise research, such as its own showing the marked superiority of filtering facepiece respirators (eg, FFP3) over surgical masks, and should re-assert its own guidance to use such respirators as personal protective equipment (PPE) for workers.

Early in the pandemic, the HSE adopted a risk-adapted management strategy and tolerated less stringent PPE requirements, perhaps because of the inadequate, depleted, and neglected state of the national stockpile of PPE. Several months have since elapsed, and billions of pounds of taxpayers' money has been spent amassing huge stocks of PPE. It is not clear why the HSE is still not recommending respirators as PPE for public transport workers and other public-facing occupations, as well as in health and social care in situations where control at source, barriers, and ventilation are not adequate.