Boris Johnson, as he has longed to be all his life, was first. The news the prime minister had tested positive for COVID-19 was greeted not with surprise, but with weary expectation. A few short weeks before, Johnson had boasted about going to a hospital and shaking hands with everyone he met, including those with symptoms. The government had sought to downplay the dangers of the virus for as long as possible, suggesting publicly and privately they might allow it to spread among the public to yield “herd immunity.” They have only been forced to adopt the stringent measures seen in other countries because of public pressure and a rising death toll tracking Italy’s trajectory.

Several short hours later, both the health secretary, Matt Hancock, and the chief medical officer for England, Chris Whitty, confirmed they had tested positive. Shortly after the announcement of Johnson’s positive test, his chief adviser, Dominic Cummings, was seen literally fleeing Downing Street, likely to avoid being caught flouting self-isolation rules (rather than in an attempt to flee the prime minister’s plague pit in fear). Cummings is now self-isolating after also developing symptoms over the weekend.

The top ranks of government have fallen to the virus, and now the National Health Service (NHS) looks set to face increasing and far-reaching pressures and partial collapse due to the Conservatives’ long- and short-term decision-making. Over the weekend, three doctors were confirmed to have died of the virus after treating patients. Doctors and health care workers have been constantly raising the alarm, risking their jobs in speaking out about the lack of personal protective equipment (PPE) needed to adequately safeguard their own health while attempting to save lives.

A medical fetish store spoke out on Twitter, critical that the NHS were so desperate for stocks of scrubs that they had approached the company, which donated its entire stock, stepping in where the government failed. Yet in 2017, the Department of Health, then under the leadership of former health secretary Jeremy Hunt, rejected advice that visors and eye-protection equipment should be stockpiled to guard against a potential influenza epidemic, because of the cost.

That cost now is paid in lives. The NHS has been deliberately run as close to capacity for as long as the Conservatives have been in power. Winter flu outbreaks had already stretched the system, and waits to see general practitioners grew ever longer. Running at capacity allows no strain without snapping, and what the United Kingdom sees now is only the beginning of the fallout. Doctors are already threatening to quit, exhausted, overworked, and risking their own safety as well as their patients’ lives in dangerous, ill-equipped situations. On Friday, many people opened their windows or stepped into gardens and onto balconies to “clap for NHS workers.” It is a welcome gesture for some, but a much greater material gesture is needed immediately and after the pandemic slows.

Bursaries for trainee nurses have been abolished under the Conservatives, so many student nurses are working above and beyond their training hours for no pay to try to save lives. Doctors’ pay and conditions have been eroded for years, with increasing workloads and recruitment problems adding to the lack of financial gratitude shown in their salaries.

But the NHS’s problems don’t begin and end with COVID-19: the mental health system was already overburdened, with long waiting lists for talk therapy and little support for issues that don’t respond to cognitive behavioral therapy. Mass lockdown and isolation will only increase the rate of mental health problems in a population facing a long-term change in their work and social habits. Health is directly linked to poverty, too: the spike in unemployment and underemployment will cause worsening physical health for people struggling to afford bills and getting by on minimal government assistance.

Many cancer patients have reported they have had their chemotherapy and radiation treatment postponed or appointments canceled at the last minute while staff are deployed elsewhere. After the UK “flattens the curve” of the pandemic, the NHS will have to deal with the huge backlog of missed appointments and treatments and an increasingly ill population, even leaving aside those who will die not of, but because of, COVID-19’s effect on NHS capacity.

The risk is that small platitudes — free coffee at chains for NHS staff, or mass cheers and claps — become the limit of the public’s appetite for change. Politicians would certainly prefer that. But the 2016 doctors’ strike showed that the public was actually behind the protests, despite usually being hostile to industrial action. When it came down to the wire, people felt doctors should earn more and were underpaid, and they realized that meant, in turn, that patients received worse treatment, and this risked the lives of their loved ones.

This time, doctors and nurses are risking their own lives, too. The crisis will strain every aspect of the NHS and affect far more people’s health than those who contract the virus. Health care workers should continue to hold the government accountable for risking our lives and their own, and should make it clear that afterward, if the government wants NHS workers to put the system back together, they need more. More protection. More funding. More staff. And more respect.