Rehman v Secretary of State for Health and Social Care & Others: Covid-19 care home claims struck out

In the judgment handed down for Rehman v Secretary of State for Health and Social Care & Others on 12 January 2026, Master Davison struck out a group of fatal Covid-19 claims arising from infections contracted in care and nursing homes during the first wave of the pandemic. Master Davison found that these claims needed to meet orthodox “but for” causation standards. 

Case background

The claims were brought by relatives of elderly residents who died after contracting Covid-19 in early 2020. The allegations centred on the March 2020 Discharge Requirements and April 2020 Admissions Guidance, which did not mandate 14-day isolation for asymptomatic admissions. The claims followed a 2022 High Court judicial review that held the policy had been unlawful as it failed to take into account the risk to care home residents of asymptomatic transmission of the virus. There were further allegations concerning failures to implement adequate infection control measures within the resident’s care homes.

The claimants argued firstly that Covid-19 infection is dose-related and that "guilty" exposures attributable to negligence materially contributed to the disease under Bonnington Castings principles. Alternatively, they argued that attribution to a particular source was scientifically impossible and that tortious exposures materially increased the risk of infection and death, relying on Fairchild principles. 

Material contribution rejected

Master Davison rejected the material contribution argument. The claimants accepted that they could not prove that the infectious particles which caused any individual resident's infection were the "guilty" particles generated by the alleged breaches. At most, they could show that tortious exposures increased ambient viral load and the risk of infection.

This was not enough to bring a Bonnington Casting material contribution claim, which requires proof that the defendant's breach made a real, non-trivial contribution to the injury itself, not merely to the risk of that injury, Master Davison stating:

“The claimants may, as the defendants accepted, show that the deceased were exposed to “guilty” viral particles attributable to breach of duty on the part of the defendants. They may also show that the presence of “guilty” particles increased the risk of them developing Covid-19 by increasing the available dose. But what they have stated in the clearest possible terms is that they cannot prove that it was the “guilty” viral particles which actually caused / partly caused their disease. There is no doubt that this is what they are required to do.”

Fairchild exception unavailable

The Master also found that the Fairchild exception could not be applied. Whilst difficult, it was not inherently impossible as a matter of medical science for the claimants to prove how their injury was caused, as stated by Master Davison:

“The words 'inherently impossible' mean that this is a condition to be applied ab initio to a class of claims that qualify. It is not to be applied to claims which fall to be decided on ordinary causation principles but which have run into difficulties of proof.

“I do not think that it is unjust to require Covid-19 claims to be proved in the ordinary way and on ordinary 'but for' principles. If the claims were permitted to go forward on a Fairchild basis it would mean that the claimants would need to do no more in each case than show a non-negligible increase in circulating viral particles attributable to a tortious act or omission.”

The decision reaffirms the orthodox causation principles in claims concerning infectious diseases. The decisions in Bonnington Castings and Fairchild are narrow exceptions which are subject to strict controls, the thresholds for which were not met in these cases. The claimants have permission to appeal.