Sickness absence rates for NHS workers in England have increased, showing the impact of the second wave of Covid-19 on health staff.
Official figures showed that absence rates last December for England were 5.1%, compared with 4.9% the previous month.
Union leaders said there were high absence levels for stress, anxiety and the toll on mental health after the challenges of the past year.
The number of full-time equivalent (FTE) days lost because of coronavirus was 164,641 in October, rising to 286,592 in November and 362,774 in December.
Covid was responsible for 9.5% of all FTE days lost to illness in October, 15.6% in November and 18.4% in December.
The percentages are even higher when looking at different types of staff.
In December alone, Covid was responsible for 20.5% of FTE days lost to illness by nurses and health visitors, 25.7% for ambulance staff and 32.6% for doctors.
The North West region reported the highest sickness absence rate in December 2020 at 6%, while the London region reported the lowest rate at 4.4%.
Ambulance trusts had the highest sickness absence rate at 7.1% in December.
Royal College of Nursing acting general secretary Pat Cullen said: “The level of staff sickness should act as a stark reminder to Government of the need for proper protection and support.
“Ministers must act now and not wait for things to improve and risk the future welfare of nursing staff.
“The nursing workforce is the greatest asset of the health and care system and all those who have given so much in the last year need to be given the time and support they need to recover.”
Unison’s head of health Sara Gorton said: “The NHS is continuing to grapple with a depleted workforce.
“There are high absence levels for stress, anxiety and the toll on mental health after the challenges of the past year, as well as the ongoing impact of Covid.
“There’s a colossal workforce challenge as the NHS comes through the pandemic and tackles the backlog of delayed treatment.
“Support from employers is critical to ensuring exhausted staff get back to full health, and that includes giving them the time they need to recuperate.
“Giving them a decent pay rise would provide a much-needed morale boost and would ease the strains caused by money worries.
“It would also help attract new staff, to relieve some of the shortage pressures making so many staff ill.”
A Department of Health and Social Care spokesman said: “We recognise the enormous pressure this pandemic has put on our heroic NHS and social care staff and we are funding dedicated mental health support, including a 24/7 helpline, to provide help to those who need it.
“There are now a record number of doctors, nurses and NHS staff working in the NHS in England, and we are backing the health service at every turn, investing £63 billion over the last year and an additional £29 billion next year, including to help address patient backlogs and tackle the long waiting lists that have built up during the pandemic.”