Dáil Éireann Debate, Tuesday - 7 December 2021
489. Deputy Richard Bruton asked the Minister for Health the measures in place to support persons with long Covid; the extent of the prevalence of same; and if cover such as medical card cover can be extended on a temporary basis. [59865/21]
View answerCOVID-19 is a new disease so information on it, its features, incidence and its course are still emerging. The natural history, clinical course and consequences of COVID-19 are still not completely understood. It is recognised that most patients with COVID-19 return to baseline after acute infection with SARS-CoV-2, but a proportion report ongoing health issues.
The number of people that are affected with longer term sequelae after acute COVID-19 remains unknown, but published reports indicate that approximately 10– 20% of COVID-19 patients experience lingering symptoms for weeks to months following acute SARS-CoV-2 infection.
Several organisations and societies have proposed different definitions based upon the constellation of symptoms that affect people after acute SARS-CoV-2 infection. To aid recognition and management of those affected, the WHO has recently through a global consensus process proposed a working clinical case definition of Post COVID-19 syndrome occurring 3 months from the onset of COVID-19, with symptoms that last for at least 2 months and cannot be explained by an alternative diagnosis. Common symptoms include fatigue, shortness of breath, cognitive dysfunction and others which generally have an impact on everyday functioning. Symptoms may be new onset, following initial recovery from an acute COVID19 episode, or persist from the initial illness. Symptoms may also fluctuate or relapse over time. However, the WHO notes that this definition may change as new evidence emerges and our understanding of the consequences of COVID-19 continues to evolve.
Patients with persistent symptoms following COVID-19 infection may be followed up by their GP or in hospital settings as clinically appropriate. People in the community who are concerned about persistent symptoms following Covid-19 should contact their GP in the first instance. Treatment is currently focused on management of specific symptoms.
Specific guidance on the treatment of 'Long COVID' is presently under development both here and internationally. The HSE is currently assessing need and the best way to care for those impacted by Long COVID to ensure the appropriate supports are in place. As part of this work on post-COVID care, the HSE is examining how it can model the possible numbers that will be affected, noting that this will take time as more evidence emerges. I understand that the HSE has also been in touch with a group of people who are suffering post-COVID symptoms to inform understanding. You may wish to note, that a Programme Manager/Implementation Lead and Clinical Leads have been identified within the HSE who will be key stakeholders in driving this programme of work.
The Department of Health will continue to develop an understanding of the implications of Long Covid to inform policy as appropriate.
Under the Health Act 1970 (as amended), eligibility for a medical card is based primarily on means. The Act obliges the HSE to assess whether a person is unable, without undue hardship, to arrange general practitioner services for himself or herself and his or her family, having regard to his or her overall financial position and reasonable expenditure. The issue of granting medical cards based on having a particular disease or illness was previously examined in 2014 by the HSE Expert Panel on Medical Need and Medical Card Eligibility. The Group concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card.
However, every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from, the social and medical impacts of an illness.
