Denis Naughten
Question:4. Deputy Denis Naughten asked the Minister for Health the steps that are being taken to provide long Covid services across the country; and if he will make a statement on the matter. [16430/22]
View answerThursday, 31 March 2022
Questions (4)
Oral answers (6 contributions)
Based on research that I commissioned from the Oireachtas Library and Research Service, we have somewhere between 145,000 and 300,000 cases of long Covid in Ireland, with a surge of these cases presenting to our already overwhelmed health service as a result of the spread of the Omicron variant late last year. I am concerned that our health service is sleepwalking into a potential avalanche of chronic illness cases as a result of long Covid.
I thank the Deputy for this important question. I acknowledge his ongoing advocacy and work on the issue.
The Government is committed to ensuring that those suffering from long Covid receive the full support they need. A few months ago, I met patients attending a long Covid clinic in Tallaght University Hospital. Hearing first hand from them about the significant deterioration in their ability to live their lives and the symptoms they were dealing with was sobering. According to the advice I have been given, we know that long Covid can be experienced through approximately 50 symptoms, the most common being fatigue, weakness, breathlessness, anxiety, difficulty with memory and concentration, and musculoskeletal pain. These are serious symptoms.
Anyone concerned with long Covid is advised in the first instance to attend his or her GP, who can refer him or her for specialist care where needed. There are services in place. Critically in the context of this question, we are expanding those services. The HSE has developed and is implementing an interim model of care to provide long Covid services nationally. Some €2.2 million has been allocated directly for that. It involves services across a number of healthcare settings, including GPs, communities and hospitals. The initial priority is to establish post-acute and long Covid clinics within each hospital group. The HSE has advised that the post-acute clinics are managing patients between four and 12 weeks after initial onset of infection and the long Covid clinics are managing patients 12 weeks post onset of infection. The clinics are established as part of a new interim model of care. They are operational in four of the hospital groups and work is ongoing to establish the additional clinics and links with the other hospital groups and clinics to ensure that we have a national network, which we need and for which the Deputy has been calling.
I welcome that these post-acute and long Covid clinics are being established, but we have been a long time waiting for that. I was promised last September that they would be put in place. We are being told that, until they are put in place at hospital level, there will not be a network back to the GPs.
The Minister has provided advice this morning that people experiencing long Covid should go to their GPs. GPs are overwhelmed and it is impossible to get an appointment. When someone goes to a GP, the GP does not have the data. When the GP sends someone for a test, the test is not showing any indication of long Covid. There is not a proper referral pathway into the acute hospital system, and even when people get into it, there is no testing or procedure in place. The clinics are only available in a handful of hospital settings.
I accept that the Deputy was told this last September. Since then, a great deal has happened and clinics have been set up. The Deputy will appreciate that, given the immense pressure that our hospital system is under, our healthcare professionals are working as quickly as they can.
The interim model of care focuses on two different aspects - post-acute clinics and, after that, long Covid clinics. As the Deputy rightly stated, we need the clinics in all of the hospital groups. We have them in four and are establishing them in the rest as quickly as we can. The Deputy is also right about the need for more engagement with GPs, primary care and the Irish College of General Practitioners, ICGP, to ensure that resources, protocols and training are available to GPs and that, in those instances where GPs are able to provide care, there is a specialised service available when their patients are referred onwards.
The difficulty is that we are experiencing an avalanche of these cases. Somewhere between one in ten and one in five people who have Covid end up with long Covid. They are presenting at GPs' surgeries at the moment but there is no referral pathway in place for the majority of them. We are looking at a minimum of 145,000 people added on top of the 1,610 people already within hospitals suffering acute Covid today.
In the numerous responses that I have received from the HSE, it has stated that it will build on the existing level of service provision. Anyone who has suffered from myalgic encephalomyelitis, ME, or chronic fatigue syndrome, will tell you that the services are not there at the moment, so we will be building on dangerous foundations.
Regarding the clinical approach, the HSE is using the UK's National Institute for Health and Care Excellence, NICE, guidelines in defining long Covid. The HSE says that long Covid is characterised by symptoms that develop during or after an infection consistent with Covid-19, persist beyond 12 weeks and are not attributable to a different diagnosis. As the Deputy is aware, there is a great deal of uncertainty in the international literature about how many people experience prolonged symptoms, but as he has consistently and rightly stated, the initial indications are sobering. While the published international reports vary, our best current understanding is that between 10% and 20% of Covid-19 patients experience lingering symptoms for weeks or, sometimes, months.
As the Deputy rightly said, it is a very significant number of people. The clinicians are at present working through what portion of those people will require ongoing clinical supports. The HSE is now putting a patient registry and an epidemiological survey in place to help with that.