Welfare bill alone could top €1bn
Denis Naughten TD has told the Dáil that an estimated 114,500 people, and rising, have ‘long Covid’ in Ireland and that it is rapidly becoming a hidden iceberg of long-term chronic illness for our struggling health service.
“This number of people with long Covid could be a sleeping crisis for our health service that may overwhelm already horrendous hospital waiting lists,” said Denis Naughten.
Deputy Naughten has provided the figure based on research produced on his request by the Oireachtas Library & Research Service and he called on the Minister for Health to establish multi-disciplinary teams as a matter of urgency to support the rehabilitation of patients with long Covid.
The World Health Organisation has defined long Covid or post Covid-19 condition as a condition that occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually three months from the onset of COVID-19 with symptoms and that last for at least two months and cannot be explained by an alternative diagnosis.
Common symptoms include fatigue, shortness of breath, cognitive dysfunction but also others and generally have an impact on everyday functioning. Symptoms may be new-onset following initial recovery from an acute Covid-19 episode or persist from the initial illness. Symptoms may also fluctuate or relapse over time.
These effects appear to occur irrespective of the initial severity of the covid infection but occur more frequently in women, middle age and in those with more symptoms initially.
“As Covid-19 case numbers grow, the number of long Covid cases will also grow, proportionately. And while not all of this group may require health services, I estimate if all 114,500 people claim Covid Illness Benefit, and subsequently Illness Benefit, for the minimum five-month duration (meeting the WHO definition) this would cost the Department of Social Protection €925m alone,” stated Denis Naughten.
“This figure does not include health care costs such as hospitalisations, General Practitioner appointments, drug costs, diagnostic investigation, out-patient department appointments or clinical specialist assessment.
“Nor does it take account of the reduction or loss of productivity and absenteeism never mind the financial and personal impact it has on those with the chronic conditions associated with long Covid.
“While the HSE stated last September that it planned to establish specialist long Covid clinics, only a Model of Care for Long Covid has been agreed, with the HSE now starting to implement it,” Denis Naughten told the Dáil.
“The HSE has stated that a variety of disciplines will need to be recruited to support these clinics and, as a result, it has no idea when long Covid clinics will become fully operational.”
Deputy Naughten went on to point out: “It is only after these become operational that pathways to and from GPs and community services will be established, even though the majority of people with long Covid will have to rely on their GP to access a service initially.
“This slow rate of action is in stark contrast to dealing with primary Covid infection,” concluded Denis Naughten.
Oireachtas Library & Research Service Briefing Paper:
watch the debate here: https://youtu.be/rpFOBsESLtc
TOPICAL ISSUE No.3
Thursday 27th January 2022 (7.30pm)
The urgent need for the Minister for Health to establish multi-disciplinary teams to support the rehabilitation of patients with Long Covid
Denis Naughten TD
Speaking note on Topical Issue
Check against delivery
Long Covid has been called a “hidden an iceberg of long-term illness” and the HSE has been slow to acknowledge the condition or provide clear pathways for care which could have serious long-term implications for those with the condition, as well as our health service and our economy more generally.
Various studies give different incidence rates for Long Covid but a research paper produced by the Oireachtas Library & Research Service at my request, using the official figures of Covid-19 cases, along with a review of the academic literature, estimates that the number of people in Ireland who have had Covid-19 and who are/who will experience Long Covid is at a minimum of 114,500 (based on case data on 24 January 2022 and rising in proportion to Covid-19 case numbers as infections continue).
Note: This is a rough estimate by the Oireachtas Library & Research Service, not supported by any specific Irish data -see attachment
As Covid-19 case numbers grow, the number of Long Covid cases will also grow, proportionately.
And while not all of this group may require health services, I estimate if all 114,500 people claim Covid Illness Benefit and subsequently Illness Benefit for the minimum 5-month duration (meeting the WHO definition below) this would cost the Department of Social Protection €925m alone.
This figure does not include health care costs such as hospitalizations, General Practitioner (GP) appointments, drug cost, diagnostic investigation, Out-Patient Department (OPD) appointments, or clinical specialist assessment.
Nor does it take account of the reduction or loss of productivity and absenteeism never mind the financial and personal impact it has on those with the chronic conditions associated with Long Covid.
The World Health Organisation definition of Long Covid (post Covid-19 condition) is that it is a condition that occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms and that last for at least 2 months and cannot be explained by an alternative diagnosis.
In general, those with the condition are impacted in their everyday functioning. Common symptoms include fatigue, shortness of breath, and cognitive dysfunction. Symptoms may be new-onset following initial recovery from an acute COVID-19 episode or persist from the initial illness. Symptoms may also fluctuate or relapse over time.
These effects appear to occur irrespective of the initial severity of infection but occur more frequently in women, middle age, and in those with more symptoms initially.
Sadly in-depth searches of the HSE website and a variety of HSE documents do not identify any sources quantifying or indicating the nature or scale of the impact of Long Covid on our health service.
This could be a sleeping crisis that may overwhelm already horrendous hospital waiting lists.
While the HSE stated last September that it planned to establish specialist Long Covid clinics, as of today only a Model of Care for Long Covid has been agreed with the HSE now starting to implement it.
The HSE has stated that a variety of disciplines will need to be recruited to support these clinics, and as a result, they have no idea when Long Covid clinics will become fully operational.
AND it is only after these become operational that pathways to and from GPs and community services will be established, even though the majority of people with Long Covid will have to rely on their GP to access a service initially.
This slow rate of action is in stark contrast to dealing with primary Covid infection.
Previous Dáil replies
Wednesday, 15 September 2021
An tOrd Gnó – Order of Business
Denis Naughten (Roscommon-Galway, Independent)
We need to bring the Minister for Health before the House as a matter of urgency to find out why the HSE has been so slow to recognise long Covid as a condition. It is estimated that there is somewhere around 35,000 people affected by long Covid, but during the past 18 months patients have found it next nigh to impossible to get doctors to believe them, even though this condition has been recognised by the World Health Organization.
The economic cost alone is in excess of €50 million and continues to grow yet our health service is not even counting the numbers. The physicians of patients with post-viral chronic syndromes most commonly refer them to the mental health services, suggesting that it is all in their minds. This is not good enough. This issue needs to be addressed immediately.
Micheál Martin (Taoiseach, Department of An Taoiseach; Cork South Central, Fianna Fail)
….. The Minister for Health has no problem coming before anybody to discuss long Covid. Our Order of Business session has not started yet. The Business Committee is meant to order the House and decide what is discussed on Tuesday, Wednesday and Thursday but we now see a new parliamentary ruse every week. Members say that they do not want the Order of Business, which they have just agreed a short while ago at the Business Committee, to proceed because they want X, Y and X to happen. If X, Y and X are to happen, we will have no time to do anything. Then there will be the genuine issue of rushing legislation at the end of the year. I worry about the balance of time between dealing with legislation and taking legitimate questions to ensure accountability. Do not get me wrong but our timeline is an issue. That is a general point.
Later during order of Business
Micheál Martin (Taoiseach, Department of An Taoiseach; Cork South Central, Fianna Fail) ………As I have said to Deputy Naughten, there is no issue with discussing long Covid. I am sure the Minister will address the issue either before an Oireachtas committee or when taking questions here in the House. There is no issue with that. We take the matter very seriously by the way. I do not believe it is in anybody’s head. It is a very serious issue that will be with us for some time to come……
Thursday, 9 September 2021
Department of Health
Richard O’Donoghue (Limerick County, Independent) 1038. To ask the Minister for Health the position regarding support for persons suffering the effects of long Covid and who are unable to return to work; and if he will make a statement on the matter. [41633/21]
David Cullinane (Waterford, Sinn Fein) 1255. To ask the Minister for Health the status of the development of specific guidance on the treatment of long Covid; the criteria and strategies for the ongoing evaluation of patients; if research reports and data are or will be made publicly available; and if he will make a statement on the matter. [42233/21]
Denis Naughten (Roscommon-Galway, Independent)
- To ask the Minister for Health the incidence of long Covid in each age cohort; the number of persons in each age cohort with long Covid after 3,6,9 and 12 months; his plans to ensure that an effective care pathway is put in place for such patients; and if he will make a statement on the matter. [42487/21]
Seán Sherlock (Cork East, Labour) 1516. To ask the Minister for Health his plans to deploy resources to research the myriad adverse health effects of what is known as long Covid; and if he will make a statement on the matter. [43158/21]
Stephen Donnelly (Wicklow, Fianna Fail)
I propose to take Questions Nos. 1038, 1255, 1347 and 1516 together.
COVID-19 is a new disease so information on it, its features, incidence and its course are still emerging. Scientific and clinical evidence is evolving on the long-term effects of COVID-19. An increasing number of reports and studies are now being published on the topic, however, at present there is no agreement on the definition or the terminology.
It is recognised that persistent and prolonged symptoms can occur after acute COVID-19 infection in a proportion of patients, including in some patients who did not develop symptoms severe enough to require hospitalisation. My Department, through the Health Research Board, continues to fund research into the clinical impacts of COVID-19.
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.
The Department of Health will continue to develop an understanding of the implications of Long COVID to inform policy as appropriate.