In the first major parliamentary debate on the impact of long COVID in Ireland, the Regional Group of TDs have tabled a Dáil motion which they will move on the floor of Dáil Éireann next Wednesday morning seeking the roll out of specialist services to support those who have failed to make a full recovery after being infected with the SARS-CoV-2 virus.
The 9 TDs will be seeking cross party support from every TD to have immediate steps taken to support all patients with long COVID, regardless of where they live, or how they are impacted.
While most people will make a full and quick recovery from COVID 19, some adults and children, can continue to experience ongoing symptoms or can have a relapse after an initial recovery, and these symptoms can persist for several months or even years.
Long COVID is an umbrella name given to a broad range of some 200 post COVID symptoms which include conditions such as chronic fatigue and brain fog, which are experienced at least three months after the initial infection for significant periods of time, in some cases for over two years.
The debate will be broadcast live on Oireachtas TV and on Oireachtas.ie between 10am-12noon on Wednesday 9th November.
The Dáil motion reads as follows:
That Dáil Éireann:
- the most recent waiting list figures available from the National Treatment Purchase Fund show over 79,000 patients are waiting for an Inpatient/Day Case procedure and a further 625,000 are awaiting an outpatient appointment
- the Irish College of General Practitioners has indicated that only one-in-five GP practices can take on new GMS patients because they are at full capacity, and only one-in-four can take on new private patients because they are unable to employ another GP or replace a retiring GP;
- According to the Irish Nurses and Midwives Organisation, 10,679 patients who were admitted to hospitals in October spent time on a trolley before securing a bed, which was more than a 25% increase on last October; and
- more than 27,000 people left Ireland’s emergency departments before being seen by a doctor during the three-month period from July to September this year.
- the World Health Organisation has defined post COVID-19 condition, also known as long COVID, as a condition which 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 lasting for at least 2 months that cannot be explained by an alternative diagnosis;
- while there are some 200 conditions associated with long COVID, common symptoms include profound fatigue, shortness of breath, post exertional malaise, dysautonomia, neurological and cognitive dysfunction, as well as others that have an impact on everyday functioning, with symptoms appearing following initial recovery from an acute COVID-19 episode, or persisting from the initial SARS-CoV-2 infection;
- research highlights the real burden that long COVID represents to the Irish population and an already overwhelmed health service, highlighting the importance of finding scientific solutions which can tackle the underlying mechanisms that are causing such diverse and debilitating symptoms;
- while there is a lack of knowledge associated with the management and treatment of long COVID conditions, this is not the first infection-associated chronic illness triggered by a viral infection, with many long COVID patients meeting the diagnostic criteria for myalgic encephalomyelitis and chronic fatigue syndrome;
- the duration of illness can be variable with some patients who developed long COVID after contracting COVID-19 in the first wave in March-April 2020, having made little or no recovery to date;
- due to the heterogenous nature of long COVID there is currently no one universal diagnosis or treatment, however, medical evidence indicates that symptom management can improve quality of life;
- research on Irish blood donors published by the Health Protection Surveillance Centre indicates that 69% of adults in Ireland have been infected by the virus;
- there are likely to be 336,451 adults nationally who are suffering from or have suffered from medical conditions associated with long COVID, based on an extrapolation of Netherlands based research published in ‘The Lancet’ in August 2022 which attributed long COVID symptoms to 12.7% of patients infected with the SARS-CoV-2 virus;
- patients with long COVID, many of whom are young with no underlying conditions, who previously presented with prolonged multisystem symptoms which can impact quality of life, affect ability to work and cause significant disability for some;
- long COVID is having a significant impact on our labour force but, as an Australian long COVID study indicates even low rates of COVID-related permanent illness or disability could still lead to significant future burden of disease;
- some 0.81% of Enhanced Illness Benefit claimants were certified unfit to return to work at least 12 weeks after their initial infection, meeting the emerging scientific criteria for long COVID; indicating that:
- on a population basis over 21,000 people may be unfit to work due to long COVID, which excludes those who have relapsed after initial recovery from SARS-CoV-2 infection or the tens of thousands more experiencing less severe forms of long COVID who have reduced participation while in employment;
- just 22.5 whole-time equivalents of the 70 health service staff to be appointed by the HSE to work with long COVID and post COVID patients were recruited up to last month, with patients waiting up to 10 months for initial assessment before joining record waiting lists to see other specialties;
- long COVID services do not exist for children;
- the Mater Hospital Clinic treating neurological conditions such as brain fog associated with long COVID has been forced to reduce its service due to a lack of funding;
- many Irish patients have been forced to seek costly treatment overseas due to a lack of clear referral and treatment pathways being developed in Ireland; and
- the primary mechanism to prevent long COVID is to minimise the incidence of COVID-19 infection, by ensuring that all practical measures to reduce the transmission of the virus are introduced and maintained in a time appropriate manner, including the provision of Evusheld to those who are immunocompromised or where vaccination is not recommended.
calls on the Government to:
- address chronic workforce issues within our GP, primary care, and acute hospital services;
- fully staff post COVID and long COVID clinics as committed to on foot of the HSE plan of September 2021, which must be updated to reflect the changing skill set required to support the emerging evidence on the treatment of conditions associated with long COVID, such as direct access to neurological clinicians;
- establish a multidisciplinary public health team incorporating patient advocates to review and manage long COVID care within the population;
- establish a dedicated and specialist led long COVID clinic for children who are without a dedicated centre presently;
- deliver in tandem with, instead of consequential on, the establishment of post COVID and long COVID clinics, fully resourced long COVID services across GP and community services to ensure a national service is in place for all who need it;
- ensure that services and supports adapt and expand based on learnings from implementation, emerging evidence in relation to long COVID and current and projected demand for all specialists and services;
- develop a public awareness campaign on what long COVID is, highlighting the risks posed to the entire population including the young and healthy, and how to minimise the risk by reducing the transmission of the SARS-CoV-2 virus;
- urgently complete an analysis of existing waiting lists to establish the incidence of long COVID and the scale of the challenge facing the heath service; and consequently;
- establish a long COVID electronic patient register to provide a secure database to store and analyse detailed information in relation to the numbers of patient presenting to long COVID clinics, the symptoms they are presenting with and their treatment outcomes;
- ensure that all healthcare and frontline workers who are unfit to work due to long COVID are entitled to special leave with the removal of the arbitrary eligibility date of 7th February 2022 for healthcare workers and further ensure that the current scheme does not abruptly cease in June 2023;
- recognise long COVID as an occupational illness for healthcare and all frontline workers;
- commence an advice and information campaign providing the best available current advice in the management of conditions associated with long COVID and other post viral chronic conditions to GPs, the medical profession and those experiencing long COVID conditions; and
- develop an innovative rehabilitative and recovery programme that is designed to meet the needs of those experiencing long COVID conditions and other post viral chronic conditions to ensure that can make a full return to as full and active life as possible.
Regional Group TDs:
Cathal Berry, Seán Canney, Peter Fitzpatrick, Noel Grealish, Michael Lowry, Verona Murphy, Denis Naughten, Matt Shanahan, Peadar Tóibín