Health service not equipped to treat long Covid patients, says expert

State ‘genuinely awful’ at treating complex, long-term illness, says DCU professor

According to recent studies, long Covid affects 10 to 15 per cent of people who test positive for the virus. Photograph: Alan Betson

According to recent studies, long Covid affects 10 to 15 per cent of people who test positive for the virus. Photograph: Alan Betson

 

Ireland’s health service is not sufficiently equipped to treat long Covid patients, a public health expert has said.

Staffing issues and a lack of capacity is contributing to the problem, according to Anthony Staines, professor of health systems at DCU.

“We have a serious capacity problem in the Irish health services for everything, essentially,” said Prof Staines told the Independent Scientific Advocacy Group (ISAG) webinar on Wednesday .

“We are not too bad at treating serious acute illness, we are genuinely awful at treating complex, long-term illness of many kinds.”

According to recent studies, long Covid affects 10 to 15 per cent of people who test positive for the virus.

Common symptoms include shortness of breath, heart palpitations, chest pain and fatigue, although symptoms vary from person to person.

Long Covid has some similarities with other post-viral chronic fatigue syndromes, according to Prof Staines, and this means any treatment will require integrated care for a reasonably large number of people over a long time.

“The capacity isn’t there to provide that at the moment. Individual colleagues have set up clinics, which is a great initiative taken by them. But the space, size and scope of what is required is not there.”

Prof Staines added that consideration should be given to treating long Covid patients within the primary care setting, and GPs need to be given support to do this. “But again, primary care is severely under-resourced.”

‘Drag on’

A great deal of money has been spent on the health service, but none of the underlying structural problems have been solved, he added. “This will make it very difficult to manage long Covid. I hope the Department [of Health] and the HSE take it seriously, but we do need the resources and the bodies on the ground.”

Good-quality data on the prevalence of long Covid, as well as more data on the symptoms associated with the illness are needed, according to Dr Gabriel Scally, professor of public health at the University of Bristol.

Also speaking at the ISAG webinar, he said long Covid symptoms can “drag on for a long time”.

“We need to see what are the main characteristics [of long Covid] that are amenable to intervention.”

Protocols also need to be developed. “We need evidence-based protocols for the treatment response for people with long Covid.”

Prof Scally added that post-viral conditions are a complex group. “My own daughter suffered from one for about 18 months, and lost a year of her schooling. She is absolutely terrified about herself and her friends getting Covid and having to go through the same thing.

“It’s not something I would wish on anyone, I think we need to take it much more seriously.”

Evidence

Dr Andrew Kunzmann, an epidemiologist from Queen’s University Belfast, said that long Covid seems to affect 10 to 15 per cent of people who get the virus.

“Overall, the evidence from the UK’s Office for National Statistics (ONS), from REACT, and from another study in the UK called Convalescence, is all pointing to around 10-15 per cent prevalence in the population, following an infection. That compares to 1 or 2 percent in the control groups used in some of the studies.

“An ONS study on children and long Covid revealed that young people were less likely to get long Covid, but the incidence was still between 5 to 9 per cent.”

Another study published on Wednesday in the Lancet Child and Adolescent Health journal suggested that just 2 per cent of children would get long Covid.

However, Dr Kunzmann said this could result in many cases if all children were exposed to the virus, and they will be at greater risk than the general population who can avail of vaccinations. He added that school will play a role in the transmission of the virus.

“Two per cent applied to the whole Irish school population is quite a high number to me. That could have a considerable long-term impact.”