‘I am no longer the fit person I was’: Doctor speaks of long Covid effects

Health sector could improve standards by being more ‘mindful of costs’, conference told

Dr Fiona Kiernan and Dr Judith Connolly were speaking at a virtual medical conference on the management of critically ill patients with Covid-19

Dr Fiona Kiernan and Dr Judith Connolly were speaking at a virtual medical conference on the management of critically ill patients with Covid-19

 

A hospital doctor said she is “no longer the fit person I was” due to effects of long Covid that she is experiencing 18 months after contracting the virus.

Speaking on Saturday at a virtual medical conference on the management of critically ill patients with Covid-19, Dr Judith Connolly of Tallaght University Hospital described how patients with long Covid were mainly being treated by under-resourced GP services.

Dr Judith Connolly
Dr Judith Connolly

“The treatment for long Covid – I don’t think there will be any magic bullet or magic potion for quite some time. I think it is probably a multi-disciplinary programme that is required because it effects everything from neurological to cardiac to respiratory, renal, gut, dermatological, immune, haemotological... I am probably missing a few there.

“If you haven’t been admitted [to hospital] it falls back to unfortunately our GP service which are already under-resourced for what they do, never mind this whole host of long Covid patients that they are currently seeing without a real definite route of referral for them at the moment.

“Some hospitals have set up long Covid clinics. But there isn’t one really rolled out for general referral.”

Dr Connolly told of how she developed the condition after she contracted the virus in March of last year.

The anaesthetist developed symptoms including muscle aches, fever, complete loss of taste and smell, progressing to significant shortness of breath, with a diagnosis of Covid pneumonia. Despite making a recovery she still suffers from long-term effects a year and a half later.

“Shortness of breath and myalgia are the main long-term effects that I have suffered. These symptoms have improved but I am no longer the fit person I was,” she told the conference.

Dr Connolly urged members of the public to get vaccinated to help prevent them from contracting the virus with the potential complication of the long-term effects some people suffer.

Collaborative purchasing

The conference also heard from an anaesthesiologist, who is also a health economics consultant for the HSE, who said that if people in the health sector became more “mindful of costs” Ireland “can catch up to European standards”.

Dr Fiona Kiernan, who is a consultant anaesthesiologist and intensivist at Beaumont Hospital, Dublin, said the HSE should move towards a model of collaborative purchasing.

Dr Fiona Kiernan
Dr Fiona Kiernan

Dr Kiernan said that pricing discrepancies existed between hospitals for identical drugs and equipment and the HSE was not using its purchasing power effectively.

“If you look at the data on it, there could be a six cent difference between the price of paracetamol between two different hospitals.”

This may not sound like much but it could mean €40,000 or €50,000 per hospital per year “just for one simple drug like paracetamol”.

She said: “The worst form of price you can have is individual negotiations between hospitals and distributors. And yet it is the form of purchasing in the HSE.

“Equipment is also purchased individually by hospitals.There is a five figure difference in the capital cost of something as homogenous as an ultrasound machine in hospitals. We need to be more responsible.”

Dr Kiernan said if we improved cost management we could potentially have enough beds and support for patients without the need for repeated additional budgets, such as those allocated during the pandemic.

“The biggest question that I get is how we can control our healthcare quality and ensure we bring our healthcare capacity in line with demand? It is often assumed that this demand is just due to an ageing population.

“The answer is not necessarily just to put more money into healthcare. The sector needs to be more responsible and mindful of costs as the biggest problem is the rapid growth in prices at hospital level.

“We do not need to pay for the most expensive equipment and drugs to get the best results – just look at Dexamethasone as a treatment for Covid, a cheap drug that has had a huge impact on lives.

“Healthcare workers have a responsibility to patients first and foremost, but we also have a responsibility to the taxpayer and people who can’t afford healthcare or private healthcare as it stands. This needs to be debated more. A conversation about costs is not about refusing care but being more responsible with the budget that is allocated.”

Now in its second year, the conference was a meeting of medical professionals working in intensive care throughout the country. It was hosted by the Intensive Care Society of Ireland, the Joint Faculty of Intensive Care Medicine of Ireland and the College of Anaesthesiologists of Ireland.