Long Covid becoming the "hidden iceberg" of health service, says Naughten

With an estimated 114,500 Irish people currently suffering the effects of long Covid, a local TD has predicted that it is rapidly becoming "the hidden iceberg" of long-term chronic illnesses which will have to be tackled by our struggling health service.

Pointing to research carried out in the UK which found previously undetected damage to the lungs of long Covid patients, Roscommon/Galway Independent TD, Denis Naugthen, said the true extent of the health problem will only become apparent when the HSE establishes long Covid clinics across the country.

A group of UK researchers found previously undetected damage to the lungs of long Covid patients, which may prove a vital tool in providing a definitive diagnosis for those who have not fully recovered from Covid-19 months after their initial infection.

“The number of people with long Covid unable to return to normal activities or employment months after becoming unwell could be a sleeping crisis for our health service that may overwhelm already horrendous hospital waiting lists,” said Denis Naughten.

“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,” Deputy Naughten told the Dáil last weeek.

“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

The local TD said the research team in the UK has reported the use of specialist MRI techniques to identify lung damage, which reduced the ability of oxygen to move from the lungs into the bloodstream, that does not show up on more traditional standard tests including x-rays or CT scans.

The Roscommon TD published research last week that he commissioned from the Oireachtas Library & Research Service which conservatively estimated that 114,500 people in Ireland have, or will get, ‘long Covid’ and that this figure is rising with the rate of Covid-19 infection.

“While this was an estimate based on the current scientific literature, it was the first time an attempt has been made to put formal structure on the scale of the long Covid health problem in Ireland, with some people suffering from this chronic condition having their concerns dismissed as being ‘all in their head’,” said Deputy Naughten.

To date doctors and patients have been relying on the World Health Organisation long Covid (or post Covid-19 condition) definition, which is 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.

“This cumbersome definition effectively means that it is only five months after the initial infection when everything else is ruled out, that a person can be categorised as a long Covid patient. This has huge implications for their medical care and rehabilitation, as well as leading to an expensive battery of diagnostic tests within our health system which already has huge waiting lists as a result of the Covid backlog.

“Therefore, the research paper from a team based in Oxford, Sheffield, Cardiff, and Manchester used xenon gas MRI scans (Hyperpolarised Xenon Magnetic Resonance Imaging) showing a clear difference between patients with long Covid and those who had not contracted Covid-19, providing potential for the diagnosis of long Covid patients complaining of breathing difficulties.

“While breathlessness is just one of over 200 long Covid symptoms that have been reported in the scientific literature, problems with breathing is one of the most common symptoms of the condition, along with fatigue and brain fog.

“This UK pilot study of a small cohort of patients who contracted Covid-19 is now being expanded to a larger group of patients before any definitive conclusions can be drawn, but it does provide some hope for both long Covid patients and the ability of the HSE to manage their care and rehabilitation appropriately."