Irish Thoracic Society Statement on Impact of COVID-19 for People with Lung Disease
Date of issue: Friday June 19, 2020
Leading respiratory experts from the Irish Thoracic Society have today warned of the impact of COVID-19 on lung health and called for urgent action to avert unprecedented rates of excess illness and death from lung disease. According to the Society, additional resources for the diagnosis, treatment and ongoing care of people with respiratory conditions are crucial if we are to prevent a lung disease crisis. This is due to the potential long-term health impacts for some of those who have recovered from the acute stage of COVID-19, as well as those who are already living with a respiratory condition but who have not been able to access timely treatment and care, and who are also in the more vulnerable patient category should they contract COVID-19.
The respiratory experts on the Society’s COVID-19 sub-group who include representatives from all hospital groups and disciplines, have expressed disappointment that the Programme for Government Our Shared Future does not include a targeted response to the burden on respiratory healthcare services amidst fears that lung health is set to become one of the biggest casualties of COVID-19. Specifically, they are calling for greater numbers of respiratory specialists and other healthcare professionals to provide essential care in community as well as hospital settings, investment in infrastructure to ensure necessary space and isolation facilities, and the development and provision of cutting-edge technology solutions for patient care.
Triple-threat
According to the Society, as Ireland enters an indefinite period of reduced access to healthcare services due to necessary physical distancing and infection control at the country’s healthcare facilities, COVID-19 has inflicted a triple-threat impact on lung health:
- COVID-19 is itself a respiratory illness that has dramatically and unexpectedly increased the already significant burden of respiratory disease both in terms of short-term acute illness and potential long-term damage to the lungs which will require ongoing monitoring and care for some patients;
- People with existing respiratory diseases are particularly vulnerable to complications if they contract COVID-19; and
- People with new and existing respiratory diseases face delayed access to essential care due to COVID-19 restrictions – this comes on the heels of a ten-week hiatus for acute respiratory admissions and routine respiratory care.
Before COVID-19 ever happened, Ireland’s lung disease rates were already amongst the highest in the world and the numbers of respiratory specialists per capita amongst the lowest. In 2016, respiratory disease was the cause of one in five deaths in Ireland, and Ireland’s death rate from respiratory disease was the fourth highest in the EU-28 and 38% higher than the EU average. In 2016, respiratory disease accounted for more hospitalisations than for cardiovascular and non-lung cancer cases combined (14% versus 8% and 5% respectively). Lung diseases include chronic obstructive pulmonary disease (COPD), asthma, lung cancer, cystic fibrosis, pulmonary fibrosis and sleep disorders.
Urgent Measures
The Society welcomes accelerated implementation of the Sláintecare Strategy as set out in the Programme for Government but is calling for this to encompass a targeted response to the specific challenges of respiratory healthcare through a range of measures. These include:
- Staffing: increased numbers of respiratory specialists to deliver timely care in the most appropriate setting at both community and hospital level, including respiratory doctors, nurses, physiotherapists and respiratory physiologists
- Infrastructure: investment and adaptation of infrastructure with availability of isolation rooms, negative pressure rooms and adequate space and streaming systems in hospitals to allow for physical distancing and management of high-risk patients
- Technology: continued development and application of technology and innovation to provide virtual solutions for clinical management, monitoring and self-care of patients
- Guidelines: urgent implementation of the most recent Irish Thoracic Society guidelines in all hospitals
Potential Lung Health Crisis at Scale Not Yet Seen
Dr Aidan O’Brien, President, Irish Thoracic Society, comments:
“It is clear that we are storing up a backlog of undiagnosed and untreated respiratory disease at a magnitude that will have untold implications for the healthcare service and for our patients in the coming months and years unless urgent action is taken. The stark reality of delayed access to care for people with lung disease is deteriorating health, reduced quality of life and, sadly, in some cases, premature death.
“We commend the Herculean efforts of our colleagues throughout the healthcare system in retaining access to non-COVID-19 healthcare as much as possible while addressing the specific challenge of COVID-19 through separate access streams, virtual consultations and other innovative solutions.
“However, in order to prevent a future lung health crisis at a scale not yet seen in this country, we need to harness this capacity for transformation, innovation and investment to ensure that our patients can access timely multidisciplinary specialist care at community and hospital levels.
“Our patients have heeded Government advice by cocooning and self-managing their way through this emergency. They have played a crucial role in ensuring that our hospitals have not become overwhelmed. We now need to ensure that this sacrifice has not been at a long-term cost to their own health and that all patients receive equality of treatment and care into the future.”
The Irish Thoracic Society Council and COVID-19 sub-group:
- Dr Marcus Butler, St Vincent’s University Hospital
- Professor Sean Gaine, Mater University Hospital, Dublin
- Professor JJ Gilmartin, Galway University Hospital
- Ms Emma Flood, Midland Regional Hospital Mullingar (Respiratory Physiology)
- Ms Siobhan Healy, Cork University Hospital (Physiotherapy)
- Dr Marcus Kennedy, Cork University Hospital
- Professor Tim McDonnell, St Vincent’s University Hospital
- Professor Lorcan McGarvey, Queens University Belfast
- Professor Eddie Moloney, Tallaght University Hospital
- Professor Ross Morgan, Beaumont Hospital
- Dr Aidan O’Brien, University Hospital Limerick, President Irish Thoracic Society
- Professor Shane O’Neill, Emeritus Professor of Clinical Medicine Beaumont Hospital, Royal College of Surgeons in Ireland
- Dr Michael O’Mahony, Galway University Hospital
- Professor Karen Redmond, Mater University Hospital
- Dr Mark Rogan, Waterford University Hospital
- Ms Paula Ryan, University Hospital Limerick (Advance Nurse Practitioner, Respiratory)
- Dr Michael Williamson, Children’s University Hospital Temple St.