Lung disease and delayed access to care

Sir, – We, the members of the Irish Thoracic Society’s Covid-19 sub-group, wish to highlight the triple-threat impact of Covid-19 on lung health and to call for urgent action to avert unprecedented rates of excess illness and death from lung disease in Ireland.

First, Covid-19 is itself a respiratory illness that has dramatically and unexpectedly increased the already substantial burden of respiratory disease here both in terms of acute illness and long-term damage to the lungs.

Second, people with existing respiratory diseases, such as chronic obstructive pulmonary disease (COPD), asthma, lung cancer, cystic fibrosis, pulmonary fibrosis, alpha-1 antitrypsin deficiency and sleep disorders, are particularly vulnerable to complications if they contract Covid-19.

Third, following a 10-week hiatus for acute respiratory admissions and routine respiratory care, people with new and existing respiratory diseases face lengthy delays in accessing essential care with reduced access to services due to physical distancing and infection-control measures.

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This is on top of an already significant burden on respiratory services pre-Covid-19, with mortality rates and hospital admission rates among the highest in Europe and the OECD, while the numbers of respiratory specialists per capita are among the lowest.

We welcome the new programme for government pledge to accelerate implementation of the Sláintecare strategy. However, this must contain a responsive approach to the specific challenges of respiratory disease so that patients can access diagnostics, treatment and ongoing care when and where they need it – in hospitals or in the community. This means increased numbers of respiratory specialists, including doctors, nurses, physiotherapists and respiratory physiologists, as well as significant investment in infrastructure and technology. 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. If we are to prevent a lung disease crisis at a scale not yet seen in this country, we now need to harness the agility and capacity for transformation, innovation and investment that has carried our health system through the last three months.

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. – Yours, etc,

Dr AIDAN O’BRIEN,

Consultant Respiratory

Physician,

University Hospital

Limerick,

President,

Irish Thoracic Society;

Dr MARCUS BUTLER,

Consultant Respiratory

Physician,

St Vincent’s University

Hospital, Vice-President,

Irish Thoracic Society,

Ms EMMA FLOOD,

Senior Respiratory

Physiologist,

Midland Regional

Hospital, Mullingar;

SUZANNE McCORMACK,

Chief Executive,

Irish Thoracic Society,

Creidim Centre,

Leopardstown Road,

Dublin 18, Prof SEAN GAINE, Consultant Respiratory Physician, The Mater Misericordiae University Hospital; Prof JJ GILMARTIN, Consultant Respiratory Physician, Galway University Hospital; Ms SIOBHAN HEALY, Clinical Specialist Respiratory Physiotherapist, Cork University Hospital; Dr MARCUS KENNEDY, Consultant Respiratory Physician, Cork University Hospital (Treasurer, Irish Thoracic Society); Prof TIM McDONNELL, Consultant Respiratory Physician, St Vincent's University Hospital; Prof EDDIE MOLONEY, Consultant Respiratory Physician, Tallaght University Hospital; Prof ROSS MORGAN, Consultant Respiratory Physician, Beaumont Hospital (Past President, Irish Thoracic Society); Dr MICHAEL O'MAHONY, Consultant Respiratory Physician, Galway University Hospital; Prof SHANE O'NEILL, Emeritus Professor of Clinical Medicine Beaumont Hospital, Royal College of Surgeons in Ireland; Prof KAREN REDMOND, Consultant Thoracic and Transplant Surgeon, The Mater Misericordiae University Hospital; Dr MARK ROGAN, Consultant Respiratory Physician, University Hospital Waterford; Ms PAULA RYAN, Advance Nurse Practitione Respiratory, University Hospital Limerick.