An infectious diseases expert has warned Ireland needs a plan for treating long Covid as the Delta variant rips through the country’s young people.
ack Lambert, professor of clinical medicine at University College Dublin, said young people are already being treated for the debilitating symptoms that can linger for months after infection. Children were at risk, he said.
“We have treated teenagers with chronic fatigue syndrome following a viral illness, even before Covid-19 existed. We know it is going to happen,” he added.
Prof Lambert cited “anecdotal” cases of a young GAA player who returned to exercise six months after contracting Covid-19. “But the day after he exercises, he can’t get out of bed. He is totally exhausted,” he said.
“We need to start keeping track of this. And we are not doing anything about this. We have got no supports, no guidance, no financing.”
With Ireland on the brink of a fourth wave of the pandemic, unvaccinated younger people and children are in the firing line. More than 30pc of all cases are in those under the age of 18, according to Prof Lambert.
An additional 631 cases of Covid-19 were reported on Friday, with cases increasing at a rate of 3pc a day, according to Professor Philip Nolan, chair of the National Public Health Emergency Team (Nphet). Hospital admissions are also trending upwards.
The surge in the highly-transmissible Delta variant will outpace the race to vaccinate a majority of the adult population, HSE chief executive Paul Reid said on Thursday. More than two million people have been fully vaccinated to date.
“About 30pc of all the cases are between the ages of zero and 18,” Prof Lambert said. “More kids are getting infected, but they are not necessarily getting sick and they are not necessarily ending up at the hospital. But there is still a risk of getting long Covid.
“There can be consequences to getting Covid. It is not as simple as letting all the young kids get Covid, they’ll get over it.”
While studies worldwide have shown children and younger people are more resilient to the virus than older adults, concerns persist that Covid-19 in children may be more than just a short-term illness.
The European Centre for Disease Control (ECDC) reported in an update last week that children of all ages are susceptible and can transmit Covid-19, but younger children pass it on to others less frequently than older children.
While children are less likely to get sick, require hospital treatment or die of illness, the report noted: “The exact burden of Covid-19 and its long-term consequences in the paediatric population is still to be determined and is a priority for further research.”
There is no data available on children with long Covid in Ireland.
Dr Augustine Pereira, director of public health in HSE, North East, said this weekend that the risk of young people developing long Covid is not known. However, it is likely that some younger people will experience it. “We know from the older population that this has happened. With the younger cohorts, I don’t have any data to make any assumptions,” he said. “We are seeing that Covid-19 is becoming a disease of the young unvaccinated person.”
He added that, with between 81pc and 84pc of cases reported in people under 40, the Delta variant is the dominant strain.
“People are getting unwell with it. A high proportion have coughs, symptoms like fever, headaches and sore throat. A lot of young people in their 20s are having all of these symptoms.”
Dr Pereira said wearing masks, social distancing and washing hands, avoiding crowds and keeping contacts down will all help protect young people from the virus.
Fine Gael North Cork TD Colm Burke has previously called on the HSE to set up dedicated centres to deal with long Covid. He said this weekend the need became more urgent with younger people now in the firing line of the fourth wave of the pandemic.
“We started dealing with Covid as an issue that we would deal with once we got the vaccines. This is not going to go away, and I think for people with long Covid it is a huge challenge for them and for society,” he said.
“We need to be careful that we don’t ignore the warnings that we have received from experts. We should not wait around to see what’s happening. Medical experts in the UK have already established long Covid clinics.”
A British study of Covid-19 in children found they are at extremely low risk of becoming severely ill or dying from Covid. During the first 12 months of the pandemic in England, 25 people under the age of 18 died of the virus, according to the study by three British universities.
The most vulnerable children were those with pre-existing medical conditions. The studies did not examine the impact of long Covid on children.
However, Dr Elizabeth Whittaker, one of the researchers and a paediatric consultant, said the data suggested the low risk of children becoming ill from Covid meant vaccines would also have to be very low risk in order to justify giving them to healthy children.
In the UK, NHS England plans to set up specialist long Covid services for what is believed to be a minority of young people who continue to suffer symptoms long after the infection has passed.
Parents of children with long Covid have formed an advocacy group in the UK. Last week, Esther Crawley, a professor of child health at the University of Bristol, warned a Royal Society of Medicine seminar of a looming “tidal wave” of long Covid among UK teens.
Earlier British studies, published in March, suggested 13pc of under-11s and about 15pc of 12 to 16-year-olds still had at least one symptom of the virus five weeks after a positive test for Covid-19.
The HSE is considering plans to innoculate children, while awaiting a decision from the National Immunisation Advisory Group on approving the Pfizer jab for 12 to 15-year-olds, which has already been approved for use by the European Medicines Agency.
There are no vaccines yet for younger children, but Pfizer is trialling versions for those between six months and two years, and children of two to five and five to 12. It is not clear when these will come on stream, but reports in the US say approval could be sought as soon as September.
The low risk to children has led international health agencies to rethink school closures during the pandemic. In an updated report on Covid-19 and schools last week, the ECDC said closing schools to control outbreaks should be a last resort. The negative impact on children’s physical and mental health outweighed the benefits to be gained from keeping them home.
The ECDC instead recommended testing and contact tracing strategies and, “ideally”, rapid diagnostic tests. The Government has appointed an expert group to consider the use of antigen testing in Ireland.
The Department of Health reported 581 new cases of Covid-19 last night. Chief Medical Officer Dr Tony Holohan asked young people to “hold firm” until they receive their vaccine.
In a tweet, he said: “We know there is worry and frustration out there, particularly for young people who have had significant parts of their lives put on hold by this disease. We ask if you are not yet vaccinated to hold firm to the public health advice as you await your vaccine.”
The number of people in hospital with the virus has been increasing slightly, with 52 cases yesterday, two more than on Friday. Of these, 16 are in ICU, one more than on Friday.