Chronic neglect means it’s right to be apprehensive about winter

In this issue of the Medical Independent (MI), our main feature focuses on the uncertainty of the coming winter period. This uncertainty is driven by the reopening of society after more than a year of restrictions to limit the spread of Covid-19. While Ireland’s high vaccination rate offers encouragement, the greater transmissibility of the Delta variant remains a cause for concern as people are allowed to gather more freely. Also, one of the side benefits of lockdown last winter was that influenza was notable only by its absence. The measures taken to contain Covid (physical distancing, mask wearing, etc) had the consequence of containing more traditional seasonal threats. While health services last year struggled in the face of Covid, at least they were spared the usual impact of influenza. This is unlikely to be the case this winter as restrictions lift. And some doctors are worried. In an interview with MI, Respiratory Consultant at Bon Secours in Cork, and senior medical lecturer at University College Cork, Dr Oisin O’Connell, warned that it was “naïve” on the part of the Government to lift some measures, such as mask-wearing, at this point.

“The transition to indoor living in Ireland’s cold, wet winters can be a breathing ground for other respiratory viral infections,” according to Dr O’Connell. He said this was worrying given the health system has already been under increasing pressure in recent months. The Government’s plan needs to be reassessed as a “priority”, he contended. One of the primary reasons for our prolonged lockdown was the very fragile state of our health service, which has suffered from overcrowding and long waiting lists for years as a result of chronic capacity and staffing deficits. In the midst of a pandemic, Ireland’s health service requires a greater layer of protection than those in many other European countries. This is not to say that restrictions should not be lifted. It is just stating that our health service has been made vulnerable as a result of years of under-investment, mismanagement, and short-term thinking.

The next number of months require careful navigation by the Government, health management, and other stakeholders, to ensure the healthcare system does not become overwhelmed on the road back to ‘normality’. The continued success of the vaccination programme is a genuine source of hope. But serious questions need to be asked before this crisis is fully over as to why the chronic problems that beset the health service have been allowed to fester for so long. Uncertainty is inevitable at a time such as this. Few countries have emerged from the pandemic without serious scars and most will view the coming winter with understandable apprehension. However, we would be on surer ground had the longstanding deficits in the community, acute, and public health sectors been adequately addressed by successive governments.