Dr. Colm Henry:

I might just finish my response to the previous question. I did not specifically answer on the medications and the polypharmacy issue. We know that multiple medication is in itself a risk factor for falls and confusion, regardless of the different types of medications. This makes it all the more important that the ICPOP teams review people's medications. As people get older, more and more medications tend to be added without reference to how they interact and, as I have said, they can cause falls and confusion.

The biggest challenge we see with younger children is the RSV surge, which has taken place slightly later than last year. It is still on the rise. While we cannot be certain, we are hopeful that we will reach a peak within a number of weeks. Based on the experience of the last couple of years, it then plateaus for a brief number of weeks and falls rapidly. While it is on that upsurge and peaking, we see huge demands and people tend to focus on hospital. However, the GP community really bears the brunt of dealing with the presentations. We see increased presentations to the paediatric emergency departments and we also see pressure on the paediatric intensive care units. This year has been like the past two years in terms of seeing that sudden upsurge around the same time, peaking higher than in previous years but then rapidly falling in December.

Last year, the peak concurred with the flu and Covid-19. Based on the surveillance we have in the community, through wastewater surveillance, the GP sentinel scheme and the other ways we look at the pattern of virus transmission acuity, we have not seen the rise yet of influenza and Covid-19 but there is no reason it will not rise in the same way it has in previous years. Once the cold weather kicks in people congregate inside more and the opportunities for transmission multiply.