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10.15.14 9:45 AM ET

The Disappearance of Kate Middleton

Acute morning sickness has laid Kate Middleton low. While she recovers at her parents’ home, Palace officials are being cagey about when she will next be seen in public.

On Monday, there was exactly the sort of event that Kate Middleton wouldn’t usually miss in a million years.

The expectant royal, 32, was announced as the new royal patron of the 1851 Trust, a charity which aims to help and inspire kids and young adults through sailing—a sport she is passionate about.

The charity gets its name from the symbolic date when the America's Cup trophy left the U.K.

But Kate was simply too ill due to her ongoing struggle with a particularly acute form of morning sickness—hyperemesis gravidarum, or HG—to attend an official event, so had to content herself with issuing a statement form her sickbed instead: “I feel very fortunate to have enjoyed sailing from a young age. And I know it is a great way of providing young people with the opportunity to develop skills and confidence.”

Her absence from public view highlighted the fact that it’s been well over a month now since, on September 8, Prince William and Kate Middleton were forced due to her illness to once again make a dramatic, early announcement that Kate was pregnant, this time with the couple’s second child.

Kate and William made the announcement after being forced to cancel a long-scheduled appearance at Oxford University.

Sources told the Royalist at the time that she was as little as five weeks pregnant, suggesting the baby will not be born until April.

Since then, it’s been radio silence from the Palace, which has steadfastly refused to be drawn on her condition.

However, the Royalist understands that Kate’s acute morning sickness is actually even worse than last time around. Sufferers of HG frequently find it hard to keep food down, and can vomit 20 times a day or more.

Some corroboration of the seriousness of Kate’s condition is to be found in the fact that there is now absolutely no chance that Kate will make a public appearance anytime before Friday October 24, when she is provisionally scheduled to do a brief meet-and-greet with the President of Singapore.

This will be a little over six weeks since the initial announcement of her pregnancy was made.

However, the reality is that even this engagement is very much being seen as touch and go by the palace.

Official sources at the palace have been quick to minimize expectations, briefing the royal press pack that while she “very much hopes to be able to undertake this engagement” a decision will be made nearer the time, and that “as with all recent engagements her attendance will be reviewed closer to the time, depending on her health.”

The most you can get out of official sources is that Kate’s engagements are being reviewed “on a case by case basis.”

Kate is sufficiently unwell that rather than staying at Kensington Palace, she has moved back in to her mum’s house in Berkshire where she is not only receiving regular home visits from the Royal obstetrician, Alan Farthing, but there is also a local medical team on call.

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The local hospital, in the nearby town of Reading, has been prepped in case of any emergency.

The prospect of Kate being out of action for much of the remainder of her pregnancy is now a real possibility. Occasionally, sufferers of HG—which impacts about 2% of pregnancies—can suffer symptoms throughout the entire nine months of their pregnancies. As well as feeling dreadful, sufferers can vomit 20 times a day or more. There is a limited amount of medication available to pregnant mums, and sometimes the best that can be done is to keep the patient hydrated with an IV drip.

Provided fluids are kept up, there is no serious risk to the baby.

However, it is undoubtedly a huge blow to Kate—and indeed the entire royal machine of which she is now such an integral part—that HG has struck again, and with even greater severity, to judge by some accounts, than first time round. Sources say that last year, Kate was only severely ill for about two to three weeks, whereas this time she is already into week four of feeling violently unwell.

The even worse news is that whereas if you get HG once, it does not necessarily mean you will get it again, some research suggests that to get it a second time is a predictor that it will affect all your subsequent pregnancies.

Although Kate and William have only ever publicly said they wanted two kids, there was little doubt among their close friends when they married that they wanted a big family.

But with HG knocking Kate out for a second time, the big question is whether Kate will join the ranks of HG-afflicted moms who vow “never again.” One has to wonder if this latest, prolonged bout of severe morning sickness means that the received expectation that Kate would have a large family can still be taken for granted.