The Forgotten Patients: COVID-19 and the impact on people living with cardiovascular disease.
June 19, 2020
COVID-19 has shone a light on the weaknesses within our healthcare systems, and we fear that the impact on vulnerable populations will be long-lasting.
The COVID-19 pandemic has hit us off guard. The need to fight the virus has been urgent and all-encompassing and, as a result, medical focus has been largely centered on the virus, resulting in the redeployment and prioritization of resources. Healthcare systems across the world have been striving to contain the impact on people, and available resources in many countries have been insufficient.
Before this pandemic hit, countries in Europe, Latin America, Asia, were dealing with the significant challenge of delivering care for patients with serious, non-communicable diseases, and we still are. The impact on patients of such diseases does not dissipate in line with our refocus on COVID-19, however pressing that may be.
The Forgotten Patients with Cardiovascular Disease
Patients with cardiovascular diseases are particularly vulnerable to COVID-19, being at higher risk of serious illness and death. Moreover, the disruptions in their healthcare provision caused by the pandemic – treatment delays, discontinuation of routine care services and uncertainty around medicine availability – has left them more at risk than ever.
In many cases, services have been reduced to protect patients from exposure to the virus, or because non-emergency care has been limited. Diagnosis of cardiovascular diseases, is expected to be significantly delayed, which may have an impact on the success rate of curative and non-curative treatment strategies.
Despite the vast efforts of patient advocacy groups across the world, the view is that protecting this particularly vulnerable population in many countries has largely been forgotten in the current public discourse. Many patients are facing added uncertainties and concern for their lives as their anxiety grows around how long COVID-19 will continue to negatively impact the care that they are able to access.
Clinical trials are also likely to be delayed or suspended due to the practical challenges of conducting research, which will not only result in a lack of options for patients, but may also signify a setback in the advancement of new medicines and technology.
Telemedicine is the future of patient visits to the doctor, but especially in this pandemic as it helps maintain social distancing safety guidelines. This will be critical in the face of the feared second-wave of COVID-19. Healthcare systems, slow to move to telemedicine before the pandemic, have dropped all pretense of caution as social distancing through telemedicine makes healthcare workers safer, without being any less effective for the patient, is now the main model for Primary Care.
The drive to adopt the technology must be a focus. What is needed for heart patients?
Despite the enormous pressures placed on our healthcare systems by COVID-19, it is vital that healthcare continues to deliver for patients in need. COVID-19 is indeed a disease that we had not encountered before, but it is not the first time we have had to contend with a highly contagious infectious disease.
It does beg the question of how we have left ourselves so exposed. We have seen a lack of crisis preparedness strategy, a lack of aligned containment approaches, and a shortage in vital equipment and supplies.
Aspects of Improvement in the Virtual Care of Patients in Cardiology and Primary Care
In these COVID-19 times, a critical step in patient care is patient management.
The divide between Primary Care and Cardiology Care, the next level of care, was always a major unmet medical need, tolerated only because of a lack of an effective, easy to use, medical device that could help bridge the gap. At 44%, the traditional ECG/EKG devices were simply never sufficiently effective pre-pandemic and will be virtually useless in a post-pandemic telemedicine environment.
Effective Cardiac-Telemedicine™ has two main conditions: First, it must support Telemedicine, allowing the physician to easily access a patient’s heart diagnostic test online, and understand it; and, second, it has to be highly effective, providing comprehensive diagnostic information on the patient’s condition, far beyond that of the traditional pre-Pandemic ECG/EKG devices.
The solution for Cardiac-Telemedicine™ is…
Cardio-HART™, a novel breakthrough technology that can detect heart diseases typically only diagnosed by a cardiologist using Echocardiography, including: Left Ventricle Hypertrophy (LVH), Dilated Cardio-Myopathy (DCM), Aortic Stenosis (AS), Mitral Stenosis (MS), Pulmonary Hypertension (PH), Atrial Enlargement (AE), in total 14 significant ECHO-findings, and 37 ECG-findings including Myocardial Infarction (MI), which together, represent over 95% of all significant and common heart diseases by prevalence. It is an aid to healthcare providers in primary care, including Cardiac-Telemedicine™.
Cardio-HART™ provides an analysis of the synchronized ECG, PCG, and MCG data for findings suggestive of pre-specified clinical conditions characteristic of hemodynamic, morphological, and functional abnormalities and dysfunctions defined by the reference standards or learned through Machine Learning. It outputs a comprehensive report of the patient’s cardiac status as an aid to healthcare providers.
It also enabled collaborative triage, ensuring that cardiologists get the relevant information to guide the clinical decisions about testing and treatment.
Policy and provisions for pandemic crisis preparedness are gathering momentum as we learn from our experiences, and groups such as patient organizations and health innovation communities should be at the table alongside other stakeholders when discussions are taking place. It is vital that these voices are heard.
We must also address the reality that our healthcare systems are generally unsustainable and address this at every level. The COVID-19 pandemic has taught us that the uptake of technology can indeed be timely when there is a collective effort, and it is important to not lose momentum in the adoption of technology as we come through the storm, but consider the lessons learned, both good and bad. We need the best user-driven tools at our disposal to protect our healthcare systems, our patients, and our citizens.