The COVID-19 outbreak has caused changes in the healthcare system in ways that we would not have considered as little as a year ago. We are seeing a shift in the use of cardiovascular (CV) doctors’ time due to the current outbreak.
On one hand, there are hospitals seeing up to as much as a 60% reduction in admissions of CV patients to the emergency room; while on the other, hospitals are having a marked uptake of need for internal medicine to attend to CV problems as a result of complications from the coronavirus disease.
Currently much of the focus is on the impacts of COVID 19 in the hospital setting. However, just as important is the need to also consider the implications of COVID-19 on physician practices and clinics. These areas are showing marked decreases in patients willing to actively control heart disease through preventative measures.
The focus needs to change to convince patients that it is safe to return for care before complications set in and coronary artery disease or heart failure becomes unmanageable. The initial wave of returning patients combined with the marked increase in patients who have developed heart complications through COVID-19 will undoubtedly create a “third wave” of healthcare problems on an already over extended system.
Today, amidst the COVID-19 pandemic, cardiologists are increasingly called in for COVID-19 patients who are exhibiting issues created by an increased cardiac workload because of acute lung injury as well as comorbidity issues. Acute complications, and infection has also been linked with long term symptoms of CV problems. Next to acute lung injury, CVD may be the primary phenomenon in COVID-19.
The need to control these situations results in an increasing workload for cardiologists in the hospital environment. Result show an 18% increase in patients struggling from cardiac complications and that 1 in 5 Covid-19 patients will develop permanent heart damage.
However, these same doctors are seeing a dramatic drop in hospital emergency room patients due to heart disease - by as much as 40 – 60%. A recent study by the American College of Emergency Physicians, shows a 38 percent drop in patients being treated with life-threatening ST-elevated myocardial infarction (STEMI) heart attacks. Patients are more afraid of contracting COVID-19 than of having a heart attack and are allowing their conditions to accelerate to more critical levels.
Patients are postponing their treatment which may exasperate their conditions creating more urgent needs. Currently, clinics and physician practices are seeing their revenues drop between 25 to 75% of their initial levels. While this creates a great financial burden on these clinics and practices, this drop will not continue.
As ischemic heart disease continues to be the leading cause of death nationally and globally, combined with the increased ongoing care needed by COVID-19 patients exhibiting heart disease problems, cardiology services need to prepare for a significant increase in workload in the recovery phase of COVID-19.
Once doctors have convinced patients that it is not only safe but imperative that they return to monitor their conditions, they will have the unprecedented problem of handling the increased volume of patients. The difficulty lies in being prepared for the “third wave” of the healthcare crisis.
Many experts are expecting a “third wave” of medical crisis when the COVID-19 epidemic begins to subside. Cardiac healthcare providers need to be prepared for the expected influx. Those suffering from long term effects represent a large portion of the population.
With 4,163,892 confirmed cases of COVID-19 in the U.S. and 145,982 deaths that means 4,017,910 are survivors. Considering that 10.5% of these will develop cardiac issues, this means that 421,880 potential cardiac patients with this new risk factor will need to be addressed. This will create a great burden on a system.
Combine this new need with the renewed burden of long term patients who have been putting off their preventative care, and the incidences of new patients with heart disease, it is the cardiologists and staff in the clinics and private practices that need to ramp up and be prepared as telehealth and virtual visits grow in addition to the number of face to face patients the healthcare professionals need to juggle.
Employers need to assess the severity of this working recession, estimate the beginning of the resurgence and be prepared, with staff and procedures developed, to combat the new third wave that will not only hit hospitals but most certainly impact clinics and physician practices.
Covid-19 has had a devastating effect on health care, in more ways than first imagined. Hospitals and healthcare workers have been strained to their limits working in areas that had not been expected while seeing unprecedented lows in other areas. The impact of COVID-19 is far from over.
The impact on the cardiovascular system caused by stress on other organs is compounding to create a need for extended care in the future. Yes, it is an issue that hospitals are full of critically ill patients and ICUs are maxed out, however it’s the drain on the other areas in the health care systems that are creating a medical emergency not only now but will continue to do so in the future.
We must begin to convince patients to “Come on in – it’s safe here” in the clinical setting so that they can begin to combat the third wave of medical crisis before it becomes too difficult to handle.