Current situation (Sunday, March 29th)
The COVID-19 novel coronavirus is a new strain of coronavirus affecting humans and we are still learning much about it. Because this is a new virus, almost all of the population have no immunity and therefore are liable to become infected. Many will only have mild symptoms, but some will develop a life threatening illness and require intensive care support. If we all catch the infection around the same time, lots of us will need hospital support simultaneously. This will result in more people needing care than there are hospital beds available. The hospitals will be swamped and overwhelmed. If intensive care beds are needed but not available, then people will die who otherwise might have survived.
The current strategy in Australia is to decrease the rate at which infection is spreading. This is currently being accomplished through social distancing and by closure of some non-essential businesses, such as gyms and restaurants. However other businesses, such as hairdressers and shops, are still open to customers. Personal training, with groups up to 10 people, can continue providing social distancing (1.5m between people) is still observed. However many countries in Europe (where the infection is more widespread) have much stricter measures in place. Groups of more than two people are banned and they advise citizens only to leave their homes for essential travel. Australia has not yet reached this level of restrictions.
Cardiology Outpatients
Earlier this week, the Government advised the cancellation of elective surgery. This helps preserve protective equipment (such as gowns, gloves, and masks), which will be needed by frontline health care staff dealing with infected patients. This is an important step and a large amount of equipment may be required during the pandemic. In some countries the supplies of protective equipment are not sufficient and nurses are wearing garbage bags as an alternative. The cancellation of non-essential procedures also helps preserve ICU beds for COVID patients, rather than for patients after surgery.
Cardiology outpatient review does not consume essential resources and will continue at present. However in the spirit of reducing travel and inter-personal contact, telephone or video-call review is available. Please contact us if you would prefer a tele-health review. The current MBS guidelines suggest tele-health review specifically if someone :
meets the current national triage protocol criteria for suspected COVID-19 infection
(i) at least 70 years old; or
(ii) at least 50 years old and is of Aboriginal or Torres Strait Islander descent; or
(iii) is pregnant; or
(iv) is a parent of a child under 12 months; or
(v) is already under treatment for chronic health conditions or is immune compromised;
Cardiac Testing
Several cardiac investigations are performed in the outpatient setting.
An ECG is a simple test. It is an electrical tracing of the heart that is usually performed at the initial consultations and often at subsequent appointments. ECG testing will continue as long as patients are being reviewed in person.
A trans-thoracic echocardiogram (or echo) is an ultrasound examination of the heart. This is important to assess the structure and function of the heart. The sonographer is in close proximity to the patient for the duration of the test, which usually takes 30-45 minutes. Echo for new patients may still be required. However routine, “follow-up” scans may be deferred. During COVID-19 more limited, focused, echo studies may take place, to reduce the time required for the examination.
Stress testing, or stress echo, involves exercising on a treadmill while a doctor and cardiac scientist are in close proximity checking blood pressure and ECG traces. Due to the prolonged nature of these tests, and the requirement for heavy breathing, only urgent stress examinations will be performed. Routine or “follow-up” tests may be deferred.
If you have any further questions, please contact the practice on 07 3831 6202