Dear CRY members and supporters
We hope you are remaining positive and embracing the significant changes ahead of us all during these difficult times associated with the Coronavirus (COVID-19) pandemic. Many of our supporters are affected by serious heart diseases that could affect their outcome in the event of contracting the Coronavirus infection.
COVID-19 is a viral infection that may present as the common cold in most people and cause a few to be bed ridden for a couple of days. It also has the potential to cause lung infection (pneumonia) and affect the heart. The risk of very serious disease is 5% and the risk of death is 2%. Individuals at the greatest risk include those aged over 70 years old, people with diabetes mellitus, overweight individuals, heavy smokers, pregnant women and individuals with a known history of heart and lung disease. Generally, children under the age of 15 years old are being considered at low risk of complications.
Recognised symptoms include persistent cough with or without fever, breathlessness, fever with no other symptoms, aches and pains, chest pain and persistent palpitations.
Prevention
Everybody should follow NHS guidelines for preventing the spread of infection as detailed on the website https://www.gov.uk/government/publications/coronavirus-action-plan . In general, preventive measures include regular hand washing. Avoid touching your mouth and nose if you have been in contact with foreign services outdoors until you have washed your hands. The virus can live on surfaces for several hours. Similarly wash your hands before eating. Stay away from individuals with symptoms. Avoid crowded places. Stand at least 2 metres away from anybody that has a cough. Avoid social gatherings including gyms, pubs, restaurants etc. There is emerging evidence that the virus remains in aerosol particles in the air for several hours after someone with infection has coughed or sneezed.
Diagnosis and Isolation
The government is not in a position to provide COVID-19 testing for everyone. Individuals are being advised to stay away from hospitals unless the symptoms are very serious, therefore you may need to self-diagnose based on your symptoms.
If you develop any of the above symptoms and are able to cope at home, please self-isolate in a contained area for 14 days. If you live alone contact friends and family for support for shopping and any other requirements. Support should be provided by a limited number of individuals who should keep at least 2 metres away from you. If you are not coping please call 111 or use the https://www.nhs.uk/conditions/coronavirus-covid-19/self-isolation-advice/ for advice and support. If you live with others they should also remain at home for a fortnight. Should any of them develop symptoms, they should stay home for another 7 days after developing the symptoms.
Self management
There is currently no cure for COVID-19. Treatment is supportive and includes adequate water intake and management of fever with paracetamol. Individuals who are struggling to breath should consult 111 at the earliest convenience. Please do not attend hospital or your GP if you are coping at home to prevent spread of disease. The infection can make cardiac disease worse therefore, if you experience rapid palpitation, increasing breathlessness or loss of consciousness you should call the emergency services. For those with Brugada syndrome, treat fever above 38oC with Paracetamol and cool sponging.
General advice on diet and medications
Try to ensure a healthy diet where possible, take your vitamins especially vitamin C. Turmeric and garlic in the diet may have a positive anti-inflammatory response. Please reduce your alcohol intake and abstain from smoking to ensure the lungs will be able to cope with infection. Please do not stop your other medications particularly angiotensin receptor blocker, statins and beta-blocker.
Cardiology Clinics
The NHS have advised to keep face to face clinic appointments to a minimum to reduce the risk of spread of disease and to maximise the number of doctors and nurses to support the care of people infected with COVID 10. Many of you affected with cardiac disease will have either had your appointment cancelled if you are stable or will have a telephone consultation scheduled by your specialist.
Individuals with defibrillators
Most individuals with an implantable cardioverter defibrillator will have home monitoring and should transmit readouts from your device to your hospital. Routine defibrillator clinics will be cancelled but your local hospital will have support lines in the event that the defibrillator has discharged, or the battery is becoming low.
Further advice and information from CRY
The CRY cardiologists have received emails from many of you regarding concerns about your cardiac health and are responding to them as soon as possible. We will do our best to answer any questions you have and provide updates on a weekly basis.
Dr Sabiha Gati and Professor Sanjay Sharma
