A short report on health, patients and well-being, by Michael A. Gatzoulis in London
Cycling to work in London now feels surreal: very few people about, a metropolis stripped of its many attractions (museums, restaurants, shops, etc.), but buildings and other material objects remain intact. It is only people who are affected. Uncertainty looms large on relaxing the draconian measures taken to slow down the spread of the disease, so we can return to some ‘normality’. Last, but not least, legitimate concerns are about the economic and psychosocial implications of the pandemic, and the consequent disruption of the societal fabric, as we know it.
And yet, there is no doubt that we will weather this, as man did weather virus pandemics and other global challenges in our long history. There is always opportunity with crises. One hopes that at the other end of this storm we will be better people, more humane, considerate, together, and appreciative of healthcare and of science, and of all other support services essential to a smooth running of a society.
This short communication is of course about health, patients, and well-being. While the frenzied efforts to combat the COVID-19 pandemic are understandable, we must not forget our primary obligation to look after our patients; their needs should not be neglected. This includes patients with life-long diseases, such as congenital heart disease (CHD), emergencies such as acute coronary syndromes, patients with suspected or newly diagnosed cancer, and many more.
We, for example, at the Royal Brompton Hospital became a COVID Centre ‘overnight’. While excited at being part of a national/global effort to defeat this aggressive virus and energized to engage in a new area (intensive care), I have some concerns regarding the care and well-being of the 12 000 adult patients with CHD that my colleagues and I collectively look after, and not only about them. We, as everybody else, converted quickly to tele-health clinics and deferred all inpatient interventions—other than necessary—to protect patients from COVID exposure. We also worked hard to inform and reassure—as much as possible—patients about COVID-19 utilizing webinars, patient association initiatives, social media, etc., and this was very well received.
However, COVID will not be with us forever. We must start preparing now for resuming our non-urgent/elective work and for catching up with all things deferred during the pandemic. Furthermore, there is now an opportunity like never before to create a new and better model of care, utilizing technology, empowering patients, and giving them a better life experience and journey. This is particularly suited to adult CHD as we have argued for some time. Now is the time to plan for it and do it. We must not lose sight, even during the pandemic, that our primary responsibility is the care and well-being of our patients; in the case of the writer; that is adult CHD patients. Our profession and healthcare planners will be judged on this, when the COVID pandemic is over.
What adult CHD (and other) patients must do/expect during the COVID-19 pandemic and beyond
Social distancing (all, until further notice)
Shielding of high-risk patients [i.e. single ventricle physiology, pulmonary arterial hypertension, immunosuppressed/compromised patients, other specific patients (consult your local provider)
Tele-health clinics and deferment of elective/prognostic procedures to minimize COVID exposure; these temporary measures need/should not compromise outlook
Made aware of contingency plans for urgent care: Where, How, When? Follow guidance from NHS and other sites, particularly so from local providers
Regular updates/information sharing about COVID-19
Mental and psychosocial well-being, exercise, lifestyle modification(s), improve oneself
A new improved model of care after COVID, utilizing technology, artificial intelligence, and, crucially, education and patient empowerment
