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Cardiovascular Care Delivery During the Second Wave of COVID-19 in Canada
Idan Roifman1, Rakesh C Arora2, David Bewick3
1Schulich Heart Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
Insights
The COVID-19 pandemic disrupted cardiac care, increasing wait times and mortality. A balanced approach is needed for future waves, integrating essential cardiovascular services with pandemic surge capacity.
Area of Science:
- Cardiology
- Public Health
- Healthcare Management
Background:
- The COVID-19 pandemic caused significant reductions in cardiac care delivery.
- Deferral of cardiovascular procedures led to decreased healthcare access and impacted patient outcomes.
- International data show increased wait times for cardiac diagnostics and procedures, correlating with higher morbidity and mortality.
Purpose of the Study:
- To advocate for a balanced approach to cardiovascular care during subsequent COVID-19 pandemic waves.
- To ensure continued essential cardiovascular services while maintaining surge capacity for COVID-19.
- To provide recommendations for minimizing disruptions in cardiac care delivery.
Main Methods:
- Review of international and Canadian data on pandemic impacts on cardiovascular care.
- Analysis of healthcare system responses to the first COVID-19 wave.
- Development of a proposed approach balancing COVID-19 surge capacity with essential cardiac care.
Main Results:
- Significant reductions in cardiac care delivery were observed during the initial pandemic wave.
- Increased wait times and negative impacts on cardiovascular morbidity and mortality were reported.
- The study proposes integrating cardiovascular care leaders into pandemic planning.
Conclusions:
- A proactive, data-informed strategy is crucial for maintaining cardiovascular care during pandemics.
- Balancing COVID-19 surge needs with essential cardiac services is achievable.
- Recommendations are provided for ambulatory, inpatient, procedural, diagnostic, surgical, and rehabilitation pillars of cardiac care.
Abstract:
Hospitals and ambulatory facilities significantly reduced cardiac care delivery in response to the first wave of the COVID-19 pandemic. The deferral of elective cardiovascular procedures led to a marked reduction in health care delivery with a significant impact on optimal cardiovascular care. International and Canadian data have reported dramatically increased wait times for diagnostic tests and cardiovascular procedures, as well as associated increased cardiovascular morbidity and mortality. In the wake of the demonstrated ability to rapidly create critical care and hospital ward capacity, we advocate a different approach during the second and possible subsequent COVID-19 pandemic waves. We suggest an approach, informed by local data and experience, that balances the need for an expected rise in demand for health care resources to ensure appropriate COVID-19 surge capacity with continued delivery of essential cardiovascular care. Incorporating cardiovascular care leaders into pandemic planning and operations will help health care systems minimise cardiac care delivery disruptions while maintaining critical care and hospital ward surge capacity and continuing measures to reduce transmission risk in health care settings. Specific recommendations targeting the main pillars of cardiovascular care are presented: ambulatory, inpatient, procedural, diagnostic, surgical, and rehabilitation.
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