COVID 19 ACHD Webinar Q & A Panel Responses

On the 8th of April 2020 Professor Michael Gatzoulis facilitated a webinar on Covid-19 and ACHD with colleagues from the Lombardy region of Italy. Below are the answers to the questions that were posed to the panel.

Question: What is my risk if I get infected?

Answer: Low.

Question: What shall I do if have symptoms in this period?

Answer: Follow the NHS and your Provider/Institution advice.

Question: How can we ensure that resources are maintained to support congenital heart patients’ tertiary needs, and other health care needs, when there has and is so much emphasis on combating Covid-19?

Answer: A challenge, but we are living up to it. The model of ACHD has been turned on its head, this should lead to good things after the pandemic, we must use technology more.

Question: For myself, I have Transposition of the Greater Arteries, I am also Mum to a severely disabled 17-year-old child, who is entirely dependent on me. If I became unwell, or if she became unwell, it would be impossible for me to self-isolate from my daughter, due to her level of care. This is obviously of great concern to me and will be a great concern for any young mother with lifelong cardiac needs whilst trying to provide for their dependent child.

Answer: Hi Rachel, we discussed this at the Webinar, best to shield yourself as much as possible, thus protect your daughter. Good to have your parents with you.

Question: I realise there is a lack of PPE for medical professionals. However, given our situation should we be using masks, gloves, if we became unwell?  Has Italy had more PPE provided and if so, did this make a difference to people getting the virus?

Answer: Maybe using a facemask, helpful when out coming across people. Follow the 2 metre rule.

Question: Are there limited ventilators, if so, would a CHD patient not be offered treatment over someone with no pre-existing health issues?

Answer: There is capacity for ICU/ventilators. Patients with ACHD should not/will not be discriminated against others, should they require IC treatment.

Question: Have congenital heart patients had COVID-19 and if so, have they survived. Has there been damage to people’s hearts on recovering from COVID?

Answer: Yes, the overall anecdotal evidence so far is reassuring. This was discussed at the Webinar and also is the case from our very early experience at the Brompton.

Question: Whilst people are meant to be social distancing, in accordance with the Government guidelines, are CHD patients safe to go for a walk? I am finding runners, cyclists are not moving out of our way, acting in accordance with Government guidelines. Different heart units are giving different advice, for myself, they have stated to shield for 12 weeks (at Leeds). However, I would think exercise, physical and mental health is important. But I suppose how safe it is, is dependent on the environment you live in, city/countryside?

Answer: YES. A walk or early morning or late evening run, ESSENTIAL. PHYSICAL ACTIVITY ESSENTIAL. IMPROVISE FOR LIMTED SPACE. YOGA, USE INTERNET CLASSES ETC.

Question: Can the virus lay dormant on clothing, post and parcels?

Answer: Yes, for about 24 hours. Washing hand thoroughly and regularly is good practice.

Question: I am in heart failure and am really scared if I catch this, what shall I do if I think I have symptoms?

Answer: Follow the NHS advice and contact your ACHD provider.

Question: My surgery has been brought forward, I’m scared I might catch the virus in hospital and don’t know if I should cancel

Answer: Maybe you should reschedule, if this an elective procedure. Discuss with your ACHD provider

Question: If my condition suddenly gets worse, can I have the surgery that has been delayed?

Answer: It is an option, if this truly urgent and in your interest; please discuss with your local ACHD team.

Question: I am worried about needing to go to hospital, are the frontline staff getting the PPE they need now?

Answer: Yes, we do.

Question: What to do if I have symptoms, at what stage would I need to go into hospital?

Answer: If symptoms persist after 7-10, discuss with your GP and local ACHD provider.

Question: How will a local hospital find out about and understand my heart condition, I’m worried they won’t have my notes?

Answer: The local hospital should be in close contact and guided by your ACHD provider. Ensure that the latter are engaging in any management plan/change/need.

Question: I have had endocarditis before, if I get this virus, will I be more vulnerable?

Answer: No, you will not.

Question: I can’t get hold of my specialist team and haven’t had a letter (saying most vulnerable) what do I do?

Answer: Try them again and their Nurse Specialist.

Question: Because I am self-isolating I want a INR testing machine at home, how can I get one quickly?

Answer: Discuss with your GP. Some patients may be suitable for NOACs, i.e. the new anticoagulants, that there us no need for blood tests. Please consult your local ACHD provider.