Since the beginning of the coronavirus pandemic, the way we receive medical care has changed drastically and remains somewhat fluid. These frequent changes can be frustrating, overwhelming and distressing, but ignoring worrisome symptoms or choosing to delay care can prove dangerous, even deadly.
“Prior to the pandemic, people would delay care, asking themselves if their symptoms were serious enough or just in their heads,” said Miami Cardiac & Vascular Institute preventive cardiologist and lipidologist Johnathan Fialkow, M.D., who also serves as the chief population health officer for Baptist Health South Florida. “Now, we see new concerns about people’s exposure to the coronavirus and their loved ones not being able to come to the hospital with them as the main reasons they choose not to seek timely medical care.”
Seek Care for Severe Symptoms
Dr. Fialkow warns that delaying care for these reasons, especially when symptoms are severe, increases one’s risk for negative outcomes. While heart attack and stroke top the list for when delaying care may quickly turn deadly, as discussed on an episode of “Baptist Health Talk” hosted by Dr. Fialkow, many other cardiovascular conditions can cause a rapid deterioration of health without proper care and immediate attention.
Symptoms that should be evaluated by a medical professional as soon as possible include:
- Chest pain
- Light headedness or dizziness
- Shortness of breath that is inconsistent with level of activity
- Swelling of arms and legs
- Difficulty breathing while lying down
- Racing heart for extended periods of time
Manage Chronic Disease
Dr. Fialkow warns that these symptoms can also signal chronic disease that warrants quick intervention to prevent devastating results.
“Just like with heart attack and stroke, signs of chronic conditions should be treated aggressively to prevent hospitalization and even save lives,” Dr. Fialkow said. “The earlier we can assess these symptoms, the better chance we have for a favorable outcome.”
As a cardiologist, he names high blood pressure – or hypertension, diabetes and heart failure as common chronic cardiovascular conditions that need consistent monitoring and often require quick medical intervention. But he also points to respiratory conditions, such as asthma and chronic obstructive pulmonary disease, or COPD, as similarly needing frequent monitoring to prevent severe complications.
Regardless of the specific condition, Dr. Fialkow says that people with chronic diseases are the most likely to be hospitalized, even absent a pandemic. Unfortunately, these individuals also have a higher risk of severe COVID-19, so they remain fearful of going out in public to get their medications and keeping their regular doctor appointments. As a result of that fear, they may stop taking their medication or alter the frequency to extend the life of their prescriptions. They may also postpone regular appointments with their doctor or healthcare providers.
Fortunately, the pandemic opened the doors for increased use of telemedicine to keep people connected to their providers.
“We quickly implemented telemedicine appointments soon after the initial lockdown took place,” Dr. Fialkow said. “While these online appointments aren’t good for every patient or in every situation, we’ve been able to catch when some patients were heading toward deterioration.”
During the first nine months of the pandemic, Miami Cardiac & Vascular Institute’s Cardiology group conducted approximately 18,000 telemedicine appointments, Dr. Fialkow says, using a secure online platform to connect with and assess their patients. While many doctors’ offices have resumed safe in-person appointments, these telemedicine visits remain an option for patients to use when appropriate for their specific healthcare needs.
Schedule Diagnostic Tests and Procedures
In addition to keeping doctor appointments and continuing medications, Dr. Fialkow encourages following through with diagnostic tests that can give cardiologists and other providers answers to what is causing symptoms. He points to enhanced cleaning protocols, mask requirements and social distancing practices as ways outpatient centers, doctors’ offices and hospitals have safely resumed diagnostic testing, including:
- Stress tests
- Electrocardiograms (EKGs)
- Echocardiograms (ECHOs)
- Diagnostic catheterizations
He also advises to no longer postpone procedures, such as valve repairs or replacements, cardiac catheterizations, heart surgery or vascular surgery to treat cardiovascular conditions. Some of these procedures were postponed at the beginning of the pandemic to preserve hospital staff and treatment areas. Now, with hospitals reopening their full range of services, Dr. Fialkow says patients should speak to their doctors about scheduling these procedures.
Resume Screenings and Vaccinations
He also urges people to resume their health screenings and vaccinations, again pointing to safety measures in place and the benefits of these outweighing the risks of contracting COVID-19.
“It’s important not to postpone mammograms, colonoscopies and vaccinations for the flu, pneumonia and now COVID-19,” he said, noting that the number of people seeking these routine procedures has been down since the pandemic began. “These are tools that your doctor uses for early detection and treatment of potentially serious diseases and tools that can keep you healthy.”
Seek Care, Even With COVID-19
Some people who have tested positive for COVID-19 delay medical care out of concern that they’ll expose others to the coronavirus. Dr. Fialkow encourages people not to let their COVID-19 status deter them from seeking medical help. For emergencies and life-threatening circumstances, such as when someone is suffering from heart attack or stroke symptoms, he advises calling 911. For non-emergent situations, where symptoms are worrisome but not life-threatening, he advises the following steps:
- Call your doctor.
- Reveal your COVID-19 status.
- Ask if a telemedicine appointment is available.
- Once a determination of the course of appropriate care is made, follow instructions on where to get care.
“We’re not where we were a year ago, thankfully,” Dr. Fialkow said. “Urgent care centers, emergency rooms and doctors’ offices are now better prepared with proper safety precautions in place and the necessary personal protective equipment, or PPE, to protect the caregivers. Plus, with most healthcare workers choosing to receive the vaccine, they are less likely to contract COVID-19.”
Dr. Fialkow stresses the importance of medical intervention for concerning symptoms in a timely manner. “The longer you wait to seek treatment, the higher the risk of your condition worsening,” he said. “We’re prepared to handle emergencies, but we’d much rather intervene before it gets to that point.”