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Experts call for swift action to avoid the chronic health condition caused by COVID-19




A SARS-CoV-2 pandemic, especially a tsunami of chronic health as a result of cardiometabolic disorders, can create a huge wave of death and disability that requires an immediate and comprehensive strategy.

In addition, COVID-19 has disrupted cardiovascular science and medicine, yet offers the opportunity to transform and create new approaches that can bring new success. These are the opinions of two respected leaders in cardiovascular care, research and strategy, detailed in two new frame-of-reference articles published today in the American Heart Association’s flagship journal. circulation..

COVID-19 has had serious implications for everyone’s daily lives, but its social and economic implications have existed for generations.

It prompted urgent response in many sectors that could serve as a model for the rapid development of real-world solutions that could improve efforts focused on the prevention of chronic health conditions. Dramatic changes in healthcare research are needed to address the cardiovascular and cardiac health disruptions caused by the COVID-19 pandemic.

The first article, “Avoiding the Coming Tsunami of Common Chronic Diseases: What the Lessons of the COVID-19 Pandemic Can Teach Us,” was written by Dr. Robert M. Caliph of Medicine. He is responsible for Verily Life’s clinical policy and strategy. Sciences and Google Health, Former Commissioner of the US Food and Drug Administration, Former Deputy Prime Minister of Health Data Science at Duke University School of Medicine, and Founding Director of the Duke Clinical Institute.

In his article, Caliph encourages swift and comprehensive action to avoid the expected chronic health status resulting from COVID-19, especially the dramatic rise in cardiometabolic disorders. .. Of the top 10 leading causes of death in the United States, three are associated with cardiovascular disease, stroke, and type 2 diabetes.

He has made significant changes to the US healthcare system, with universal health, public health, research strategies, and more effective and efficient prevention and treatment protocols and programs that incorporate “big data” throughout society. We are asking you to include improved medical data sharing that can provide information. “”

Calif also has the impact of structural racism and social determinants of health at all levels of research, clinical care, and in the community and to achieve equitable and systematic improvement in health outcomes. I point out that it must be incorporated into society as a whole.

He advocates universal access to broadband internet that can increase access to medical information, digital support programs, and telemedicine appointments with healthcare professionals.

He recommends more real-time, detailed tracking of chronic health, as well as a rapid data dashboard implemented to track COVID-19 cases, hospitalizations, and deaths. With quick access to better information, strategies for preventing and treating chronic health conditions can be measured and adapted accordingly.

Caliph also proposes a new initiative called “Operation Warp Evidence,” which is modeled after the rapid COVID vaccine initiative “Operation Warp Speed.” This is a rapid, high-priority clinical trial infrastructure that assesses the risks and benefits of new therapies over existing chronic therapies. Health status. This allows a vast number of clinical trials to focus on prevention, care, and immediate interventions that can improve outcomes.

Many of Calif’s comments are in line with the November 2020 Presidential Advisory of the American Heart Association, “Action Encouragement Phrase: Structural Racism is the Fundamental Driving Force for Health Inequalities,” which the association said. Outlined a proactive and meaningful plan to address structural inequality to eliminate. Remove barriers and increase diversity, fairness, access and inclusiveness for all. They also reflect the association’s findings in recent heart disease and stroke statistics-2021, indicating that COVID-19 is likely to affect cardiovascular health and mortality over the next few years. I have.

The second article, entitled “Incremental Change vs Disruptive Transformation: COVID-19 and the Cardiovascular Community,” comes from Dr. Nanette K. Wenger, a professor of medicine at Emory University School of Medicine, Department of Cardiology. He is a founding consultant for the Emory Heart and Vascular Center and the Emory Women’s Heart Center, and director of the Grady Memorial Hospital Heart Clinic and Portable Electrocardiogram Institute in Atlanta.

Wenger has been at the forefront of patient care progress for over 60 years, focusing on women’s atherosclerosis and assessing a variety of cardiovascular risk factors, symptoms and conditions in women compared to men. Was one of the first doctors to do. ..

She was one of the first women to graduate from Harvard Medical School and has received much acclaim throughout her outstanding career in pioneering research on women’s cardiovascular disease.

In particular, she is the author of the Association’s 2007 Guidelines for Women’s Cardiovascular Disease and has received multiple awards from the Association, including the Gold Heart Award, Lifetime Achievement Award, and more recently the 2020 Eugene Brownwald Academic Mentorship Award. doing.

Wenger’s article documents her view that the United States is experiencing three pandemics at the same time: COVID-19, economic turmoil, and social injustice.

The COVID-19 pandemic has widened the social and healthcare gap. Millions of people have lost their jobs. Many industries and SMEs are in financial decline. And every aspect of scientific research and medicine has changed-education, research, clinical care.Still, she admits that there have been many successes and significant changes, including rapid recruitment. Telemedicine, It can lead to a wide range of transformations in healthcare delivery and improve access to care for more patients.

The inequality was found to include patient hesitation in receiving care. Patients’ self-quarantine to avoid exposure to the emergency room and COVID-19 undermined many of the improvements achieved in the last 50 years in the care of acute coronary syndrome and stroke.

COVID-19 has driven the urgency of research to understand the disease, its course, treatments and vaccines, but has opened the door to the success of a new public-private partnership that delivers rapid results. Wenger asks, “Will these be models of future progress?”

Academic education has moved to a virtual environment, many laboratories have been closed, and some programs have rushed to track students to join a pool of professionals providing emergency patient care.

Career opportunities for medical students and professionals have changed in unexpected ways, and female scientists have been disproportionately affected by quarantine because of their historic childcare responsibilities. “Is there a long-term impact on science and discovery?” Wenger pointed out.

In Scientific Publishing, COVID-19 research has been accelerated through the peer review process to respond to pressure, creating an effective model for higher efficiency that should be continued. Rapidly performed health registries to track COVID-19 patients have been used to measure, treat, and outcome cardiovascular disease, especially because there are still so many unknowns about long-distance COVID and sustained cardiovascular effects. Can be extended to include.

The correlation between perceptions of social justice and its deterioration of health was due to imbalanced COVID-19 deaths in African-American, Hispanic / Latino, Native / Alaska, and Pacific Islands communities last year. It became clear. COVID-19 facilitated an important effort to widen these disparities and dismantle structural racism, as discussed by the AHA 2020 Presidential Advisory Board mentioned above.

The convergence of all these issues, their impact on cardiovascular disease and care, provides a unique opportunity for change in cardiovascular medicine, clinical care, and research. To maximize innovation and achieve equity for all, we need to focus and be flexible during this unprecedented time. “

Dr. Nanette K. Wenger, FAHA, Professor of Cardiology, Emory University School of Medicine


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