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Hospital rooms have been cramped, and now sheets of protective and exhausted health care workers clad in layers of personal protective equipment are scrambling to bring in more staff.Marc Grandmaison/The Canadian Press

People living with cardiovascular disease are worse off than they were prior to the pandemic because of delays in accessing care, and a new survey of health professionals and researchers suggests the effect may continue even as COVID-19 pressures lift

The national survey, commissioned by Heart & Stroke in partnership with Environics Research, queried health professionals and researchers who work with those living with heart conditions, stroke or vascular cognitive impairments. The patient group is a fraction of the population that had non-urgent but necessary medical appointments changed, cancelled or delayed as a result of pandemic pressures on the health care system.

The survey found that 92 per cent of respondents worried that the health of people living with heart disease or stroke worsened because they were not able to access needed care during the pandemic.

Delays in diagnosis and treatment resulting in worse health was the biggest issue for 82 per cent of health professionals and researchers surveyed, and 54 per cent cited mental-health issues as “significant” for people living with heart disease and stroke during the pandemic.

A total of 370 health professionals, including heart and brain health researchers, neurologists, cardiologists, and family and emergency physicians participated in the online survey, which was conducted Aug. 16 through Sept. 7.

Clare Atzema, a staff emergency physician at Toronto’s Sunnybrook Health Sciences Centres and a senior scientist at Sunnybrook Research Institute and ICES, said the drop in care was apparent to her early in the pandemic when heart and stroke patients suddenly seemed to disappear.

“I think I saw a few tumbleweeds in the ER,” she said. “There were COVID patients and cancer patients who were so sick that they had to come in, but where were the patients having heart attacks? And the patients with heart failure? Did they just sit through the chest pain? Did they take [nitroglycerin] at home? Did they die of COVID? I don’t know.”

While the survey found that 73 per cent of respondents believe there will be more virtual health care opportunities as a result of innovations during the pandemic, Dr. Atzema said physicians still must see heart and stroke patients in person to assess issues such as cholesterol levels and fluid in the lungs. She added that, during the pandemic, people were generally engaging in less exercise – the “best prescription in the world” for preventing heart attacks, strokes and arrhythmias.

Heart and stroke survey

Heart and Stroke surveyed people living with cardiovascular

conditions during the pandemic to understand how it affected

their health and well-being. Below are the findings from an

online survey that took place March 23 – April 26, 2021,

with a total of 3,016 respondents

CONCERNS

Respondents concerned about catching COVID-19

4 out of 5

Respondents concerned about mental health...

1 out of 3

INTERRUPTED HEALTH CARE

People who had at least one medical appointment changed,

delayed or cancelled...

66%

ADAPTATIONS OF HEALTH CARE SYSTEM

People who report having had a virtual health care

appointment...

More

than 80%

Virtual health care appointments were more often

the only option for people

60%

People who rated virtual appointments as good

as in-person interactions...

60%

...and those who confirmed that virtual appointments

were convenient

80%

A newer survey of 370 health care professionals and

researchers (Aug. 16 – Sept. 7), found the following:

Health professionals and researchers worried that heart and

stroke patients became worse because they were not always

able to access the care they needed

90%

Delays in diagnosis and treatment resulting in worse health

was the biggest issue for people living with heart and stroke

according to health professionals

82%

Health professionals and researchers who think the health

care gap has widened between those who receive

appropriate care and those who do not

84%

THE GLOBE AND MAIL, SOURCE: heart and stroke

Heart and stroke survey

Heart and Stroke surveyed people living with cardiovascular

conditions during the pandemic to understand how it affected

their health and well-being. Below are the findings from an

online survey that took place March 23 – April 26, 2021,

with a total of 3,016 respondents

CONCERNS

Respondents concerned about catching COVID-19

4 out of 5

Respondents concerned about mental health...

1 out of 3

INTERRUPTED HEALTH CARE

People who had at least one medical appointment changed,

delayed or cancelled...

66%

ADAPTATIONS OF HEALTH CARE SYSTEM

People who report having had a virtual health care

appointment...

More

than 80%

Virtual health care appointments were more often

the only option for people

60%

People who rated virtual appointments as good

as in-person interactions...

60%

...and those who confirmed that virtual appointments

were convenient

80%

A newer survey of 370 health care professionals and

researchers (Aug. 16 – Sept. 7), found the following:

Health professionals and researchers worried that heart and

stroke patients became worse because they were not always

able to access the care they needed

90%

Delays in diagnosis and treatment resulting in worse health

was the biggest issue for people living with heart and stroke

according to health professionals

82%

Health professionals and researchers who think the health

care gap has widened between those who receive

appropriate care and those who do not

84%

THE GLOBE AND MAIL, SOURCE: heart and stroke

Heart and stroke survey

Heart and Stroke surveyed people living with cardiovascular conditions during the pandemic

to understand how it affected their health and well-being. Below are the findings from an

online survey that took place March 23 – April 26, 2021, with a total of 3,016 respondents

CONCERNS

Respondents concerned about catching COVID-19

4 out of 5

Respondents concerned about mental health...

1 out of 3

INTERRUPTED HEALTH CARE

People who had at least one medical appointment changed,

delayed or cancelled...

66%

ADAPTATIONS OF HEALTH CARE SYSTEM

People who report having had a virtual health care appointment...

More than 80%

Virtual healthcare appointments were more often the only option for people

60%

People who rated virtual appointments as good as in-person interactions...

60%

...and those who confirmed that virtual appointments were convenient

80%

A newer survey of 370 health care professionals and researchers (Aug. 16 – Sept. 7), found the following:

Health professionals and researchers worried that heart and stroke patients

became worse because they were not always able to access the care they needed

90%

Delays in diagnosis and treatment resulting in worse health was the biggest

issue for people living with heart and stroke according to health professionals

82%

Health professionals and researchers who think the health care gap has

widened between those who receive appropriate care and those who do not

84%

THE GLOBE AND MAIL, SOURCE: heart and stroke

“None of that’s happened, the preventative care, the exercise,” she said. “You put those things together, and we’re going to have a wave of patients that are far sicker than they would have been and some will die.”

More than half (54 per cent) of health professionals and researchers surveyed said they were worried about a decrease in cardiovascular health in people who did not have existing conditions prior to the pandemic.

Respondents also identified significant challenges that are expected to continue beyond the pandemic. Specifically: 68 per cent highlighted health care provider burnout as the biggest postpandemic challenge, while 65 per cent said it would be increased wait times for appointments and procedures, and 45 per cent flagged the increased burden on the health care system because of more and sicker patients.

About three-quarters of respondents were also concerned about the slowing or stoppage of critical heart and brain research during the pandemic.

A separate Heart & Stroke online survey of 3,016 people living with a heart condition, stroke or vascular cognitive impairment, which took place March 23 to April 26, found that two-thirds of respondents had at least one medical appointment changed, delayed or cancelled during the pandemic.

When Paul King of Owen Sound, Ont., began feeling pain in his arms and a tightness in his chest during a hike last November, he stopped to do a Google search of his symptoms. Finding that they all appeared to be heart-related, Mr. King followed up with several virtual doctors’ appointments, which led to two stress tests and an angiogram. He learned that he had seven blockages in his arteries and would need bypass surgery.

While Mr. King’s coronary artery bypass graft, first scheduled for May 13, was delayed three times, he was still able to undergo surgery by month’s end. He described his time in hospital as a stressful stay that opened his eyes to the pressures on both health care workers and the health care system. Hospital rooms were cramped, sheets of protective plastic hung from two-by-fours, and exhausted health care workers clad in layers of personal protective equipment could be heard trying to bring in more staff.

“It was pretty nerve-racking at the time, in terms of, you really didn’t know if they were going to have the ability to even do [the surgery],” said Mr. King, 58. He is now in his fifth week of cardiac rehabilitation, and on Monday completed an 18-kilometre bike ride.

He said that two takeaways from his experience are that health care workers are owed respect and gratitude, and that people cannot be afraid to go to hospital if they require care.

“I was scared the whole time,” he said. “For sure there was COVID in the hospital when I was there. But don’t delay getting tested. Some things you have to go to the hospital for. Wear two masks, sanitize as much as you want. But don’t delay going to hospital.”

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