Rural and Remote Cardiology During the COVID-19 Pandemic: Cardiac Society of Australia and New Zealand (CSANZ) Consensus Statement

Ruth H Arnold¹, Philip A Tideman², Gerard P Devlin³, Gerard E Carroll⁴, Alex Elder⁵, Harry Lowe⁶, Peter S Macdonald⁷, Paul G Bannon⁸, Craig Juergens⁹, Mark McGuire¹⁰, Justin A Mariani¹¹, Sean Coffey¹², Steven Faddy¹³, Alex Brown¹⁴, Sally Inglis¹⁵, William Y S Wang¹⁶

Affiliations

¹ Orange Health Service, Orange, NSW, Australia. Electronic address: ruth@coldhearts.com.au.
² Integrated Cardiovascular Clinical Network SA, Adelaide, SA, Australia.
³ New Zealand Heart Foundation, New Zealand.
⁴ Calvary Hospital, Wagga Wagga, NSW, Australia; University of New South Wales, Sydney, NSW, Australia.
⁵ Orange Health Service, Orange, NSW, Australia.
⁶ Orange Health Service, Orange, NSW, Australia; Concord Hospital, Sydney, NSW, Australia; Royal Prince Alfred Hospital, Sydney, NSW, Australia; The University of Sydney, Sydney, NSW, Australia.
⁷ University of New South Wales, Sydney, NSW, Australia; St Vincent's Hospital Sydney, Sydney, NSW, Australia.
⁸ Royal Prince Alfred Hospital, Sydney, NSW, Australia.
⁹ Orange Health Service, Orange, NSW, Australia; University of New South Wales, Sydney, NSW, Australia; Liverpool Hospital, Sydney, NSW, Australia.
¹⁰ Royal Prince Alfred Hospital, Sydney, NSW, Australia; The University of Sydney, Sydney, NSW, Australia; Prince of Wales Hospital, Sydney, NSW, Australia.
¹¹ Alfred Hospital, Melbourne, Bairnsdale Hospital, Bairnsdale and Monash University, Melbourne, Vic, Australia.
¹² University of Otago, Dunedin, and Southern District Health Board, Dunedin, New Zealand.
¹³ NSW Ambulance, Sydney, NSW, Australia.
¹⁴ South Australian Health and Medical Research Institute (SAHMRI) and University of Adelaide, Adelaide, SA, Australia.
¹⁵ CSANZ Cardiovascular Nursing Council, University of Technology, Sydney, NSW, Australia.
¹⁶ CSANZ Indigenous Health Council, Princess Alexandra Hospital, Brisbane, and University of Queensland, Brisbane, QLD, Australia.

PMID: 32487432
PMCID: PMC7203036
DOI: 10.1016/j.hlc.2020.05.001

Rural and Remote Cardiology During the COVID-19 Pandemic: Cardiac Society of Australia and New Zealand (CSANZ) Consensus Statement

Ruth H Arnold et al. Heart Lung Circ. 2020 Jul.

. 2020 Jul;29(7):e88-e93.

doi: 10.1016/j.hlc.2020.05.001. Epub 2020 May 7.

Authors

Affiliations

¹ Orange Health Service, Orange, NSW, Australia. Electronic address: ruth@coldhearts.com.au.
² Integrated Cardiovascular Clinical Network SA, Adelaide, SA, Australia.
³ New Zealand Heart Foundation, New Zealand.
⁴ Calvary Hospital, Wagga Wagga, NSW, Australia; University of New South Wales, Sydney, NSW, Australia.
⁵ Orange Health Service, Orange, NSW, Australia.
⁶ Orange Health Service, Orange, NSW, Australia; Concord Hospital, Sydney, NSW, Australia; Royal Prince Alfred Hospital, Sydney, NSW, Australia; The University of Sydney, Sydney, NSW, Australia.
⁷ University of New South Wales, Sydney, NSW, Australia; St Vincent's Hospital Sydney, Sydney, NSW, Australia.
⁸ Royal Prince Alfred Hospital, Sydney, NSW, Australia.
⁹ Orange Health Service, Orange, NSW, Australia; University of New South Wales, Sydney, NSW, Australia; Liverpool Hospital, Sydney, NSW, Australia.
¹⁰ Royal Prince Alfred Hospital, Sydney, NSW, Australia; The University of Sydney, Sydney, NSW, Australia; Prince of Wales Hospital, Sydney, NSW, Australia.
¹¹ Alfred Hospital, Melbourne, Bairnsdale Hospital, Bairnsdale and Monash University, Melbourne, Vic, Australia.
¹² University of Otago, Dunedin, and Southern District Health Board, Dunedin, New Zealand.
¹³ NSW Ambulance, Sydney, NSW, Australia.
¹⁴ South Australian Health and Medical Research Institute (SAHMRI) and University of Adelaide, Adelaide, SA, Australia.
¹⁵ CSANZ Cardiovascular Nursing Council, University of Technology, Sydney, NSW, Australia.
¹⁶ CSANZ Indigenous Health Council, Princess Alexandra Hospital, Brisbane, and University of Queensland, Brisbane, QLD, Australia.

PMID: 32487432
PMCID: PMC7203036
DOI: 10.1016/j.hlc.2020.05.001

Abstract

The challenges: Rural and remote Australians and New Zealanders have a higher rate of adverse outcomes due to acute myocardial infarction, driven by many factors. The prevalence of cardiovascular disease (CVD) is also higher in regional and remote populations, and people with known CVD have increased morbidity and mortality from coronavirus disease 2019 (COVID-19). In addition, COVID-19 is associated with serious cardiac manifestations, potentially placing additional demand on limited regional services at a time of diminished visiting metropolitan support with restricted travel. Inter-hospital transfer is currently challenging as receiving centres enact pandemic protocols, creating potential delays, and cardiovascular resources are diverted to increasing intensive care unit (ICU) and emergency department (ED) capacity. Regional and rural centres have limited staff resources, placing cardiac services at risk in the event of staff infection or quarantine during the pandemic.

Main recommendations: Health districts, cardiologists and government agencies need to minimise impacts on the already vulnerable cardiovascular health of regional and remote Australians and New Zealanders throughout the COVID-19 pandemic. Changes in management should include.

Keywords: COVID-19; Cardiac services; Remote monitoring; Rural; Telehealth.

Copyright © 2020 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

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References

1. Australian Institute of Health and Welfare . AIHW; Canberra: 2018. Australia's Health 2018. Australia's Health series no. 16. AUS 221.
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Rural and Remote Cardiology During the COVID-19 Pandemic: Cardiac Society of Australia and New Zealand (CSANZ) Consensus Statement

Affiliations

Rural and Remote Cardiology During the COVID-19 Pandemic: Cardiac Society of Australia and New Zealand (CSANZ) Consensus Statement

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical