Tuesday, August 11, 2020
Aug. 11, 2020

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Compile your post-lockdown health care checklist


COVID-19 lockdowns are easing across the U.S., but is it safe to go back to the gym? Or the doctor?

And when it is safe, what should be on your post-lockdown health checklist?

As you prioritize your health to-do list, be aware of coronavirus rates in your area, your personal risk from COVID-19 based on your age and medical conditions, and what experts are advising in your area and for your personal care.

Work with your health care team to reschedule high-priority procedures or screenings, where available.

In a recent report, 16 North American cardiovascular societies issued guidance for health professionals on safely reintroducing diagnostic tests and invasive cardiovascular procedures, with an eye to regions with lower rates of infection.

The pandemic has taken a toll on cardiovascular care, said cardiologist Dr. Robert Harrington, chair of the department of medicine at Stanford University in California. He co-authored the report as president of the American Heart Association.

“We’ve seen a large drop-off in patients seeking acute care for suspected heart attacks and strokes. There’s been a decrease in more elective procedures such as exercise testing, cardiac catheterization and other procedures. Anecdotally, we also hear of people having worsening symptoms at home, with a reluctance to seek care for issues such as heart failure management.”

Among other concerns, the new report stresses the need for cardiovascular care providers to prioritize procedures or tests with the most benefit for the most people, and to balance risk of further care postponement against risk of further spreading COVID-19.

“Video and phone visits remain the preferred mode for care for the near future as social distancing, masks and good hand hygiene remain critical to prevent and reduce the risks of infection,” Harrington said. “There should be local protocols for all of this in the clinical environment that also take into consideration recommendations from local public health departments.”

The American Cancer Society addresses similar questions about resuming cancer screenings and exams, urging people to talk to health care providers about their personal situations and whether they’re having symptoms. Among the considerations: balancing the risk of the cancer being screened for against the risk from COVID-19, how involved the screening is (at-home colorectal cancer screening tests are available), how active the coronavirus is locally and what local health officials advise, and precautions taken by individual medical centers to prevent COVID-19’s spread.

People who have missed routine medical care can schedule a catch-up visit, including by telephone or video. Primary care providers will want updates on their patients’ health during the pandemic, including any weight or diet changes, depression symptoms, sleep problems, and COVID-19 or other illness. They’ll want to know how home monitoring of chronic conditions has been going.

Also, primary care providers can help people balance their personal health vulnerability against local COVID-19 infection trends to determine whether and when to pursue in-person visits for routine care like vaccinations and dental checkups.

It’s safe for most people to return to health care facilities, said Mercedes Carnethon, an epidemiologist and vice chair of the department of preventive medicine at Northwestern University in Chicago.