COVID-19: Advice for individuals living with heart disease or stroke

The Croí Health Team is here as always if you need support. Contact us by email at healthteam@croi.ie or call 091-544310.

Updated July 20th

Latest developments: 

Moving to phase 4 of the government road map has been paused. As the pandemic accelerates around the world, we must remain vigilant here in Ireland. With the reopening of society, it is important to remember that COVID-19 is a highly infectious disease. The message is to Stay Safe. Physical distancing should continue to be maintained at all times.

Continue to follow good hand washing, respiratory hygiene and physical distancing because we know these work and are even more important than ever. Face coverings are now required on public transport, should be worn in shops and shopping centres and in situations where physical distancing is not possible. If you have cold or flu like symptoms, even mild ones, it is important to isolate at home and call your GP.

Further information on latest updates can be found on the Government website.

  • People over 70 years and the extremely medically vulnerable, who have been cocooning remain at the highest risk of severe illness from COVID-19 and are advised to stay at home as much as possible, and to limit physical contact with other people.
  • It is important that you continue to attend essential medical services such as GPs and receive medical care at home (if appropriate) to protect your health and wellbeing.
  • Limit the amount of time you spend in direct contact with other people, avoiding crowded areas and limiting close contacts to a small number of people. Social visits to people’s homes should be limited to a maximum of 10 visitors – from no more than 4 other households.
  • No more than fifty people may gather socially indoors while maintaining strict social distancing. However, outdoor meetings up to 200 people are preferable to indoor meetings.
  • For further guidelines and information about how to correctly fit/ remove face mask or how to make your own mask visit the HSE website.
    • Facemasks should not be worn by those:
      • aged under 13 years of age
      • who have trouble breathing
      • who are unconscious or incapacitated
      • who are unable to remove it without help
      • with special needs and who may feel upset or very uncomfortable wearing the face covering

The Croi Health team are determined to stay connected with all our groups and supporters and aim to keep you informed and up to date on a regular basis. We will continuously explore the latest evidence on COVID-19 and cardiovascular disease and will share this important information with you.

COVID-19 is a new illness that can affect your lungs and airways. It’s caused by a virus called coronavirus. There is currently no vaccine to prevent COVID-19 and the best way to prevent illness is to avoid being exposed to this virus.

For heart and stroke patients, prevention is key. While it is normal to feel anxious about how this condition might affect you, you are at no greater risk of developing COVID-19 than anyone else. However if you do contract the virus you have a higher chance of developing complications.

Groups that are at risk of more serious illness if they catch coronavirus are:

  • Those aged 60 years of age and over; people over 70 are particularly vulnerable and should cocoon as outlined below.
  • People with a long term medical condition – for example heart disease, stroke, lung disease, diabetes, cancer, kidney disease, liver disease or high blood pressure
  • People who have a weak immune system (immunosuppressed)
  • People who have a medical condition that can affect their breathing
  • Resident of a nursing home or other residential care setting
  • People who are in specialist disability care and are over 50 years of age or have an underlying health problem

Therefore you need to be extra vigilant by following the advice of the HSE, being aware of the symptoms and by taking the recommended precautionary measures. From 30th March this now includes the advice to stay in your own home as much as possible. Staying at home is the best way to minimise the risk of COVID-19 to your friends, families and communities.

Everyone has a role to play in reducing the spread of this virus and if we all take collective responsibility we will minimise the risk for everyone.

Is there any specific advice for individuals living with heart disease or stroke?

As you are at higher-risk of a more serious illness if you contract coronavirus, you are being advised to stay at home as much as possible and to limit your social contact. We strongly urge you to take extra care in ensuring you follow all of the recommended precautions. Please see our advice below on cocooning.

While all individuals with underlying cardiovascular disease are at increased risk of complications if affected by COVID-19, those at greatest risk include individuals who have:

  • Had a heart transplant
    • At any time in the past or more recently.
  • Are pregnant with a heart condition
    • Lung viruses can cause severe illness in pregnant women, particularly those with an underlying heart condition.
    • Heart conditions include symptomatic coronary disease, hypertrophic cardiomyopathy (if it affects your heart function), thickening of the heart muscle (left ventricular hypertrophy, pulmonary hypertension, a moderate / severely narrowed or leaking heart valve, heart failure that affects your left ventricular function), or significant congenital heart disease.
  • Had recent open heart surgery
    • Including coronary artery bypass grafts (CABG) and valve repair or replacement.
  • Heart failure
    • Especially if you have been recently diagnosed, it affects your activities of daily living or you have been recently hospitalised for treatment.
  • Heart valve disease
    • Where this is severe disease or you have ongoing symptoms or are awaiting valve surgery.
    • A heart murmur in itself where you do not have symptoms or not diagnosed with valve disease does not increase your risk.
  • Congenital heart disease
    • There are many types but in particular if you have complex disease or have other underlying conditions increasing your vulnerability.
  • Cardiomyopathy
    • Any type if you have ongoing symptoms or your daily activities are limited.
  • Angina
    • That limits your daily activities or means you have to use your GTN spray frequently.
  • Heart disease with other health conditions such as chronic kidney disease and lung disease

With the emphasis being on minimising contact outside the home, it is still important to maintain your healthy lifestyle habits and not to disregard your usual exercise routine. As this may not be possible to continue outdoors please see our website for lots of helpful health tips and advice to keep you on track.

Refill your medication prescription as normal and have over the counter medications such as paracetamol and a thermometer in your home. There is no disruption to the supply of medicines and therefore there is no need to order more medicines than you need. Ask a family member to collect any medicines you need. If you do feel unwell, it’s still really important to carry on taking any medication you’ve been prescribed and speak to your doctor if you have any concerns.

Look after your emotional health and well-being. Any unexpected changes to our daily lives can be a source of stress and COVID-19 is no different. It is important to obtain information from reputable sources and focus on the facts rather than opinions on social media.

Cocooning

What is cocooning?

Cocooning is a recommendation from the HSE and the Irish government to protect those who are most at risk of developing serious complications if they contract the COVID-19 virus. Cocooning aims to minimize interaction between those most at risk and others.

What should I do?

It is advised that you don’t leave your house for the next 2 weeks.

  • This means avoiding face to face interaction.
  • Do not go out shopping for food or medicine. Ask a friend or neighbour to do this for you, or arrange for your shopping to be delivered. Many shops are now offering this service for free. Also many communities have set up support groups to help and support those in need.
  • Ask for your shopping to be left outside at your door.
  • People who visit to help care for you should still attend as long as they have no symptoms of COVID-19. Ask them to wash their hands on arrival and when possible keep 2 meters apart.
  • Avoid anyone who is sick – If you usually have carers, have a backup plan in case one of them becomes unwell.
  • You can ask your family to keep in touch with you via Whatsapp, video or social media so you don’t miss out.
  • You may leave the house to get fresh air or exercise within 5km of your home, if social distancing is observed.
  • If you need to contact your GP use the telephone.

 

Do I need to cocoon?

The HSE have advised the following people to cocoon:

  • people aged 70 years or over;
  • solid organ transplant recipients (including heart transplant);
  • people with specific cancers, rare diseases, respiratory conditions; and
  • women who are pregnant with significant heart disease, congenital or acquired.

 

In addition to HSE recommendations, international cardiac societies advise people living with the following conditions to cocoon:

  • Heart conditions, including symptomatic coronary disease, hypertrophic cardiomyopathy (if it affects your heart function);
  • Had recent open heart surgery;
  • Heart failure;
  • Heart valve disease – that is moderate or severe;
  • Significant congenital heart disease;
  • Cardiomyopathy – any type if you have ongoing symptoms or your daily activities are limited;
  • Those with Angina that limits your daily activities or means you have to use your GTN spray frequently.

What are the symptoms of COVID-19?

The main symptoms to watch out for are:

  • a cough
  • a high temperature
  • shortness of breath
  • breathing difficulties
  • a reduced sense of smell or taste and there is no other obvious cause

Other symptoms are fatigue, headaches, sore throat, aches and pains. But these symptoms do not necessarily mean you have the illness. The symptoms are similar to other illnesses that are much more common, such as cold and flu.

If you are experiencing any of these symptoms and are concerned you should contact your GP for further advice.

How to avoid catching or spreading COVID-19

Coronavirus is spread by droplet infection – coughing and sneezing or by close contact with someone who has the virus. As it’s a new illness, we do not know how easily the virus spreads from person to person. Spread is most likely from those who have symptoms.

Limit close contact

Latest recommendations include the closure of all non-essential retail outlets. People need to stay at home and only leave to:

  • go to work
  • go to the shops for essential supplies
  • care for others
  • for brief individual exercise – within 5 kilometres of your house. (You can bring children but must keep 2 metres away from others for social distancing)

As Ireland has local transmission of the virus, the country has entered the ‘delay phase’ of managing COVID-19.  Physical distancing and avoiding close contact is strongly advised to reduce the spread of coronavirus. Key recommendations are:

  • Avoid hand shaking and close contact with people- keep a distance of 2 meters (6.5 feet) between you and others.
  • Work from home if and where possible.
  • Children should stay at home, but may leave the house to exercise within 5km radius of their house. They should not be meeting or visiting friends or family members.
  • Make a joint plan with family friends and neighbours on what to do if you become ill.

Travel

  • Avoid all non-essential travel.
  • You will need to restrict your movements for 14 days if returning from any other country.
  • You DO NOT need to restrict your  movements if you are returning from northern Ireland or you are an essential supply chain worker such as a pilot, haulier or maritime staff member.
  • Check with the department of foreign affairs for the latest advice before travelling abroad.

Self-quarantine and self-isolation

  • To help stop the spread of coronavirus you may need to either self-quarantine or self-isolate.
  • Self-quarantine means avoiding contact with other people and social situations as much as possible. You will need to do this if you are a close contact of a confirmed case of coronavirus and you are still well.
  • Self-isolation means staying indoors and completely avoiding contact with other people. You will need to do this if you have symptoms of coronavirus.

 

Other Do’s and Don’t’s include:

Do:

  • Wash your hands with soap and water often – do this for at least 20 seconds.
  • Always wash your hands when you get home or into work.
  • Use hand sanitiser gel if soap and water are not available.
  • Cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze.
  • Put used tissues in the bin straight away and wash your hands afterwards.
  • Try to avoid close contact with people who are unwell.

Don’t:

  • Do not touch your eyes, nose or mouth if your hands are not clean.
  • Do not share objects that touch your mouth, for example bottles and cups.
  • Do not shake hands.
  • Don’t have visitors to your home, unless they are helping with your care needs.

Treatment for COVID-19

There is currently no specific treatment or vaccine for COVID-19. The treatment approach involves alleviating symptoms and reducing the risk of others becoming infected. This includes:

  • Getting plenty of rest
  • Staying hydrated by drinking plenty of water
  • Taking paracetamol to help with symptoms such as a high temperature
  • Staying in isolation away from other people until you have recovered

Further information

For further information you can visit the following websites:

  • www.hse.ie
  • www.gov.ie
  • Spunout – Crisis Text Line is a 24/7 messaging support service with trained volunteers available to listen to people going through a tough time. Crisis Text Line provides in-the-moment anonymous support and problem solving when you need it most. Text YMH to 086 1800 280 to begin right now. (Standard SMS rates may apply)