More than 300,000 people in England alone are waiting for heart treatment as a new report outlined the "collateral damage" the Covid pandemic has caused to cardiac services. Doctors warned that cases of heart disease - already Britain's biggest killer - are likely to increase as a result of the backlog caused by Covid.
An "urgent recovery plan" to help already "overwhelmed" cardiac services in England deal with the increasing number of people who now need treatment is needed, according to the British Heart Foundation (BHF). Researchers found that in the two years from December 2019 when health systems around the world were under extreme pressure amid fears of catching Covid, people suffering a heart attack or heart failure either stayed away or could not get admitted to a hospital.
The study describes a “substantial global decline” in hospital admissions of people suffering from cardiovascular disease. As a result, the number of people dying at home or in the community from heart conditions increased.
The findings, published in the European Heart Journal, show that there was a 34 per cent decline in people attending hospital with a less severe form of heart attack, where an artery is partially blocked. However, the drop in patients was not due to fewer heart attacks but fewer people attending hospital for treatment.
Globally, there was a 34 per cent drop in heart operations during the pandemic. In cases where people did get medical help there was, on average, more than an hour’s delay in reaching hospital or having contact with paramedics.
The chances of people surviving a major heart attack depends on timely and appropriate treatment. More people have been dying at home from cardiovascular disease in the UK, according to the report.
Involving an international team of doctors and data scientists led by the University of Leeds, the study gives the first global assessment of the way cardiovascular services coped during the pandemic. Figures from the BHF show that at the end of March this year, 309,796 people were on a waiting list for cardiac treatment in England – a figure that has been growing over the previous 21 months.
Consultant cardiologist Dr Sonya Babu-Narayan, associate medical director at the BHF, said: “We need a comprehensive and specific cardiovascular plan to address the burden of cardiovascular care including the backlog - and provide immediate and long-term solutions to our cardiovascular workforce shortage. Without this we will continue to see heart attacks, lasting heart damage, or even premature deaths that could have been avoided.”
The research team analysed data from 189 separate research papers looking at Covid's impact on cardiovascular services from 48 countries on six continents and covering a two-year period from December 2019. Lead author Dr Ramesh Nadarajah, a BHF Clinical Research Fellow at Leeds University, said: “Heart disease is the number one killer in most countries – and the analysis shows that during the pandemic, people across the world did not receive the cardiac care they should have received.
“That will have ramifications. The longer people wait for treatment for a heart attack, the greater the damage to their heart muscle, causing complications that can be fatal or cause chronic ill health. Health systems need to be reinforced so they can support and treat people whose heart conditions will inevitably be worse because of the pandemic. The paper provides evidence of that.”
He said that the disruption to cardiovascular services will leave a legacy that will require "prompt action" on the part of health administrators. Dr Nadarajah added: “Collateral cardiovascular damage from missed diagnoses and delayed treatments will continue to accrue unless mitigation strategies are speedily implemented. The deferral of interventional procedures, especially for structural heart disease, leaves many patients at high risk of adverse outcomes.”
Senior author Professor Chris Gale, also a consultant cardiologist, said: “The repercussions of the Covid-19 pandemic on cardiovascular care and outcomes will be with us for a long while yet. There is little doubt that there will continue to be deaths and illness that would not have otherwise occurred. Urgent action is needed to address the burden of cardiovascular disease left in the wake of the pandemic.“
Professor Deepak Bhatt, of Harvard Medical School in the US, added: “This analysis really brings to light the substantial impact the Covid-19 pandemic has had and will continue to have in harming cardiovascular health globally.”
