The COVID-19 pandemic continues to plague communities across the country, sowing uncertainty as to what the future will bring. The virus can have catastrophic consequences for patients, particularly those with cardiovascular disease and other chronic conditions. We must continue to come together for our patients and provide the steady, evidence-based guidance that can help them reduce their risk, navigate the tumult and allay fears.

Since the beginning of the pandemic, the ACC has convened a number of scientific and educational sessions with experts from around the world and across a spectrum of disciplines. From these discussions, many points of consensus have emerged about best practices for slowing the spread of the new coronavirus and mitigating its harm, including a number of simple measures clinicians can encourage patients to embrace. These messages can make a difference this Fall throughout the country and the world.

1. Recommend patients wear a face mask, practice distancing and wash hands.
   There is general consensus that wearing a mask and washing hands can reduce the transmission of the virus. Whenever possible, we should reinforce the importance of continued vigilance and wearing of masks when in close proximity to others, and especially when indoors. A reminder on how to properly wear a mask for maximum protection is also crucial. Similarly, patients should practice sensible social distancing, including avoiding large public gatherings, to curb disease transmission.
2. Encourage influenza vaccination.
   It is essential that people with cardiovascular disease get a flu shot this year. The vaccine saves lives and there are growing concerns that the dual threat of influenza and COVID-19 might potentiate the harm of either one alone, leading to a dramatic uptick in serious illness and death. Our patients should act now to get the vaccine and reduce their risk from influenza.
3. Allay fears and remind patients not to ignore symptoms or delay treatment.
   We've learned from many patients that they are nervous about going to medical offices and hospitals and, in some instances, have delayed seeking care even when they have new or worsening symptoms, fearing exposure to the virus. ED visits for heart attack and stroke have dramatically dropped, and many patients have missed vital follow-up visits. Now is the time to reassure patients that 1) medical practices and hospitals have implemented stringent protocols to safely care for people with non-COVID-19 emergencies – even in hot zones and 2) if they have symptoms suggestive of an acute event, they should immediately seek care. Moreover, telehealth visits can help connect physicians and patients and ensure continuity of care for people with chronic conditions. Appointments that were missed or canceled should be rescheduled.
4. Reinforce the importance of medication adherence.
   It is good practice to ensure that your patients have ample supplies of their medications and continue to take them as directed. This is particularly important for high-risk patients. If patients are concerned about going to the pharmacy to get their prescriptions filled or refilled, help them find a local drugstore or mail-order pharmacy that can deliver their medications directly to their home.
5. Assess how patients are coping, proactively address confusion and help find solutions.
   Not surprisingly, discussions with patients reveal that the pandemic has inflicted considerable stress and a sense of helplessness. In addition, patients are faced with conflicting information from news reports and social media, and social distancing has also left many feeling isolated and depressed. We must take time to offer reassurance and accurate information to help our patients find the right balance between limiting their exposure to the virus and managing their condition and living a heart healthy lifestyle within this new normal.

These five recommendations can help people to lower their risk and assure that they check in with us. The medical community should come together with a common voice. We hope that the coming months will bring much progress against SARS-CoV-2, but, in the meantime, these actions can help us support our patients.

We have not made testing recommendations because every situation is different, and the availability of tests is changing rapidly. Nevertheless, a cadence of testing for essential workers is a reasonable approach. We anticipate there will be some breakthroughs in testing quality, convenience and availability soon. For now, these five recommendations should go a long way to helping patients stay safe.

More COVID-19 clinician and patient information is available on ACC's COVID-19 Hub.

Clinical Topics: COVID-19 Hub

Keywords: COVID-19, Coronavirus Infections, Coronavirus, severe acute respiratory syndrome coronavirus 2, Pandemics, Influenza, Human, Medication Adherence, Plague, Emergencies, Cardiovascular Diseases, Follow-Up Studies

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