Orange Health Service, Orange, NSW, Australia.
Integrated Cardiovascular Clinical Network SA, Adelaide, SA, Australia.
Heart Lung Circ. 2020 Jul;29(7):e88-e93. doi: 10.1016/j.hlc.2020.05.001. Epub 2020 May 7.
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.
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.
由于多种因素,澳大利亚农村和偏远地区以及新西兰的急性心肌梗死不良预后发生率较高。心血管疾病(CVD)在区域和偏远地区的人群中更为普遍,且已知患有 CVD 的人群因 2019 冠状病毒病(COVID-19)而导致发病率和死亡率更高。此外,COVID-19 与严重的心脏表现有关,这可能会在限制旅行的情况下,对本已有限的区域服务造成额外的需求。目前,由于接收中心实施大流行协议,可能会导致潜在的延迟,且心血管资源被转移到增加重症监护病房(ICU)和急诊科(ED)容量,因此医院间的转院面临挑战。区域和农村中心的工作人员资源有限,如果在大流行期间工作人员感染或隔离,将使心脏服务面临风险。
在整个 COVID-19 大流行期间,卫生区、心脏病专家和政府机构需要尽量减少对区域和偏远地区澳大利亚人和新西兰人已经脆弱的心血管健康的影响。管理方面的改变应包括。