COVID-19 (coronavirus) Featured Heart health

An open letter to Ontario’s ‘missing’ patients: We’re worried about you.

Dr. Harindra Wijeysundera, MD, PhD (left) is Chief of the Schulich Heart Program, Sunnybrook Health Sciences Centre and Canada Research Chair in Structural Heart Disease Policy and Outcomes. Dr. Patrice Lindsay, RN, PhD is Director of Health Systems Change for Heart & Stroke.

When you think about how COVID-19 has impacted the health of people living in Ontario, it’s natural that your mind goes first to the more than 500,000 who have already been infected, the tragedy in long term care, the plight of essential workers and the uneven burden this pandemic has placed on lower socioeconomic and racialized communities. How to care for those with COVID-19 and protect those most at risk has rightly been top of mind for health care practitioners and public health experts for almost fourteen months.

However, there is a side to the pandemic that has not received the attention it deserves – the impacts on people accessing other kinds of care, in particular, for time-sensitive conditions such as heart disease and stroke. These are the untold victims of the COVID-19 pandemic. Untold, because so many of these patients have disappeared from hospitals, clinics and doctors’ offices, and even emergency departments. Today we, and on behalf of our health-care colleagues, are writing to them: Ontario’s missing patients.

To you, the missing patient, we want to say this: we’re worried about you.

We are worried you might be ignoring changes to your health because you don’t want to place additional burden on a system that you keep hearing is overwhelmed. Perhaps you feel you would not receive the quality of care you normally would. Or you might be concerned about contracting COVID-19 in our hospitals and clinics.

We understand your concerns, but we want to reassure you; while our health care system is very stretched, it is not broken. We want you to know that more than a year into this, we have learned a lot and we have applied what we have learned, including how to protect and care for you when you come to see us.

If you experience signs of a medical emergency like a heart attack or stroke, you should call 9-1-1 immediately. For heart attack, these signs include chest or upper body discomfort, sweating, and nausea. In the case of stroke, watch for weakness on one side of your body, changes to speech or drooping of the face.

But even if it’s not an emergency, let us assess you and determine if it is something that can be safely postponed. Changes to your health including increased lightheadedness, shortness of breath, tightness in the chest or jaw are all reasons to reach out.

The bottom line is simple: please don’t triage yourself. Let your health care provider do that – that’s our job and we are here for you. If we can assess you virtually, we will. If we need to see you in person, we will make sure that it’s done safely. And if your symptoms change, our approach will adapt.

But we can’t help you if you stay silent. The nature of cardiovascular disease is that your symptoms may be stable for a time, but then change very suddenly. In our world, days, hours, and even minutes can make a difference. The longer you wait, the more difficult your recovery will be – if you survive. So please don’t wait.

The consequences of COVID-19 on the health of Ontario’s missing patients are not hypothetical. Delaying heart and stroke care has very real and very serious consequences. Our health care system and the people who work in it have been challenged by COVID-19, but we are still here and ready to help you. Please let us.

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