COVID-19 has dealt a huge blow to the country’s cardiac patients as many heart patients are afraid of seeking health care fearing infections while health services have largely been disrupted and the access to health care for the heart patients has been drastically reduced.
People of all ages can be infected by the new coronavirus, but the virus poses a particular risk to people over the age of 60 and those with underlying medical conditions, including cardiovascular disease.
Bangladesh annually reports about 2.5 lakh cardiac patients but the COVID-19 contributed to the lower number of reports of such patients.
Hospitals’ data also showed that the services for cardiac patients were reduced significantly due to the COVID-19 crisis.
On this backdrop, World Heart Day is going to be observed in Bangladesh today as elsewhere in the world.
‘COVID-19 has disrupted our programmes and services related to non-communicable diseases, particularly the cardiac diseases,’ said Directorate General of Health Services line director for NCDs, Habibur Rahman.
‘As we are clueless about the course of COVID-19, we are trying to streamline the services,’ he said.
The country’s top public hospital for heart patients, the National Institute of Cardiovascular Diseases, reduced the healthcare services significantly since the emergence of COVID-19 in the country in March.
The number of patients increased manifold as the COVID-19 situation improved but the services did not reach the desired momentum, officials and patients said.
NICVD director Mir Jamal Uddin said that between March and July, the number of hospitalised cardiac patients reduced to 200.
Since the beginning of August, the number of patients started increasing but the full-fledged services are still not offered due to the fear of COVID-19, he said.
‘NICVD usually conducted around 100 heart surgeries per day before COVID-19, but now it dropped to one to two a day,’ Jamal said.
‘As a result,’ he said, ‘A surgery now requires the patients, the doctors, nurses and other staff to test for COVID-19 as too many caregivers have been suffering from COVID-19 or in quarantine.’
Ratan Sutradhar, a cardiac patient who recently went through a heart implant operation at the NICVD, said that he suffered a cardiac arrest on April 17.
He underwent a stent implant on September 2 after an influential person helped him in availing the services finally, he said.
‘I was in persistent fear of dying over the last few months,’ he said.
NICVD associate professor Kajal Karmakar said that many patients are found COVID-19 positive while a number of doctors and nurses are also found infected with the coronavirus.
‘The COVID-19 infection creates a challenge for us to offer treatment,’ he said.
National Heart Foundation epidemiology professor Sohel Reza Chowdhury said that COVID-19 increased the risks of the cardiac patients by five folds.
‘COVID-19 appeared to have dealt a big blow to the cardiac patients as the patients are afraid of seeking care fearing infections and also because the healthcare providers reduced the services,’ he said.
The number of people with cardiac diseases is increasing in Bangladesh alarmingly as about 2.5 lakh people die of the complications of the heart disease every year in the country, 30 per cent of the total annual deaths, according to the government and World Health Organisation data.
In 2014, the number of people who died of heart diseases was 1.5 lakh a year, or 17 per cent of the deaths, according to WHO.
According to the non-communicable disease wing of the DGHS, 67 per cent of people dying every year in Bangladesh die of non-communicable diseases, and among this 67 per cent deaths and heart disease fatality tops the list with 30 per cent.
The top cause of the mortality, morbidity and hospital admission in the country is also cardiovascular diseases.
The National Health Bulletin 2017, published in 2018, described cardiovascular complications as the first major NCDs in Bangladesh.
According to the bulletin, the top cause of morbidity among the people in 2017 was cardiovascular diseases — 13.2 per cent at district hospitals and 12.2 per cent at medical college hospitals.
The major cause of mortality among patients found in different medical college hospitals was also cardiovascular diseases — 54.24 per cent.
The distant second top cause of mortality at medical college hospitals was respiratory disease — 4.93 per cent.
At the district-level hospitals, cardiovascular complications topped the list of major causes of mortality — 47.53 per cent and the second top cause was respiratory diseases — 20.13 per cent.
Similarly, at the upazila-level hospitals, cardiovascular diseases are identified as the most important cause of mortality — 32.42 per cent, while the second dominant cause was respiratory complications — 24.71 per cent.
Cardiac diseases also ranked first in the list of top-10 causes of deaths in Bangladesh, according to the National Health Bulletin 2018, published this year.
DGHS NCDs line director Habibur Rahman said that the patients are being requested to be cautious about their lifestyle during the COVID-19.
Sohel of National Heart Foundation said that the government needs to ensure the services for cardiac patients and the patients with the risks of heart diseases during the coronavirus situation.
He said that individuals at risk of cardiac diseases may demonstrate raised blood pressure, glucose, and lipids as well as overweight and obesity, but these can all be easily measured in primary and secondary care facilities in Bangladesh and the government should ensure such services.
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