Are you aware about your heart healthy in COVID times
In the COVID-19 pandemic, diabetes and heart disease has emerged as one of the important underlying illnesses that complicates effective treatment.

COVID-19 is an illness that infects the lungs. It is caused by a new coronavirus that started in China in late 2019 and has quickly spread worldwide. Although it is part of the same family of viruses that cause the common cold, COVID-19 is very different. Because it had never been seen in humans before, no one had existing immunity or ability to fight it.

We are learning more about the virus every day. For starters, we do not yet know:

  • What the long-term health effects might be
  • How long someone can give the virus to others
  • If a person who has had the virus can get it again
  • Whether it will stick around in warmer weather or come back in the months and years ahead (seasonal influenza tends to drop off during the spring and summer, but many coronaviruses persist year-round)
  • Why some people get very ill, while others do not have obvious signs of having it

People with COVID-19 have reported a wide range of symptoms that include:

  • Cough
  • Shortness of breath or difficulty breathing
  • Fever
  • Chills
  • Muscle pain
  • Sore throat
  • New loss of taste or smell

Some people have also reported less common symptoms such as nausea, vomiting, or diarrhoea. Symptoms usually occur within 2-14 days of being exposed to the virus. But many people do not have any symptoms and do not even know they are infected.

Most people with the new coronavirus will have mild or moderate symptoms. This means they can usually recover at home, while isolating themselves from the rest of the household. But for as many as 1 in 5 people with COVID-19, the virus can be more serious. COVID-19 can lead to pneumonia, not getting enough oxygen, heart problems and even death. These complications are more common in older adults and those with existing health conditions, including heart disease.

Anyone can get COVID-19. But following people are more prone to developing infections:

  • Adults 65 year and older
  • People living in nursing homes or long-term care facilities
  • People who smoke
  • People with existing:
    • Heart conditions
    • Lung disease (COPD, moderate to severe asthma)
    • Diabetes
    • Illnesses that lower the immune system’s ability to fight infection, for example people undergoing cancer treatments or bone marrow or organ transplants (some medications can do this too)
    • Obesity

There are no proven drugs, therapies, or vaccines available for COVID-19. Right now, the focus of treatment is to control the infection and manage symptoms and complications.

COVID-19 spreads mainly by droplets produced as a result of coughing or sneezing of a COVID-19 infected person. This can happen in two ways:

  • Direct close contact: One can get the infection by being in close contact with COVID-19 patients (within one Metre of the infected person), especially if they do not cover their face when coughing or sneezing
  • Indirect contact: The droplets survive on surfaces and clothes for many days. Therefore, touching any such infected surface or cloth and then touching one’s mouth, nose or eyes can transmit the disease

It is important to keep taking medications as directed. Till now there is no evidence that heart medications make you more likely to get COVID-19 or become seriously ill from it.

Managing heart condition during a pandemic stays the same just as you did before the COVID-19 outbreak, keep up with heart-healthy habits, manage stress and do not stop any medications without consulting your doctor. Heart attack or stroke Symptoms should not be ignored. It will still happen during a pandemic. These are medical emergencies and getting quick care is critical to limit any heart or brain damage. Do not delay calling your doctor because of fears that you might get COVID-19 at the hospital.

Beyond following the tried-and-true measures to avoid getting sick, people with existing heart conditions, should take six additional steps to stay healthy and heart strong.

1. Keep up with heart-healthy habits: Heart healthy habits will help to slow or prevent heart disease from getting worse.

  • Choose heart-healthy foods and snacks (plant-based and unprocessed foods are good choices)
  • Exercise daily
  • Stay hydrated by drinking plenty of water
  • Get enough sleep by aiming for seven to eight hours a night
  • Do not smoke or overindulge with food or alcohol
  • Follow your care plan, stay up to date with vaccines and call if you have questions or concerns; use telehealth options if new symptoms or concerns arise
  • Ensure you have at least one month of prescribed medication at home
  • Maintain social distancing, but do not socially isolate yourself

2. Continue taking your medicines as directed :

  • Take heart and diabetes medications as prescribed unless you are told by your health care professional
  • Be sure to check with your doctor before starting any new therapy, including over-the-counter drugs, vitamins, or supplements
  • talk to your doctor before stopping any of your current medications

3. Maintain distance :

  • Maintaining physical distance between yourself and others and staying at home as much as possible are key, especially if you are older, or have heart disease or another health condition

4. Wear a cloth mask when you go out :

  • Wear a cloth face covering when going out to public places, such as the grocery store, pharmacy, or other places where it might be difficult to avoid close contact with others.

5. Have enough food, medications and supplies on hand-and ask about delivery :

  • Try to keep at least two weeks of groceries and other essential supplies in your home during this time. Keep at least a month’s supply of medications

6. Manage stress, stay connected :

  • Minding your mental health during COVID-19 is important. Be sure to keep tabs on how you are feeling and share your concerns with your care team.

Gather your supplies :

  • Collect phone numbers of your doctors, pharmacy, and insurance provider
  • Compile a list of medications and doses (including vitamins and supplements).
  • Gather simple carbs like regular soda, honey, jam, Jell-O, hard candies or popsicles to help keep your blood sugar up if you are at risk for hypoglycaemia
  • Keep a stock of your medications so you do not have to leave the house as often
  • Always have enough insulin for at least 14 days in case you get sick or cannot refill
  • Make sure you have glucagon and ketone strips, in case of lows and highs
  • Have enough household items and groceries on hand so that you will be prepared to stay at home for at least 14 days in case you need to quarantine

Talk/ discuss with your doctor :

  • When to call doctor (for changes in food intake, medication adjustments, etc.)
  • How often to check your blood sugar
  • When to check for ketones
  • Medications you should use for colds, flu, virus, and infections
  • Any changes to your diabetes medications when you are sick

Take everyday precautions :

  • Wash your hands often with soap and water for at least 20 seconds or use alcohol-based sanitize containing at least 60% alcohol especially after blowing nose, coughing, sneezing, or spending time in a public place
  • Avoid touching high-touch surfaces in public places—elevator buttons, door handles, handrails, handshaking with people, etc
  • If someone inside home becomes sick, they should be tested for COVID-19. If they test positive, they should isolate from other household members. Outside home, at least six feet distance should be maintained from people
  • Everyone should wear a mask or other face covering in public settings, especially when social distancing measures are difficult to maintain and masks should completely cover both the nose and mouth
  • Frequently touched surfaces should be cleaned and disinfected (e.g., cell phones, keyboards, doorknobs, light switches, etc.)

If you think you may have been exposed to COVID-19 or feel like you are developing symptoms of COVID-19, contact doctor. Seek medical care immediately if you experience any of the emergency warning signs, including:

  • Trouble breathing
  • Persistent pain or pressure in the chest
  • New confusion
  • Inability to wake or stay awake
  • Bluish lips or face

If you do become sick, here are some common tips. Please note these may vary for each person :

  • Drink lots of fluids. If you are having trouble keeping water down, have small sips every 15 minutes or so throughout the day to avoid dehydration
  • If you are experiencing a low blood sugar (below 70 mg/dl or your target range), follow the 15-15 Rule: eat 15 grams of simple carbs that are easy to digest, like honey, jam, hard candy, juice or regular soda, and re-check your blood sugar in 15 minutes to make sure your levels are rising. Get in touch with doctor
  • Wash your hands and clean your injection/infusion and finger-stick sites with soap and water or rubbing alcohol if soap and water is not available

The risk for severe illness with COVID-19 increases with age, with older adults at highest risk. Severe illness means that a person with COVID-19 may require hospitalization, intensive care, or a ventilator to help them breathe, or they may even die.

Everyone should take steps to protect themselves from getting COVID-19.

  • Consider the level of risk before deciding to go out and ensure that people at increased risk of severe illness from COVID-19 and those who live with them, are taking steps to protect themselves
  • The best way to protect yourself and to help reduce the spread of COVID-19 is to:
    • Wear a mask, when you interact with others
    • Limit your in-person interactions with other people as much as possible, particularly when indoors
    • Keep space between yourself and others (stay 6 feet away, which is about 2 arm lengths).
    • Wash your hands often with soap and water or use a hand sanitizer that contains at least 60% alcohol
    • Avoid touching eyes, nose, and mouth with unwashed hands
    • Wear a mask, when you interact with others
    • Cover coughs and sneezes with a tissue or the inside of your elbow
    • Clean and disinfect surfaces and things you touch often
    • If you start feeling sick and think you may have COVID-19, get in touch with your healthcare provider within 24 hours

Delay or cancel a visit if you or your visitors have symptoms of COVID-19 or have been exposed to someone with COVID-19 in the last 14 days.

Everyone should take steps to prevent getting and spreading the virus that causes COVID-19 to protect themselves, their communities, and people who are at increased risk of severe illness.

  • Protect yourself by practicing everyday preventive actions
  • Plan shopping trips when stores are typically less crowded in early morning or late in the evenings
  • Older adults can use “senior hours” when shopping
  • Use alternatives to on-site dining such as delivery, take-out
  • When venturing out keep mask, tissues, and hand sanitizer with at least 60% alcohol handy
  • Wear masks and avoid others who are not wearing. Masks should be worn over the nose and mouth
  • First check for your symptoms. Symptoms of COVID-19 can range from mild symptoms to severe illness and death
  • Symptoms may appear 2-14 days after exposure
  • If you have symptoms of COVID-19, get in touch with your doctor within 24 hours
  • In some cases, older adults, and people of any age with underlying medical conditions may have symptoms that are not typically seen in others, or they may take longer than others to develop fever and other symptoms
  • Fever Temperatures can be lower in older adults
  • In patient aged 65 or older, be aware that a single reading higher than 100°F (37.8°C), multiple readings above 99°F (37.2°C), or a rise in temperature greater than 2°F (1.1°C) above the patient’s normal (baseline) temperature may be a sign of infection
  • Staying healthy during the pandemic is important
  • Talk to your healthcare provider about whether your vaccinations and other preventive services are up to date to help prevent you from becoming ill with other diseases.
  • It is particularly important for those at increased risk of severe illness, including older adults, to receive recommended vaccinations against influenza and pneumococcal disease
  • Stay physically active and practice healthy habits to cope with stress
  • If you have a medical emergency, do not delay seeking emergency care
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