Those with chronic conditions are at a higher risk during the Covid-19 pandemic in South Africa. Dr Etti Barsky and Dr Daniel Israel explain why this is not the time to avoid medical care.
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Since the novel Coronavirus arrived on our shores, anxiety levels have climbed and with that the perception that the worst place to be is in a doctor’s waiting room!
The fear of contracting Covid-19 has in many cases, not stopped people from shopping and interacting with strangers – some of whom may or not be wearing masks, or who may ignore social distancing rules.
It has, however, affected the self-care of our population as regular visits to the doctor are now avoided.
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Decreased monitoring of chronic conditions or just ignoring the body’s signals that something may not be quite right, often results in health deterioration that could have been avoided.
As GPs we are noticing that many of our patients with chronic conditions are neglecting their health, sometimes with severe consequences.
Dr David Jankelow, a cardiologist, reported to the GGPC that out-of-hospital cardiac arrests (heart attacks) have increased since the Covid-19 pandemic. A study in America showed that a third of cardiac patients delayed seeking medical care because of fear of contracting COVID-19.
Prior to March 2020, a comorbidity was a term of medical jargon not commonly used. Nowadays, the average South African understands a comorbidity to be 'a chronic background medical condition that puts you at risk of dying if you contract Covid-19.'
Whilst, this assertion may be true, the concept of 'comorbidity' needs a far sharper understanding to equip us to make sense of its significance and to influence our behaviour.
We need to control risk not only with regards to Covid-19, but also the risk that the chronic condition poses if it is not well-controlled.
These underlying chronic medical conditions are largely non-communicable and can’t be transmitted from one person to another.
They need regular surveillance to optimise health outcomes.
The most common ones include:-
● Hypertension/High Blood pressure
● Heart conditions - ranging from arrhythmias to heart failure
● Kidney disease
● High Cholesterol
● Thyroid abnormalities
● Auto-immune conditions
The reason it is so important to ensure that a chronic medical condition is well-controlled is that the consequences of poor control affect the quality and length of life.
We will highlight a few examples of poor outcomes of not seeking help to manage specific chronic medical conditions but all the above conditions need frequent monitoring.
Uncontrolled blood pressure can cause symptoms ranging from headache or a nosebleed to more life-altering events such as strokes, heart failure and kidney failure.
Poor blood sugar control can affect many organs of the body:
Eyes- irreversible eyesight deterioration. Nerves - numbness or pins & needles of your hands and feet.
This can result in the condition known as a ‘diabetic foot: a loss of the ability to feel pain in your feet and therefore high propensity to foot injury and infection.
Brain- decreased level of consciousness or coma.
Kidneys- kidney failure.
Heart and blood vessels- higher risk of heart attack and stroke.
Heart failure symptoms which should not be ignored include worsening leg swelling or shortness of breath.
These may indicate that your heart is not coping in its day to day function and as a result, a fluid build-up occurs, especially in your lungs which can put you at risk for pneumonia.
It is also important to consult your doctor if new symptoms develop such as uncontrolled weight loss or weight gain, changes in appetite, mood and bowel habits.
All these things are your body’s signs telling you that you need looking after. Don’t ignore them.
Doctors are well placed to know the transmission risks of Covid-19 and most have taken every precaution in their practices.
There is therefore little need to be concerned about the risk of contracting Covid-19 at the doctor’s rooms. As an extra precaution, we suggest you wait in your car until the doctor is ready to see you so that you spend the minimum amount of time in the practice.
Covid-19 is with us - and it is not going to suddenly disappear. It is the responsibility of each of us to reduce transmission by mask-wearing, sanitising and social distancing.
However, It is also vital that we don't neglect our health. Your GP or primary health practitioner is someone you can trust to look after you and your family. Don't’ let your health become a casualty of Covid-19
Focus on what you can control, and control it well.
In other news, Briefly.co.za reported that a shift to Level 1 of the Covid-19 national lockdown remains likely in the next week or so.
Both Health Minister Dr Zweli Mkhize and President Cyril Ramaphosa have acknowledged the need to provide economic relief by reducing the remaining restrictions.
With infections declining steadily, many believe that this is the right move despite the ever-present risk of a second wave of cases.
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