It’s becoming increasingly clear that the impacts of the global COVID-19 pandemic will be felt long after the number of cases has decreased and the world has adjusted to the new normal. Lasting effects on business, daily life and the medical sector will influence the way society moves forward – and significant changes to the healthcare field and its standard protocols are to be expected. One of the departments that will likely undergo shifts as a result of coronavirus is cardiology, and specifically, the cardiac catheterization lab.
Many cardiologists are still hard at work during the pandemic, providing assistance to help combat the crisis as needed and performing emergency cases like acute ST-segment-elevation myocardial infarctions (STEMI) and percutaneous coronary interventions (PCI). Patients experiencing acute cardiac events still need care – however, a recent study in Hong Kong showed large delays in patients with STEMI seeking medical help, even though hospitals in the city implemented stringent infection control measures including universal masking, full personal protective equipment (PPE) and suspension of ward visits and volunteer services, among others. The pandemic has highlighted the importance of keeping both patients and doctors safe in the hospital setting, whether through proper sanitation measures or medical equipment designed for optimizing safety. This new perspective will likely impact the way hospitals in the U.S. and beyond move forward with safety protocols even after the COVID-19 pandemic has abated.
New regulations or protocols that were designed for the pandemic could potentially remain in place afterwards and alter the way cardiologists work. Some measures taken to prevent the spread of COVID-19, such as detailed histories and chest X-rays, may delay the start of procedures and take away critical time physicians have to work on their patients. Additionally, many hospitals currently utilize positive pressure in their cath labs, which allows contaminated air to spread throughout the facility. As a result of COVID-19, healthcare systems may need to re-evaluate this setup and consider steps such as negative pressure rooms to prevent the dispersion of diseased air into uninfected spaces. Hospitals and health systems will need to be innovative with the techniques and technologies they use to prevent the spread of diseases and need to look closely at how to best protect patients and staff in the cath lab and beyond.
Some hospitals already have systems in place to help protect people from disease and ensure that patients are getting the best care possible. For example, all cardiologists and techs working in the cath lab are required to don some degree of PPE, including sterile gowns, gloves and masks. Other healthcare systems may even have technology that could protect doctors and patients from the spread of dangerous viruses and bacteria. For example, hospitals that utilize robotic systems for interventional procedures benefit from having the physician seated behind a protective shield or inside the control room adjacent to the lab while controlling the robot. The design protects physicians from radiation emitted from the fluoroscopy system used in cardiovascular procedures and this separation between the doctor and patient could have the potential to prevent the spread of disease by positioning the operator further away from patients with communicable diseases such as COVID-19. In a recent article with TCTMD, Could Robotic PCI Play a Protective Role in Pandemics?, Dr. Jon George, Interventional Cardiologist at Einstein Medical Center, noted there may be a role for robotic-assisted interventions during an infectious disease outbreak by minimizing the amount or duration of person-to-person exposure/contact. A further consideration of robotics to reduce exposure to infectious disease will be the implementation of remote technology, where physicians and patients won’t need to be in the same hospital or geographic location. However, there is still much to be understood around the role of robotics in a global pandemic situation.
Although the healthcare industry is primarily focused on battling COVID-19 right now, eventually there will be a return to some semblance of normalcy and patients will come back to hospitals to have the elective procedures that were delayed as a result of the pandemic. However, the impacts of coronavirus will not be forgotten, and many changes implemented as a result will be long lasting. Hospitals would do well to implement measures that set them up for a smooth transition to the new normal in a post- COVID-19 world. Be it re-evaluating the PPE that they require their providers to wear or investing in new technologies or systems that prevent contamination by increasing infection control standards, the measures taken now will help prevent future challenges and will position hospitals to protect their workers and the patients they care for in our new-normal world.