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Impact of COVID-19 on cardiology services in a district hospital and adapting to the new normal
  1. Saad Hasan1,
  2. Haseeb Ur Rahman1,
  3. Anish Patil1,
  4. Carla Lewis1,
  5. Ciaran Haye2,
  6. Samuel Townsend1,
  7. Stephen Hutchison1
  1. 1 Cardiology, Aneurin Bevan University Health Board, Abergavenny, UK
  2. 2 Cardiology, Nevill Hall Hospital, Abergavenny, UK
  1. Correspondence to Stephen Hutchison, Cardiology Department, Nevill Hall Hospital, Brecon Road, Abergavenny; stephen.hutchison2{at}wales.nhs.uk

http://dx.doi.org/10.1136/postgradmedj-2020-138228

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    On March 23, 2020, in response to the COVID-19 outbreak, the UK government announced a series of measures (lockdown) to slow the spread of the virus and protect national health service (NHS) capacity. We describe the immediate effects on cardiology services in our hospital, comparing activity over the same period (March 23 to April 22) in 2019 and 2020.

    Nevill Hall provides an acute cardiology service using 6 coronary care unit and 16 ward beds, non-invasive investigations and clinics. Routine angiography and pacing are currently undertaken at another hospital in the same health board on a shared waiting list, while acute coronary syndrome (ACS) patients are admitted here and have intervention at the local tertiary centre on a treat-and-repatriate basis.

    There was a striking reduction in inpatient cardiology activity, particularly in the first week. Average patient numbers fell from 21 to 8. The other dramatic change was in heart failure presentations from 10 per month to 2. Throughout this period, there was plenty of bed capacity as elective surgery was cancelled and there was a fall in all non-COVID presentations, as reported in the UK.1 There is no reason to believe that patients have been admitted to other units.

    The British Society for Echocardiography produced clear guidance for provision of echocardiography during the pandemic2 which we have followed, restricting inpatient scans to essential situations. Outpatient scans stopped along with face-to-face …

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    Footnotes

    • Acknowledgments All the authors made substantial contributions to the conceptualisation, design of work, data acquisition, validation, drafting the work or revising it critically. All the authors have read and approved the final version of the manuscript and agreed to be accountable for all aspects presented in the article.

    • Contributors Dr Stephen Hutchison is the consultant cardiologist who heads this district hospital service and is the senior author. Dr Saad Hasan (Speciality Registrar), Dr Haseeb Ur Rahman (Physician Trainee), Dr Anish Patil & Dr Ciaran Haye (Foundation Programme), Carla Lewis (Advanced Nurse Practitioner) and Samuel Townsend (Physician Associate) have contributed as coauthors in addition to collecting and analysing data and reviewing this article.

    • Funding The authors have not received a grant for this article from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; internally peer reviewed.