COVID-19 And Cardiovascular Health: The Role Of The Heart And Stroke Foundation South Africa During A Local And Global Crisis

Our generally positive outlook on life, despite certain economic barriers, changed overnight with the realization that the coronavirus was literally causing havoc around the world. On 29th March 2020 it was reported that, globally, over 600 000 people have been infected with COVID-19, and more than 30 000 people have died. These numbers are continually rising, exponentially.

It was only a matter of time that COVID-19 hit our South African shores. This is a very difficult time indeed. The Heart and Stroke Foundation South Africa (HSFSA) is committed to consistently mobilizing all South Africans to stop the transmission of COVID-19. In South Africa, the statistics on 29th March 2020 indicated that at least 1 280 people were infected with the coronavirus. It was also a sad day for our country, as we now have two coronavirus related deaths. Most concerning is that whilst older people are more vulnerable, many young people have been infected. Of the two individuals who died in South Africa, one was in her 40s and the other in his 70s. There are many reasons why people are susceptible to contracting the virus. It’s, therefore, complicated as we have to take into account both socio-behavioural and biological factors.

People with underlying medical conditions are more vulnerable to contracting COVID-19.

Given that our Foundation focusses on heart disease, strokes and other circulatory diseases (broadly CVD), it’s important to understand what we know about the relationship between COVID-19 and CVD. If you have CVD, you form part of a group that is known as the “risk group” for COVID-19 infection. In addition, results of a recent study in China showed that about 20% of 83 COVID-19 patients that died, suffered some form of cardiac injury, although it is unclear whether the virus directly caused this injury to the heart. Of these patients 30%-60% had a history of CVD or hypertension. Having CVD and other medical conditions such as diabetes, cancer, TB and so on, increases your risk for becoming infected with the coronavirus. Your health behaviours also put you at risk. Smoking and unhygienic practices are examples of behaviours that lead to worse health outcomes. Given this scenario, it is important to follow the law and public health measures that our Government has put in place to prevent COVID-19 transmission, to protect you and your family, as well as fellow South Africans.

Our main asset in this war against the coronavirus is our health work-force. They are going above and beyond to save lives. A key way of avoiding the spread of COVID-19 is to keep the physical and social distancing whilst staying emotionally and socially connected through various means including social media. Social distancing will also help to reduce the burden on our doctors, nurses and allied health professionals because if we decrease the number of infections, fewer COVID-19 patients will present at health care settings.

In the face of COVID-19 there are strategies one can use to protect your heart, mind and overall health. The HSFSA would like you to consider the following important information to help you navigate your way throughout the period of the pandemic.

Nutrition

While food procurement may be more challenging, healthy eating is as important as ever. Food choices and eating habits can start affecting cardiovascular health and immunity in a matter of weeks, whether positively or negatively. Most people are familiar with the effect of foods on high blood pressure, elevated cholesterol or diabetes, and this remains important, particularly for people already living with these conditions. Food can also have a profound effect on enhancing or dampening the immune system, changing susceptibility to infection and the body’ ability to fight disease.

• The South African food supply remains intact. Aim for a healthy diet filled with a colourful selection of fruits, vegetables and legumes, unrefined and processed foods where possible, herbs and spices, and fatty fish. (see more on this on our website soon!)
• Be wary of nutritional supplements or ‘superfoods’ that promise to improve immunity and guard against Covid-19. While nutrients like Vitamin C, A, selenium or zinc are needed to host a good immune response, no supplement is a miracle worker, and some nutrients can even be counterproductive when taken in larger dosages. If you take vitamin and mineral supplements, don’t regularly exceed the recommended daily amounts, or consult with your health professional first.
• The gut microbiome is critical to maintaining the immune system. Plenty of whole grains and probiotics such as yoghurt can help to improve the balance of gut bacteria.
• Good food hygiene is always advised, but now is a time to be even more vigilant. Rinse foods to be consumed fresh and be sure to wash hands thoroughly during food preparation and before eating.
Alcohol consumption
We encourage people to use alcohol sensibly in moderation. Alcohol intake is set to rise for many who have stockpiled and those who may drink out of sheer boredom or frustration.
• Alcohol abuse and binge drinking are known risk factors for heart disease and strokes, but can equally affect immunity, particularly relating to lung health.
• The dampening effect of alcohol on immunity is most pronounced with chronic heavy drinking, but acute binge drinking can make the lungs more susceptible to pathogens like viruses and bacteria too. Binge drinking can mean as little as three drinks in a row, depending on your weight. Best evidence suggests drinking only up to 7 standard-sized drinks per week or not at all.

Exercise and Stress

Continue being active during the lockdown period to maintain both physical and mental health. Moderate physical activity not only reduces the risk of heart disease, but it can play a vital role in maintaining an optimal immune response. The opposite is equally true; excessive or overly-strenuous exercise can suppress the immune system, increasing susceptibility to infection.

• Keep Moving: A positive movement which has emerged from the pandemic is the surge in free online fitness classes to help support and motivate exercise. Choose something you like and become part of one of these virtual communities.
• Start Now: If you are usually sedentary, this can be a perfect time to start, albeit it gradually!
• Sleep is essential to manage stress and for our bodies to repair cells, clear toxins etc. Sleep deprivation can have major impact on our health and can increase risk of developing chronic health conditions, like diabetes, obesity and heart disease.
• Social connection is as important for our health. Everyone, until this pandemic is over, should practice some degree of distancing and care – you need to protect yourself. It is normal to feel stressed, confused and scared during a crisis. Talk to people you know and can trust to help you.

Mental Health

Mental health, well-being and physical well-being go hand-in-glove

• Think physical distancing not social distancing: Remember that while we are told to maintain social distancing to prevent the spread of the coronavirus, what we are being told is to actually have physical distancing
• Remain socially and emotionally connected with your loved ones, social and work networks through social media and other communication methods
• Stay connected: The lock-down period may lead you to become increasingly anxious due to social isolation, especially if you live on your own. Connect with others and reach out to people who care about you and those you care about
• Existing mental health difficulties: If you have an existing anxiety, depressive or other mental health condition, remember to continue to take your treatment and stay in contact with people who understand you and what you are experiencing
• Maintain your sense of well-being by adopting healthy behaviours and appreciating nature and a slower pace of life
• The betterment of humankind: Remember that looking after our own mental health and well-being whilst maintaining physical and social distancing will have a ripple, positive effect on all South Africans as we work together to stop the spread of COVID-19.

Manage your existing health conditions

• Do not lapse on good care for your other existing medical conditions. Continue taking medications as prescribed, follow your health practitioner’s lifestyle advice, and seek treatment when needed.

Hygiene, Hygiene, Hygiene

• Wash hands frequently with soap and water for at least 20 seconds
• Maintain social distance at least one metre between yourself and anyone who is coughing or sneezing
• Avoid touching eyes, nose or mouth, as hands touch many surfaces and pick up viruses and can transfer.

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