COVID Challenges
We spoke to women with heart failure (HF) who highlighted other over-arching challenges that influenced their experiences. The COVID-19 pandemic occurred during the course of our interviews, impacting the discovery, treatment, care and on-going management of HF for several of the people we spoke with. Women with heart failure described not being able to access cardiac care at all, either because providers were not available, or programs were shut down due to service changes related to public health measures during the pandemic.
Lack of access impacts health
COVID-related public health restrictions changed the way care was accessed, delivered, or experienced by several women with HF. Accessing cardiologists was already difficult for women, particularly those living in smaller communities. But once COVID started, cardiologists were even less available – many stopped providing in-person care, instead shifting to phone consultations or communication with patient via email. Women told us that these changes had negative effects on their health. Lois, who was interviewed in March 2022, indicated that she had not seen her cardiologist in almost 3 years, despite seeing all other heath care providers in that time period “when did I see her last? Mid-2019.” Likewise, Anne1 described a 5-year period of time passing before her cardiologist determined that her ejection fraction had deteriorated to 26%: “I think that because A. my cardiologist is very busy, and B. I was doing pretty well so he probably thought ‘I can let this woman slide’. Then COVID came along and that impacted everything.”
Dido felt dismissed during the pandemic and not able to access cardiac rehab.
Transcript
And I thought there’s something wrong here. But every time I went to approach health practitioners, I was told again it was a pandemic and that I was a 50-year-old woman in a high stress job. The damage that was done to my heart over the year of the pandemic […]
Louise relocated to a new city and could not see a cardiologist due to COVID.
Written testimony
After 46 years in a small city in Alberta, I finally moved back to Calgary in September 2019, to be closer to my family and all of my specialists. I got referred to this wonderful family doctor and saw her a couple times. Then she said ‘Louise, you need to focus on your heart. That’s really your biggest problem, you know? Your other doctors are doing all the other stuff, but your heart is a real problem. And you should be talking to your cardiologist.’
And so I tried, but my cardiologist had retired after I saw him in July. And my new cardiologist didn’t have a clinic setup yet, and he didn’t have the staff. He didn’t have anything. I finally had to insist that I really needed to at least talk to him because my family doctor was saying ‘you’ve got a lot of issues he needs to talk about’. The cardiologist finally ordered tests that I did in March 2020, which turned out to be the start of COVID shut down. I finally got to talk to him in April, but it was on the phone. And that’s when he calmly added that I had heart failure. Unexpected words from a doctor I had never even met.
After 7 more phone appointments, and with encouragement from my family doctor, I finally told him that despite COVID, I needed to meet him in person. And he actually agreed! Even though everything was still in lockdown, I met my new cardiologist and a nurse, in the dark and deserted heart clinic at the university in April 2021.
With 87 medical appointments in 2020, and similar in other years, COVID changed many of my physicians to be on phone calls instead of in person. I prefer meeting in person, but was grateful to talk to my doctors in any setting.
COVID left women alone to navigate care systems
Communication channels between levels of health care and providers broke down, leaving women without information or anyone to ask questions to. Some cardiologists preferred to relay information to patients via family doctors, but this was not always reliable since family doctors were also not readily available and were adopting new ways of operating their practices.
Ginette could not get answers or more information as access to doctors was so limited.
Transcript
I just talked to cardiologist back in April and we upped my Atorvastatin pill for the cholesterol because my cholesterol was a little bit higher. So I was on 20 mg now I’m on 30 from the blood test result that he saw that I did in February. But I […]
Immunocompromised women with HF were cautious, trying to avoid getting COVID, but this meant becoming more socially isolated. Lillian says “The other thing that makes this different is the pandemic, like the isolation has been pretty hard like trying to not get COVID.” Lois spoke about limiting her social activities – “I haven’t travelled in a very long time but that of course … three-quarters to do with COVID.” Some of the women spoke about experiencing increasing anxiety levels as less supports were available, particularly during tests or appointments. COVID restrictions in hospitals, offices and labs did not permit patients to bring along anyone and so women experienced stressful events or news on their own.
Naomi, who was 19 at the time of her diagnosis, describes how scared she was having to face this new illness alone.
Transcript
One of the biggest things was just my parents not being able to be there. Like my mom like I think I begged and pleased and cried and they felt very badly for my little 19-year-old self that was very anxious and they allowed my mom to stay and gave […]
Barbara describes calling an ambulance to get tests done in the ER as labs were completely overbooked and inaccessible.
Transcript
The doctors closed up their offices, rolled up the sidewalks and they closed up their offices and there was no care for two years. That was despicable. Because the doctors had all moved around, they were all working out of different places it was really, really hard to get a […]
COVID was not equally challenging for all
COVID brought virtual care into the routines for doctors, some doing consultations by Zoom, allowing patients to stay at home. Some women liked using virtual options but did not feel it could take the place of an in-person meeting. Virtual communication using Zoom did help restore social contact for some women, allowing them to develop a broader range of friendships. Jennifer said:
“The fact that COVID has forced us all onto zoom, I think was a good thing, because I have developed friends over Zoom from my various voluntary positions that, you know, I would never have gotten to meet. Possibly I’d gotten to meet them but for a one-hour meeting, or a one-day conference. But because of zoom, you know, it’s expanded my horizons of friendships.”
Some women that we spoke to reported that COVID had little effect on the care they received. When asked if she had any issues accessing care during COVID, Ronda indicated “No I was still able to get my follow up appointments and bloodwork done.”
Maya describes herself as lucky to have had no issues with accessing care during COVID.
Transcript
I mean I think I’ve been pretty lucky to be in a stable place but most of my care has been fine over the phone. I have the same providers in person, and I have gone for a couple of follow up scans. I’ve done an exercise test just to […]
Joanne reported little interruption to her care due to the COVID 19 pandemic.
Transcript
Will I think the COVID-19 the only thing that somewhat affected me was the virtual teleconferences with the doctors. But again I cant complain about that because it was very thorough and stuff. I still managed to go to city and get my tests that I needed so it didn’t […]