Life after lockdown should start with this healthy to-do list

By American Heart Association News

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(PeopleImages/E+, Getty Images)

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COVID-19 lockdowns are easing across the U.S., but is it safe to go back to the gym? Or the doctor?

And when it is safe, what should be on your post-lockdown health checklist?

As you prioritize your health to-do list, be aware of coronavirus rates in your area, your personal risk from COVID-19 based on your age and medical conditions, and what experts are advising in your area and for your personal care.

Reschedule missed procedures or screenings

Work with your health care team to reschedule high-priority procedures or screenings, where available.

In a recent report, 16 North American cardiovascular societies issued guidance for health professionals on safely reintroducing diagnostic tests and invasive cardiovascular procedures, with an eye to regions with lower rates of infection.

The pandemic has taken a toll on cardiovascular care, said cardiologist Dr. Robert Harrington, chair of the department of medicine at Stanford University in California. He coauthored the report as president of the American Heart Association.

"We've seen a large drop-off in patients seeking acute care for suspected heart attacks and strokes. There's been a decrease in more elective procedures such as exercise testing, cardiac catheterization and other procedures. Anecdotally, we also hear of people having worsening symptoms at home, with a reluctance to seek care for issues such as heart failure management."

Among other concerns, the new report stresses the need for cardiovascular care providers to prioritize procedures or tests with the most benefit for the most people, and to balance risk of further care postponement against risk of further spreading COVID-19.

"Video and phone visits remain the preferred mode for care for the near future as social distancing, masks and good hand hygiene remain critical to prevent and reduce the risks of infection," Harrington said. "There should be local protocols for all of this in the clinical environment that also take into consideration recommendations from local public health departments."

The American Cancer Society addresses similar questions about resuming cancer screenings and exams, urging people to talk to health care providers about their personal situations and whether they're having symptoms. Among the considerations: balancing the risk of the cancer being screened for against the risk from COVID-19, how involved the screening is, how common coronavirus infections are locally and what local officials advise, and precautions taken by individual medical centers to prevent COVID-19's spread.

Make a catch-up appointment with your primary care doctor

People who have missed routine medical care can schedule a catch-up visit, including by telephone or video. Primary care providers will want updates on their patients' health during the pandemic, including any weight or diet changes, depression symptoms, sleep problems, and COVID-19 or other illness. They'll want to know how home monitoring of chronic conditions has been going.

Also, primary care providers can help people balance their personal health vulnerability against local COVID-19 infection trends to determine whether and when to pursue in-person visits for routine care like vaccinations and dental checkups.

It's safe for most people to return to health care facilities, said Mercedes Carnethon, an epidemiologist and vice chair of the department of preventive medicine at Northwestern University in Chicago.

"Health care delivery teams have been thoughtful about setting up their offices in a way to reduce the probability of exposure by wearing protective health equipment such as masks and gloves, reducing the number of patients in the waiting room at any single time and converting those visits that can be done remotely to telehealth. In most cases, the health care provider's office will welcome questions about safety from patients," she said.

Take care of your lungs

Given that COVID-19 is a respiratory disease, keeping the lungs healthy should be high on the to-do list, Carnethon said.

Because smoking and vaping cause lung damage that's preventable, she said, "Don't start smoking now, and search for resources to help with quitting."

Make a plan for future medical care

Any health care checklist can include discussions with family about future health decisions in the case of serious illness, with the goal of recording those wishes in advance health care directives. AARP and the AHA provide resources to help.

Set and follow through on health priorities

"The same principles of a healthy lifestyle hold true in our post-COVID world as they did pre-COVID," Carnethon said. "Individuals will thrive by committing to a lifestyle where they are thoughtful about what they eat, how much they move and how much they sleep." In particular, physical activity can promote both physical and mental wellness, she said.

Harrington additionally advises people to take medicines as prescribed and reduce stress through yoga, meditation or other methods.

People ready to venture back to the fitness center should evaluate whether the risk of COVID-19 transmission is low or high in their community. Either way, Harrington said, "social distancing and masking when near others and using good hand hygiene remain important."

Editor's note: Because of the rapidly evolving events surrounding the coronavirus, the facts and advice presented in this story may have changed since publication. Visit Heart.org for the latest coverage, and check with the Centers for Disease Control and Prevention and local health officials for the most recent guidance.

If you have questions or comments about this story, please email editor@heart.org.


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