Cardiac Rehabilitation During the COVID-19 Era: Guidance on Implementing Virtual CareCardiac rehabilitation programs across Canada have suspended in-person services as a result of large-scale physical distancing recommendations designed to flatten the COVID-19 pandemic curve. Virtual cardiac rehabilitation (VCR) offers an alternate mechanism of care delivery, capable of providing similar patient outcomes and safety profiles compared with centre-based programs. To minimize care gaps, all centres should consider developing and implementing a VCR program. The process of this rapid implementation, however, can be daunting.
Guiding Cardiac Care During the COVID-19 Pandemic: How Ethics Shapes Our Health System ResponseThe COVID-19 pandemic has raised ethical questions for the cardiovascular leader and practitioner. Attention has been redirected from a system that focuses on individual patient benefit toward one that focuses on protecting society as a whole. Challenging resource allocation questions highlight the need for a clearly articulated ethics framework that integrates principled decision making into how different cardiovascular care services are prioritized. A practical application of the principles of harm minimisation, fairness, proportionality, respect, reciprocity, flexibility, and procedural justice is provided, and a model for prioritisation of the restoration of cardiovascular services is outlined.
Use of Renin-Angiotensin System Blockers During the COVID-19 Pandemic: Early Guidance and Evolving EvidenceThe COVID-19 pandemic invoked the need for prompt guidance and rapid research to address emerging clinical questions. In response to early theoretical concerns regarding the use of renin-angiotensin system (RAS) blockers, including angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs), and angiotensin receptor–neprilysin inhibitors (ARNIs) during the COVID-19 pandemic, the Canadian Cardiovascular Society (CCS) and Canadian Heart Failure Society (CHFS) issued guidance to continue these therapies among patients with heart failure and hypertension.