Employee Health and Fitness

Employee Health and Fitness

HEALTHY LIFESTYLES

A Healthier Workforce

The push to improve the health and
fitness levels in America’s workforce

To say that Diane Hart has dedicated her life to health and fitness is an understatement. In 1981, she launched Hart to Heart Fitness, her personal training business in Albany County. Her career path extended to launching corporate wellness and resilience programs for area businesses. Diane’s leadership skills and passion for helping people change their health and lifestyle led to her current role as President and Executive Director of the National Association for Health and Fitness (NAHF). She brought her signature “high energy” personality to a recent episode of HeartTalk, presented by Capital Cardiology Associates, to discuss workplace health and fitness.

Advocating for healthier communities

Moments before our program, Diane had just finished a phone call with Senator Chuck Schumer. She shared the details of their conversation, Diane was lobbying for consideration of legislation to be included in the Senate’s next Stimulus Package. “We have attempted to pass this for six years, it’s the Personal Health Investment Today (PHIT) Act. This has tremendous bipartisan support,” she added. PHIT would make any expense exclusively intended to be physically active, eligible for FSA/HSA reimbursement. This would cover sporting equipment, health club memberships, youth camps, pay to play sports fees, tournaments, and fitness tracking devices for health conditions (like heart disease). “This act promotes a healthy culture. When you look at healthcare costs today, 3.3 trillion expenditures go towards people with chronic and mental health conditions, which we know physical activity can improve. We also hope this will relieve some of the comorbidity factors Americans face due to COVID.”

Diane Hart accepting the 2016 President’s Council on Fitness, Sports & Nutrition Lifetime Achievement Award

Advocating for legislation that improves American communities’ health is just a part of the NAHF’s mission. The Association’s members are also leaders in developing change-behavior programs, like Global Employee Health and Fitness Month (GEHFM). This event, traditionally, was a workplace-focused health awareness month held during May. It’s active in 38 states, with almost 7,000 companies and organizations participating. However, Hart noted that following the impact of the pandemic, 2020’s edition would need to be updated. “We realized the need to move it virtually when the world moved to work from home and exited office buildings.”

The state of health in the American workforce

A 2018 Kaiser Family Foundation survey reports that 82% of large firms and 53% of small employers across the country offer some form of a wellness program. There are two reasons why: many employers believe that improving their workers’ health and their family members can improve morale and productivity and reduce health care costs. The CDC reported the systematic review of 56 published studies of worksite health programs which showed that well-implemented workplace health programs can lead to 25% savings each on absenteeism, health care costs, and workers’ compensation and disability management claims costs. The CDC added that productivity losses related to personal and family health problems cost U.S. employers $1,685 per employee per year or $225.8 billion annually. Healthy workers are more productive workers, and that helps the company’s bottom line.

Today’s job seekers are also looking for employee benefits that extend past competitive compensation, medical/dental/vision coverage, and time-off. Employers who consistently rank as a “Top Workplace” has noticed that Americans working full-time spend more than one-third of their day, five days per week at the workplace. Applicants are pursuing happiness — an offering that includes work/life balance and positive workplace culture. Firms with an on-site gym or those that offer gym memberships as perks are highly sought by savvy job hunters. While these amenities may not be possible for all business owners, Hart pointed out examples of company fitness opportunities like participating in 5K runs or healthy eating demonstrations, creating healthy moments where individuals can bring these good habits home. “The excitement from participating in these projects needs to expand to help families and children.”

The recent push to offer health incentives has not moved the needle on the state health for the American workforce. “I’m sad about that,” Hart said as she took a deep breath. “We are actually 35th in the world, mostly because our workforce is over-worked.” Last year, Spain surpassed Italy on the Bloomberg Healthiest Country Index, which ranks 169 economies according to factors that contribute to overall health. According to the University of Washington’s Institute for Health Metrics and Evaluation, by 2040, Spain is forecasted to have the highest lifespan at almost 86 years. The country has seen a decline in cardiovascular diseases and deaths from cancer. Experts note that their eating habits, particularly following the Mediterranean diet, have reduced Spain’s obesity rate. That is not the case in America.

Type 2 Diabetes and Obesity are the two main causes of heart disease. According to an article from Corporate Wellness Magazine, more than 50% of health care costs in the United States are due to unhealthy lifestyle habits, such as smoking, inactivity, and weight gain. Healthy workplace activities and programs reduce the development of chronic disease risk factors like alcohol/tobacco use, raised blood pressure, and high blood sugar or cholesterol levels — all by-products of unhealthy diets and sedentary lifestyles. “When I look at the chronic diseases in America, six out of ten of us as adults have a chronic disease or condition,” noted Hart. “Sadly, we know that most heart disease cases, heart attack, stroke, and cancer can be prevented through good lifestyle choices and regular health screenings.”

Written by Michael Arce, host of HeartTalk presented by Capital Cardiology Associates

How A Drug Is Made

How A Drug Is Made

PATIENT EDUCATION

A Drug’s Journey to
Your Medicine Cabinet

The steps involved to test a new drug for use

The pharmaceutical industry is working quickly to test a wide variety of potential cures for COVID-19. While drug makers have suggested a cure will be available by the end of the year, researchers are setting a timeline of 12 to 18 months to develop a vaccine. We asked, Mohammed Uddin, Albany College of Pharmacy and Health Sciences intern to explore the clinical trials and research development involved in drug development.

Microscope

The journey of an experimental drug from the laboratory into your medicine cabinet takes on average about 15 years. The researcher’s main goal is to find better ways to prevent, detect, and treat diseases. The first 6 to 7 years of drug development consists of researchers discovering a number of molecules that have the potential to become a drug for medical treatment. Once a molecule is identified by a researcher, it first goes through the preclinical testing period to ensure it is safe and effective in the laboratory and in animals.

Prior to testing the molecule in humans, researchers must find out whether the drug molecule has the potential to cause serious harm. If the results of preclinical testing determine the molecule to be safe and effective, researchers will then file an ‘investigational new drug application’ (IND). The IND must be approved by the Food Drug Administration (FDA) and by an institutional review board (IRB). The purpose of the IRB is to protect the safety and well-being of people who will be testing the new drug and to ensure ethical values are met. If the FDA approves the IND, this means the researcher may begin phases of clinical trials. Clinical trials are research studies that involve humans to test the new drug for safety and efficacy, and is typically done in a series of 3 steps:

Phase 1 Trials

This phase takes several months and includes about 20 to 100 healthy volunteers. The goal is to find a safe dose for the new drug, determine how the treatment should be given, and learn how the drug affects the body. If safety is determined, then the drug testing moves to the next phase.

Phase 2 Trials

This phase may take several months and up to 2 years and includes several hundred people with the disease or condition for which the drug is being developed. The goal is to further assess safety, but now also see if the drug actually works. If efficacy is determined, then the drug moves to the next phase.

Phase 3 Trials

This phase may take up to 4 years and may include several thousand people from patient populations for which the medicine is eventually intended to be used. The goal is to further assess if the drug works, but also to look at the long-term side effects of the drug.

If all 3 phases are successfully completed and the trials have shown the drug is safe and effective, then the researcher may file an application known as the “new drug application” or NDA. The purpose of this application is for the FDA to approve the researcher to begin marketing the drug for commercial sale. Reviewing of the NDA by the FDA can take up to 2 years. If the NDA is approved, the drug may be marketed with FDA regulated labeling.

After approval, a phase known as ‘post-marketing monitoring’ begins. Although clinical trials have shown the drug is safe and effective, it is impossible to complete long-term safety information by the time the drug is approved. After the public begins to use the medication, the researcher is responsible to submit safety updates such as side effects and other reports of issues or concerns to the FDA. The FDA will review these reports and may decide to add cautionary statements for use or if side effects are too serious, may withdraw the drug from the market.

New drugs are protected by patents when they are approved for marketing, which means no generic drugs can be manufactured until the patent expires. Although this process may be seemingly long, it is the only way to get the safest drugs to make it to your local pharmacy!

Written by Mohammed Uddin, Pharmacy Intern

References:
Drug Development Process [Internet]. [cited 2020Jun13]. Available from: https://ccts.osu.edu/content/drug-development-process
Learn About Drug and Device Approvals [Internet]. 2018 [cited 2020Jun13]. Available from: https://www.fda.gov/patients/learn-about-drug-and-device-approvals
The Drug Development and Approval Process [Internet]. [cited 2020Jun13]. Available from: https://www.fdareview.org/issues/the-drug-development-and-approval-process/

What To Expect When You Visit Your Doctor This Summer

What To Expect When You Visit Your Doctor This Summer

What To Expect When You Visit Your Doctor This Summer

“Be prepared to be screened, to wear a mask, and aim to arrive a little earlier than you normally would.”

TOP FIVE TIPS

CALL AHEAD

Call ahead up to 24 hours before your visit.

WAIT OPTIONS

You can wait in your car.

ONE VISITOR

ONE visitor per patient.
,

SOCIAL DISTANCING

Try to keep 6 feet between people.
q

WEAR A MASK

A mask or face covering must be worn at all times.

As New York State reopens, there is a backlog of patients waiting for elective surgeries and office visits. If you haven’t visited a medical facility since the virus outbreak, your experience will be very different due to safety guidelines. Dr. Lance Sullenberger, a board-certified cardiologist at Capital Cardiology Associates and member of the Albany COVID-19 Task Force, shares insight in what to expect when you visit your doctor or an area hospital this summer.

“One of the things I am most proud of at CCA is that we have never closed our doors during the pandemic. Our team adapted on initially a daily basis, now its more like a weekly basis, in terms of providing the highest level of safety for our patients and staff in this environment,” stated Sullenberger. Currently, at all Capital Cardiology Associates locations, patients and their guest are required to passing a temperature check along with providing satisfactory answers to COVID-19 guideline screening questions before being admitted into the building. We also require all patients and their guest to wear a mask or face covering, at all times, during their visit. “We are wearing masks and ask that you do the entire time you are in the building.”

At our Corporate Woods location, patients are allowed to bring one visitor per visit. Due to restrictions at our Troy office in the Samaritan Medical Arts Building, only patients are allowed in the facility. “If you are visiting a facility, what you can do as a patient, please aim to arrive a little earlier than before to allow for the screening and extra time to check-in,” Sullenberger added. Our team is diligent in keeping our schedule on time. Still, Dr. Sullenberger has noticed that patient visits have tended to run over their booked time due to additional questions on the virus or discussions on a patient’s treatment or medications during the outbreak. “I am spending more time digging into the lifestyle changes that could have led to a change in heart health.”

What your doctor will ask you

There were several lifestyle changes that could have impacted your heart health during the shutdown. The World Health Organization (WHO) specifically warned about alcohol use during the COVID-19 pandemic.

Alcohol distributors reported a 50% increase in the sales of alcohol from one week in March of the coronavirus compared to a week the same year ago. Home delivery of liquor increased dramatically, and one report noted a 300% increase in alcohol sales in March compared to January. “I’m seeing that more people are coming in with extra weight due to increased alcohol use or eating more processed or canned food during the pandemic,” Sullenberger commented. Increased alcohol consumption is one of the four modifiable risk-factors for heart disease. “Very few patients are coming in with normal blood pressures. There is a low level of anxiety in our population as well, combine that with increased sodium intake, this condition requires attention and adjustment on medications.”

Fewer heart cases

Emergency Room

Another concern we reported during the outbreak was the drop in hospital visits. Hospital visits declined 33-62% from March to mid-April, according to a report. Some of the drop was attributed to the cancellation of elective procedures due to hosptials needed staff, resources, and room for COVID patients. The sentiment in the medical community was that heart patients were missing from hospitals. “I am finding is that more people had symptoms that they lived with, ignored, or didn’t give attention to, over fear from going to a hospital for treatment,” said Sullenberger. Cardiologists around the world united to share the immediate message that heart disease, heart attacks, and stroke due not take time off during health epidemics. “I want to reassure people that the medical community is doing all we can to mitigate risks as much as possible. If you have been sitting at home, waiting on having your symptoms addressed, you are not doing yourself any favors. If you have chest pain or shortness of breath, now is the time to get the visit done! It is safe to seek attention for your medical needs.”

Healthcare returning to normal operations

Albany, Rensselaer, and Schenectady Counties are now eligible to resume elective surgeries. Governor Cuomo announced that New York State will allow elective outpatient treatments to resume in counties and hospitals without significant risk of COVID-19 surge in the near term. “The elective procedures that have been put on hold have been joint replacement, knee surgeries, hip surgeries, and some ear, nose, and throat,” Sullenberger clarified. A total of 47 counties can now resume these procedures. “We are still waiting for some guidance from the State Department of Health and from the hospitals on what it will take to perform these procedures. Pre-operative (pre-op) steps will require meeting with your surgeon and getting a date scheduled. The major issue is that patients will have to be tested for COVID infection. That is a nasal swab, three days before the procedure. Then the patient must self-quarantine after the surgery. I think we all want to avoid a patient unknowingly who may be asymptotic, bringing infection into a hospital setting.”

Some cardiologists do interventional procedures such as stenting, but they do not perform surgery. Dr. Sullenberger outlined his role in patient pre-op evaluations. “The cardiologist’s responsibility is to make sure that a patient who has any surgical procedure is not at risk of having a heart attack or cardiovascular compilations. We provide an assessment of that risk. As you can imagine, there are people in their 30’s and 40’s who have no cardiac risk factors which don’t need to see a cardiologist and won’t be referred. Likewise, some older people may have a history of diabetes or have high-risk factors, like high blood pressure or heart disease, that require attention. Our role is to see these patients in pre-op visits, to speak with the patients, and sometimes conduct an echocardiogram or stress test to evaluate and gauge any risk.”

The new normal

As far as this “new normal” of temperature checks, health question screenings, and safety guidelines for healthcare providers, Sullenberger has spotted a silver lining in a post-shutdown system. “The handling of the COVID pandemic here from a medical standpoint taught me a lot. In our office, we had an organized team that worked on operating under the guidelines on a daily basis. In the hospital, the setting was different; it was how to take care of patients from a cardiovascular perspective who have active COVID infections. This virus does have multiple manifestations, and it does involve heart-related symptoms and illness. We need to be cognizant of that if we see a second wave in the local population. My key takeaways are that we are going to be in masks for awhile. I don’t know what a while is, I’m not Dr. Faucci, but I would expect at least a year. I also recognized that I have a great group of colleagues. These are dedicated people who work in our offices and hospitals, who are passionate when caring for patients.”

COVID team

Written by Michael Arce, Marketing Coordinator, Capital Cardiology Associates

COVID-19: Do I Need to Stop or Change My Meds?

COVID-19: Do I Need to Stop or Change My Meds?

HEART HEALTH

Ask a Pharmacist

Do I Need to Stop or Change My Meds?

COVID-19 is a very new virus, and there is a lot that we still do not know about it. There have been some recent claims or speculation about how certain drugs may interact with the COVID-19 infection, but nothing yet has been proven. Some of the medications discussed throughout media sources recently include angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and non-steroidal anti-inflammatory drugs (NSAIDs), all of which are very common among CCA patients.

There is a protein, ACE2, in our bodies that the COVID-19 virus binds to and thereby enters targeted cells. An early concern was that patients on medications like ACE inhibitors, ARBs, or NSAIDs that also work on ACE2, may be at an increased risk of getting COVID-19 or having worse outcomes. However, this has not been proven, and in fact, there are recent suggestions that the opposite occurs with ACE inhibitors and ARBs, and that being on one of these medications may be beneficial in the setting of COVID-19.

Below, we aim to help you understand your risks and the best plan of action in these uncertain times. As always, it is highly recommended that you speak to your healthcare provider before changing any of your medications.

ACE inhibitors and ARBs

What are ACE inhibitors and angiotensin receptor blockers (ARBs)?
ACE inhibitors and ARBs are medications commonly used to treat high blood pressure or heart failure and include lisinopril, enalapril, losartan, irbesartan, and valsartan.

Should I continue to take my ACE inhibitor or ARB?

To date, there is no data to support this hypothetical concern. The American College of Cardiology (ACC) and American Heart Association (AHA) both recommend continuing to take ACE inhibitors or ARBs as directed by your healthcare provider. Recently there has been one small study published that provided encouraging data for continuing the use of ACE inhibitors and ARBs. While this evidence is preliminary, it is promising that the benefit of these medications in cardiovascular health may outweigh the risk in COVID-19. Overall, the use of guideline-directed medical therapy is key in controlling blood pressure, and stopping them could lead to a heart attack or stroke.

In conclusion, the FDA, WHO, and CDC are currently unaware of any scientific literature connecting the use of NSAIDs, ACE inhibitors, or ARBs and worsening or causing COVID-19 infections. The information being reported is mainly from purely observational studies, and not based on scientific data. New studies are planned, and we will continue to keep you updated as any new information emerges.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDS)

What are NSAIDs?
NSAIDs include medications you may know more commonly as ibuprofen (Motrin, Advil), naproxen (Aleve), celecoxib (Celebrex), and aspirin. They are commonly used to reduce fevers and relieve mild pain.

Is it safe to continue taking NSAIDs?

There are currently no studies that suggest taking NSAIDs increase your risk of getting COVID-19 or worsening outcomes with COVID-19 infection. The European Society of Cardiology (ESC) and the Food and Drug Administration (FDA) are both unaware of any scientific data to support the worsening of COVID-19 infection associated with NSAID use. The concern to avoid the use of these medications is theoretical, and at this time, patients can continue to use them safely and as directed. The National Institute for Health (NIH) suggests using the lowest dose of NSAIDs, for the shortest period of time, to provide relief of pain and fever, and this is especially important for those with cardiac conditions and kidney issues.

Is there an alternative medication I can take for fever or pain?

If you are looking for a medication to help with pain and fever reduction that is not an NSAID, Tylenol (acetaminophen) is an option! The CDC currently states that acetaminophen (Tylenol) is an appropriate choice to help reduce pain and fever related to COVID-19 infection. Over-the-counter (OTC) products are safe and effective when you follow the directions on the label and use them as directed by your healthcare provider. The maximum daily recommended dose of acetaminophen (Tylenol) is 3,000 mg per day.

Is it safe to take my ‘baby’ Aspirin?

Yes! A low or “baby” dose, 81 mg, aspirin is commonly taken for heart health. The findings of “aspirin worsening COVID-19” are unfounded. It is very important to continue aspirin therapy as it has significant benefits, especially after a heart attack, a coronary stent, or stroke. Aspirin works by a different mechanism of action than other NSAIDs, and thus the cardio-protective effect and the reduction in risk of cardiovascular events outweigh any theoretical risk of aggravation of COVID-19 symptoms.

Please call Capital Cardiology Associates or the Clinical Pharmacy Team at Capital Cardiology Associates for more information, questions, or concerns.

Stay well and wash your hands!

Written by Emily Kronau Pharm Intern, Dylan Carmody Pharm Intern, Emily Plumadore PharmD, Kate Cabral PharmD, BCCP

References:
1. Center for Drug Evaluation and Research. FDA advises patients on use of NSAIDs for COVID-19 [Internet]. U.S. Food and Drug Administration. FDA; [cited 2020Apr3]. Available from: https://www.fda.gov/drugs/drug-safety-and-availability/fda-advises-patients-use-non-steroidal-anti-inflammatory-drugs-nsaids-covid-19
2. Coronavirus [Internet]. World Health Organization. World Health Organization; [cited 2020Apr3]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019
3. Coronavirus Disease 2019 (COVID-19) [Internet]. Centers for Disease Control and Prevention. Centers for Disease Control and Prevention; 2020 [cited 2020Apr3]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/index.html
4. Uncertainty Surrounds Use of OTC Anti-Inflammatory Drugs in Patients With COVID-19 [Internet]. Pharmacy Times. [cited 2020Apr9]. Available from: https://www.pharmacytimes.com/news/uncertainty-surrounds-use-of-otc-anti-inflammatory-drugs-in-patients-with-covid-19
5. New Study Provides First Clinical Insight into ACE-inhibitors and ARBs in patients with COVID-19 [Internet]. Pharmacy Times. [cited 2020Apr13]. Available from: https://www.pharmacytimes.com/news/new-study-provides-first-clinical-insight-into-ace-inhibitors-and-arbs-in-patients-with-covid-19
6. HFSA/ACC/AHA Statement Addresses Concerns Re: Using RAAS Antagonists in COVID-19 [Internet]. American College of Cardiology. 2020 [cited 2020Apr13]. Available from: https://www.acc.org/latest-in-cardiology/articles/2020/03/17/08/59/hfsa-acc-aha-statement-addresses-concerns-re-using-raas-antagonists-in-covid-19

What we have learned about the coronavirus

What we have learned about the coronavirus

HEART HEALTH

What we have learned about the coronavirus

“We are learning about
this virus every day and
working together to
benefit all of us.”

It has been a month since the coronavirus spread throughout New York, closing schools, sending non-essential workers home, canceling public events, clearing our social calendars, and stalling the economy. When the first reports of patients infected with coronavirus disease 2019, COVID-19, in China surfaced in early January of 2020, most Americans were focused on the beginning of the new year. In only a few months, we have transformed into a society on PAUSE as medical officials and elected leaders responded to a virus that can only be viewed under an electron microscope, virtually unknown to science until its effect was reported on the nightly news.

Scott Purga, MD, FACC

What has the Capital Region medical community learned about the coronavirus and how might that knowledge help end this pandemic? That is the question we posed to Dr. Scott Purga, a board-certified cardiologist at Capital Cardiology Associates, who is part of the area’s COVID-task force. “What’s new for all of us is that we are learning about this virus every day. Our team is quite thorough and working together to provide the best care. You may see things on the news about how hospitals were overwhelmed, that is not the case in Albany. We had extra time to get our systems in place.” Dr. Purga joined me on a recent episode of HeartTalk, presented by Capital Cardiology Associates to discuss the treatment, recovery, and possible cure options during this pandemic.

What we have learned

It has been established that COVID-19 is highly contagious and quickly spread across the globe after first being reported in Wuhan, China, on December 31, 2019. The World Health Organization began publishing risk assessments and advice to the public health crisis that was developing in Wuhan medical institutions. On January 13, the first confirmed case of COVID-19 in Thailand was reported, signaling that the virus had traveled outside of China. Fast forward to February 29 when the first death from the virus was reported in America. Dr. Purga explained the challenge with COVID-19 is in identifying those who have the virus. “We have seen COVID-19 in patients with the main presenting symptom of fever, chills, the usual flu-like symptoms, but then a substantial portion also have lung involvement.” The virus had reached America during the peak of the seasonal flu. Common respiratory viruses (like the common cold and influenza) affect young children, those with health conditions, and adults 65+ at greater rates, causing a spike in hospitalization. Unlike the cold and flu, coronavirus “can progress to pneumonia, which can become severe, requiring intensive care unit (ICU)admission. A large subset also have cardiac complications, either from the virus itself or from breathing issues associated with the virus. Anywhere from 10-20% are going to have a heart issue coming from the coronavirus infection, particularly those that are more severe cases,” noted Dr. Purga.

Another unique twist to coronavirus is that an infection can be generally mild. “A substantial portion, manly younger and healthier people with fewer comorbidities, they have a relatively mild illness with flu-like symptoms with shortness of breath for a few days but can recover quickly,” commented Dr. Purga. Mild symptoms create an opportunity for the virus to spread to others through a cough, sneeze, or any close contact. This is why there is a concern about hand washing, wearing masks, and adhering to social distancing. And like the cold and flu, coronavirus is transmitted from germs that can live for hours on unsanitized surfaces.

Dr. Lance Sullenberger, COVID-19 task force

“Once inside, the virus attacks the body’s immune cells and is able to ‘get inside’ to replicate using our own cells to make more copies of the virus. The concern here is that this virus spreads to affect the lungs, which is the major reason that this virus is deadly. This virus is able to get through certain receptors on the cell surfaces. You may have heard about the ACE receptor. (Cell receptors play a key role in passing chemicals into cells and in triggering signals between cells.) There are some theories that COVID is using these receptors to gain entry into cells. A lot of that is being studied every day by researchers,” said Dr. Purga. Even worse, coronavirus may trigger the body’s immune system into overdrive, causing inflammation in the lungs, causing Acute Respiratory Distress Syndrome (ARDS), which requires the use of a ventilator to assist with breathing. “The downside is two-fold, we are learning about residual damage to the heart and lungs from the virus as well as the fact that these people can spread the virus to others without realizing it. We think a good percentage of people are asymptomatic, meaning that they have the virus infection but have no symptoms of it. They can be walking around with friends, spreading the virus without realizing it. That is the double-edged sword when you have milder cases.”

COVID-19 Task Force members at Albany Med

Working together

There is no specific antiviral treatment recommended for COVID-19, and no vaccine is currently available. While we have been separated during this pandemic with social distancing and the New York State on PAUSE guidelines, a group of Albany-area medical professionals has formed to combat this virus, together. Special COVID-19 task forces have been assembled at area hospitals, comprised of emergency room nurses and physicians, nursing care, respiratory therapists, ICU physicians, and cardiologists. “We do this in a controlled fashion, keeping everyone safe, isolating COVID patients for treatment,” detailed Dr. Purga. “The cardiologists consult the attending internal physicians on the care and treatment progress. Our diverse backgrounds are the strength of the team; we can bring new ideas to each other and share what we know from our unique specialties and training. Our team at Albany Med can collaborate with the team at St. Peter’s to benefit all of us. It is a good atmosphere and quite unique!”

There are two main goals in ending the COVID pandemic: treating symptoms and finding a cure. Currently, there is considerable discussion on the effectiveness of drugs used to treat other illnesses on COVID patients. Dr. Purga addressed the two most popular drugs being used to treat symptoms. “Under controlled circumstances, it is useful to give these drugs under physician supervision. Zithromax, or as it is called ‘Z-pack,’ is typically used for community pneumonia, pneumonia caught outside of the hospital, and some other bacterial infections. It also can reduce inflammation in the lungs. That is why we think it may be helpful in combatting the lung problems associated with coronavirus. Hydroxychloroquine is traditionally an anti-malarial drug that is used to fight that parasitic infection. It also has some anti-inflammatory properties and has been used in autoimmune conditions like lupus. The thought here is that by reducing the body’s response, this may reduce the frequency of severe complications, needing a ventilator and other respiratory problems. They are being used together with the hope that they are helping. It’s premature to say that they are making a definitive impact yet.” It has also been reported that remdesivir, a drug developed to treat disease caused by the Ebola virus, could possibly stop the virus from being able to copy and spread to other parts of the body. The drug was successful in animals and laboratory dishes, but scientists insist on more studies to confirm its effectiveness in people. “There is a lot to come, with the use of other off label anti-inflammatory medication options that are being used in the hospital, on the treatment of COVID symptoms,” added Dr. Purga.

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The race for a cure

As of April 8th, there were 115 COVID-19 vaccines under development around the world. The most advanced candidates have recently moved into clinical development, some looking to being human testing this year. Time is the one commodity scientists will need to develop a cure. Even Dr. Anthony Fauci, the longtime director of the National Institute of Allergy and Infectious Diseases (NIAID), has questioned a drug being developed within a year. While scientists have cracked COVID-19’s code in record time (determining the genetic sequence of the virus), there are still critical steps in developing a vaccine. Researchers will use clinical trials to test for dangers, and adverse side effects in small to large populations before a cure can be released. “Typically, randomized trials, say for a new heart drug that comes to the market, that usually takes several phases of trials over years to develop approval from the FDA. In the case of the COVID virus, the CDC and FDA have are expediting approval of trials and allowing us to enroll patients quickly due to the rapid need for this data,” said Dr. Purga.

Healthcare during the new normal

One concern that has developed while we wait for things to return to normal is that doctors throughout the United States have reported treating fewer patients than normal for heart attack and stroke symptoms since the start of the COVID-19 pandemic. This week, the Journal of American Medical Association reported results from a large study involving patients hospitalized with COVID-19 in the New York City area, that people with obesity, diabetes, and high blood pressure are at greater risk for complications from the coronavirus. I asked Dr. Purga about the issue of patients not reporting their conditions out of fear of the virus. “My message is if you have a true concern, a new symptom: chest pain, shortness of breath, dizziness — any of our red flag cardiac symptoms — do not stay home. Heart disease isn’t on hold just because there is a viral outbreak. People have heart attacks, stroke, arrhythmia even while staying at home during this pandemic. The hospitals have isolated patients being treated for COVID conditions. Setting foot in the hospital does not mean you are going to catch coronavirus. I would encourage people who are presenting heart or cardiac symptoms to call their primary doctor, call our office, or if it is an emergency, go to the hospital.”

(l to r): Karen Canniff, NP with Dr. Scott Purga – holding a portable ultrasound unit

Written by Michael Arce, Host of HeartTalk presented by Capital Cardiology Associates