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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 32, No 4, July/August 2021
AFRICA
177
Covid-19 and cardiovascular disease
One cannot write an opinion piece or editorial and not address
one of the biggest issues facing medicine in 2021, both globally
and in Africa. When the current Covid-19 pandemic struck
South Africa and Africa in early 2020, I was still in part-time
employment in the public academic hospital where I had
trained as a medical student and then spent virtually my whole
professional life. The hospital administrators took the wise
decision that all older staff, in view of their at-risk status, should
be excluded from the hospital premises. The result was that I,
and many others who were still, after retirement, involved in
some measure of patient care and teaching, had to leave the
premises. I vacated my office and have never returned. My initial
reaction was one of resentment at being excluded from what
clearly was going to be a major effort on the part of the many
colleagues, at all levels, with whom I had worked for decades.
Currently I am no longer resentful but grateful that that
decision was taken and I was spared, involuntarily, exposure
both to the disease and the rigors of the changes in practice that
my colleagues have experienced when managing it. Despite not
being in the hospital, I remain in touch virtually and am aware
of the enormous disruption the pandemic has caused in the
lives and practices of my erstwhile colleagues. Deployment to
providing or supervising care for Covid victims has interrupted
their normal provision of specialist cardiology care. I salute
those who have interrupted clinical and research careers to care
for victims of the pandemic. I am filled with admiration that
many have managed to maintain the research enterprise and
continue to publish.
Despite the best efforts of universities and departments,
the pandemic must have impacted on undergraduate teaching
and this will take a considerable time and effort to correct. The
impact on post-graduate training may be even more severe. I
understand most hospitals, both public and private in South
Africa and, I suspect, in the rest of Africa, have had to limit
elective admissions. We need to admit that this almost certainly
limits the access of trainees in invasive cardiology and cardiac
surgery to patients in the treatment of whom they may learn or
be taught. There needs to be creative thought given as to how
this education gap will be covered. To date I have not heard
any suggestions. I would welcome any, and offer the CVJA as a
forum to air them.
It is not possible to conclude an editorial such as this without
commenting on the views of members of the broader cardiac
community, recently aired in a variety of media. I view these
with dismay. There are many matters that may block access to
vaccines for our patients. The views of high-profile ‘medical
experts’ should not be among them. I have always considered
that I should only comment on matters within my area of
expertise. Beyond that I believe I should be directed by scientific
sources that I trust. Suffice it to say that I and my immediate
family are vaccinated.
PJ Commerford
Editor-in-Chief
From the Editor’s Desk