Hi. I'm Bob Graham.
I'm the executive director of the Victor Chang Cardiac Research Institute and I'm here today
to talk to you about COVID-19 or coronavirus, which is a very important disease obviously
and one that's afflicting many, many people.
I'm sure that people have lots and lots of questions about their risk and where we should
go and how we should deal with this.
If you have heart disease, are you at increased risk of contracting coronavirus?
The answer is you're not necessarily at increased risk of contracting it, but you're at increased
risk of having more serious disease.
We know that a lot of the problems are not
just respiratory, that is not just affecting your breathing.
But when you have very severe coronavirus problems as you can have with any form of
flu, then it can affect your heart directly.
People who are dying from coronavirus often are dying of heart problems rather than respiratory problems.
It causes an acute myocarditis and acute inflammation of the heart and it causes acute injury to
the heart muscle so the heart doesn't function as well.
What advice would I have for someone with a pre-existing heart condition?
I would advise them to take every precaution they can to see if they can minimize the chances
of contracting the virus and that is to stay away from crowds.
To try and keep a distance of at least a six to 10 feet from other people.
To wash their hands regularly.
To, it may sound unpleasant, but to put the toilet seat down before they flush it so you
they get aerosol spread, because it can be spread in feces and to try and minimize their
contact with other people.
The reality is that probably 60 to 70% of people are going to contract coronavirus.
In most of those, in 80% of them it's going to be a mild disorder.
But if you have underlying heart disease, you're at increased risk of running into problems.
So you want to try and be in that group of people who don't get it.
The best thing to do is to be as cautious as you can to reduce your chances of getting the virus.
Should I be concerned if my child has congenital heart disease?
Anyone who has an underlying heart condition, especially serious ones like that
is probably at increased risk if they are to get the virus.
Now the good news is, for some reason we are unable to fully understand yet,
children seem to have relatively mild disease when they get the virus.
It'll take time to get a vaccine.
It's going to take 12 to 18 months at least to get a vaccine.
In the mean time there are lots of potential other avenues we could look at
to see if we can help in mitigating the severity of the virus disease.
And that's going to take research and it's going to take cooperation
and it's going to take ethics committees to be a little more lenient in what they require
to allow these studies to go on in compassionate use.
Now, that's a personal thing that we're grappling with,
but these are serious times and we need to sometimes look at
serious ways of trying to reduce the risk to our population.
Look, I think you need to consult your own
doctor and your cardiologist.
But the overall advice is yes you should.
The reason for that is that because they've got an underlying heart condition, even the
common flu can cause problems in people with heart disease.
Also, it will prevent your confusion if you get symptoms and you already have had the
vaccination, it's more likely not to be the common flu but to be coronavirus.
So it's very wise to get it.
And then the other question I frequently get
is, should you be vaccinated early or late?
If you are vaccinate early, you're not protected for the whole winter.
On the other hand and given the situation at the moment, I think most people are going
to be would
opt for going early so that you at least covered during this period when there's lots
of virus around.
An article I read only yesterday really shows, I think that we've underestimated the extent
of this disorder.
It's not a problem for the individual person.
Because as I said, 80% of people will do all right.
But on a population basis it's an enormous problem.
It's like having the regular flu that we have every year, except that's 30 to 50 to maybe
100 times more lethal.
So the death rate from what we can gather is somewhere between one and 2%.
The death rate for the common flu is about 0.1%.
So you're just looking at the flu, but it's a more deadly flu.
And also because it's spreads before you have symptoms,
It's very hard to contain it.
The only way to do that effectively is isolation, which is what we're all trying to do.
And to try and reduce interactions with people who may carry it.
Therefore we need to not be in big crowds.
I mean, it doesn't make sense to be as the the Prime Minister has said,
to be going to football games with 60,000 people.
That doesn't make sense of the moment.
I mean, one of the most telling things I heard
of recently is that in Italy they are so inundated with cases that anyone over 60 is got a co-morbidity
is allowed to die because they don't have the facilities to look after them.
If we get into that situation, obviously...
Well, hopefully we won't.
That's just tragic.
I mean it's just terrible for doctors and nurses to have to make that decision about
who lives and who dies because they don't have the equipment and the wherewithal to
treat them.
So this is a serious situation.
I don't want people to panic, but I think people need to be cognizant of the risks and
to try and reduce them.
It is. And I think that if we put our head in the sand,
we're going to suffer with that.
We need to be aggressively proactive about this.
Yes, we are just starting a study where we tried to use STEM cells to see if we can dampen
down the excessive immune response that occurs when you get the virus and that's what kills people
They get acute respiratory distress syndrome and they get this acute cardiac injury and
there's a small study just published in seven patients suggesting that a certain type of
cell can dampen down the immune response and
the nice thing is it doesn't have the receptors,
those proteins on the surface of the cell that allow the virus to get in and kill those
cells.
So we can use those cells to both dampen down the immune response and they are themselves
immune to the virus.
So they seem to be doing really good things.
So we are looking into potentially starting a trial.
So that's very much in progress and we're not there yet
but we hope to start that pretty soon.
Look, I think that's an excellent question.
Does it heighten the importance of medical research?
I think nothing else has heightened the awareness of medical research and its importance than
this coronavirus pandemic that we have at the moment.
I think everyone can see how vulnerable the population is.
If we don't have medical research to help us, we're going to be in big problems.
You'll have what happened in the 1819 Spanish flu pandemic when more people died than in
the first world war.
It's been estimated about 50 million people worldwide died.
Now, to put that into a perspective and context,
don't forget, now we have much better ways of treating viral diseases.
We have ways of supporting people while they are very sick.
So I don't think anything like that hopefully will ever happen again.
But it shows you the power of these viruses, which can be really deadly and can only be
addressed by having good medical research.
What I'd like to say.... I mean, I've given you lots of information here
which may come across as being frightening.
But look, but rest assured that the Australian government has been very proactive so far
and number of cases that we have here is minuscule.
We have really advanced medical treatment throughout Australia, which we can be very
proud of.
We also have outstanding research.
So I think one should be positive about this.
Also don't forget, as I said on the individual
level, it's really not an issue because 80% of us are going to have a mild or asymptomatic
disorder.
It's for that smaller group of patients who are going to get severe problems that we really
have to worry about.
If it spreads in the community and you get a lot of virus, then of course you're going
to have a lot of people who are going to have serious problems.
But rest assured that the Australia is better
off.
Better off in many ways than say the United States, which is also a developed country.
And that we have very good medical service here.
Our Government, both locally and also the federal government have been very proactive
about this.
Yes, let me just finish by saying that look as the executive director of the Victor Chang
Cardiac Research Institute, we're obviously very concerned about all of the people out
there and we're thinking of you at this time. We're working as hard as we can to try and help.