Coronavirus warning issued for the 4.2 million Australians who are affected by cardiovascular disease

Watch the extended video interview with Professor Bob Graham about coronavirus (COVID-19) and its impact on the heart.

13 March 2020
Update 25 Nov 2021: Information from this article was accurate at the time of publishing and reflected the rules/advice announced by governing bodies at that time.

Video transcript - 13 March 2020

Hi I'm Bob Graham. I was the Founding 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 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 (COVID-19)?

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 it 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.

How does coronavirus (COVID-19) affect the heart?

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 do I have for people who currently have a heart condition or cardiovascular disease?

I would advise them to take every precaution they can to see if they can minimise 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. It may sound unpleasant, but to put the toilet seat down before you flush it, because it can be spread in faeces and to try and minimise their contact with other people.

The reality is that probably 60 to 70% of people are going to contract coronavirus in most of those and 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?

Look, anyone who has an underlying heart condition, especially a serious one, is probably at increased risk if they get the virus. The good news is, for some reason, which we are unable to fully understand yet, children seem to have a relatively mild disease when they get the virus.

To clarify, people with children with congenital heart disease shouldn't be overly concerned as the majority of these children have normal heart function, and given children seem to be doing very well compared to the elderly who contract COVID-19. Visit our Children & COVID-19 FAQs to learn more.

Is there a coronavirus (COVID-19) vaccine available?

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 meantime, 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.

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 a population.

If someone has a pre-existing heart condition, should they get the flu shot this year?

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 cardiovascular 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 vaccinated early, you're not protected for the whole winter. On the other hand and given the situation at the moment, I think most people would be opting for going early so that you at least covered during this period when there's lots of virus around.

As one of Australia's leading scientists, what has been one of your most interesting reads on this topics?

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 1 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.

That's because it's spread 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, as the Prime Minister has said, to be going to football games with 60,000 people. That doesn't make sense at 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 with comorbidity 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 cognisant of the risks and to try and reduce them.

This sounds very concerning....

It is. It is. I think that we can maybe put our head in the sand. We're going to suffer with that. We need to be aggressively proactive about this.

Is the Victor Chang Cardiac Research Institute doing any research in the coronavirus (COVID-19) space?

Yes, we are just starting a collaborative study where we try 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.

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.

Does coronavirus (COVID-19) heighten the importance of medical research?

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.

Is there anything else you'd like to say?

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 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.

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 and we're working as hard as we can to try and help.

** Professor Bob Graham was the founding Executive Director of the Victor Chang Cardiac Research Institute for 26 years.

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