COVID-19 Plans

As of March 19, 2020, we have decided that we will be trying to limit direct contact between our staff and patients at this time. The office remains open. We will still be consulting with patients, but we'll be using other methods (Telehealth or phone) to try and minimise contact.

This is because of our need to protect both our patients and our staff, and in so doing protecting the community and "flattening the curve".

Technology and determination are key to this. My staff, Tarryn and Lauren, will spend some time in the office at East Melbourne, and some time at home. Luckily we're a fully paperless office so the transition to working from home shouldn't be too difficult for them. We may have some glitches, please be understanding, and email us using the
contact form. If we don't get back to you, try again. We are implementing contingencies to ensure that we stay connected with our patients in this very difficult time.

For patients seen at Reservoir Private, Bairnsdale Consulting Rooms, and Alfred Hospital Heart Centre, we will be following the same plans.

Here to Help

For consulting where possible, Dr Mariani will be using either video consults (Telehealth) or phone consults to assess your condition. He already uses Telehealth a lot to help assess and manage many of his country patients. Here's an article about it. We describe Telehealth options below.

At the moment, we are focussing on patients who have appointments scheduled between mid-March and end of April.

If you're concerned, email us or ring the rooms. We understand that it's a tough time and there's lots of uncertainty.

Just call the rooms and we'll try and help. Anything to try and help with social distancing, and minimising risk of contact.

Telehealth and Phone Consults

The Department of Health, through Medicare, has enabled doctors, including specialists, to use a new series of item numbers for patient management. Patients seeing a cardiologist who are eligible for this service, and including city patients, are those who are considered high risk of getting sick with COVID-19.

These are
bulk-billed assessments, however you will still need a current referral. Your GP can also do Telehealth or Telephone consults to provide a referral.

Referrals can be used for new or review patients. They are performed via Telehealth or telephone. As above, Dr Mariani prefers Telehealth as there is face-to-face communication, which will be increasingly more important with "social distancing". Appointments can be easily scheduled.

For Patients with Pacemakers, Loop Records and Defibrillators

For patients with pacemakers, loop recorders and defibrillators, it's a bit more complicated.

About one-third of Dr Mariani's patients already have remote monitors. Why not more? Well, because before COVID-19 we didn't see a need for everyone. Remote monitors were offered to rural and remote patients, those who found it difficult to attend clinic, and those at high risk and needing more regular review than could be managed in clinic. However, we have a very good system of remote monitoring with a well established infrastructure which we could scale up for patients as needed.

We are still formulating a plan for patients who don't have remote monitors. This includes reviewing your previous device check.

If interested, please contact the rooms, or contact Nick at remote who manages my remotely monitored patients (virtually all device types can be managed remotely although it only involves interrogation - not reprogramming).

Here's the link to Nick's service.

Please understand that most of our patients are in the highest risk category from the COVID-19 infection and we're planning with your best interests at heart.

If you think you may have Coronavirus, please contact by phone your GP or COVID-19 clinic to discuss assessment and management. Please do not attend our clinics.

We thank you for your understanding in this very unusual situation.

Heart Medications and COVID-19

An area of concern, and many patients have contacted us, is regarding the link between COVD-19 infection and a few specific drug classes, especially ACE inhibitors and Angiotensin Receptor Blockers. Patients with hypertension, heart failure, and/or diabetes, may be taking these tablets.

At this stage, there is no data to recommend that patients stop these tablets and convert to alternative class of tablets, or risk the potential for worsening of their status by stopping these tablets (each of which have a mortality benefit in the above risk groups).

We are following the guidance of many learned societies. If things change, the information will likely be distributed by the media.

Here are some links:

Heart Foundation of Australia - Link

The Conversation - Link

Royal Australian College of General Practitioners - Link

Cardiac Society of Australia and New Zealand - Link

How to Be Ready to Do Telehealth

Essentially, Telehealth uses telecommunications apps to enable video chat. The standard apps are Skype, What's App and FaceTime.

Skype needs software (go to the Skype download page on chrome) and an account. We will provide instruction on finding our Skype address. Skype is very robust. It would be great if you knew how to use it before trying a consultation however.

What's App (available in the Apple store for iPhone or Google Play store for Android) allows messaging and video chat, and uses your phone number. It's very easy to use. Dr Mariani will call you once an appointment time has been established.

FaceTime is a Mac based program that allows communications between iPhones and macs. It only works if you have an iPhone or an iCloud email. Dr Mariani is happy to use this, and has found most patients prefer to use this system.

Of course, there's the standard telephone.
Stacks Image 13