Coronavirus disease 2019 (COVID-19) is the illness caused by a novel coronavirus now called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; formerly called 2019-nCoV), which was first identified amid an outbreak of respiratory illness cases in Wuhan City, Hubei Province, China.(1)It was reported to the WHO on December 31, 2019. On January 30, 2020, the WHO declared the COVID-19 outbreak a global health emergency. (2,3).On March 11, 2020, the WHO declared COVID-19 a global pandemic.

RF/RHD continues to be a major cause of disease burden among children, adolescents, and young adults in low-income countries and even in high-income countries with socioeconomic inequalities. The major determinant of the persistent burden of RF/RHD in developing countries are because of poor standards of living conditions and overcrowding. Similarly COVID 19 also spread fast due to poor hygiene and lack of social distancing as reported by WHO. There are many questions about whether children and young adults with rheumatic heart disease are likely to get more unwell than other people if they develop COVID-19 (coronavirus) infection. However report from initial cases from China is reassuring from 3 points :

1. Data on individuals aged 18 years old and under suggest that there is a relatively low attack rate in this age group (2.4% of all reported cases). Within Wuhan, among testing of ILI samples, no children were positive in November and December of 2019 and in the first two weeks of January 2020.The Joint Mission learned that infected children have largely been identified through contact tracing in households of adults. Of note, people interviewed by the Joint Mission Team could not recall episodes in which transmission occurred from a child to an adult.

2. Young people mostly experiencing mild disease when they get COVID 19. Sometimes there are hardly any symptoms or just a running nose, mild cough, sore throat and fever. This is because their immune systems are better than adults.

3. China had record number of cases and also had reasonable number of patients with RHD but severity was observed in those who are older and having diabetes, hypertension or lung disease, not children or young with RHD. Medical papers reporting COVID 19 do not mention RHD as a comorbidity.

According to WHO, poor regions haven’t been spared with COVID 19 and the need for a context-specific response has become urgent. Large and densely populated areas with widespread poverty and high migration which are prone for RHD, are also more vulnerable to airborne pandemics like COVID 19. As a global organization representing the cardiovascular community, World Heart Federation (WHF) want to ensure that everyone, especially those living in poorer areas, is aware of the necessary measures to protect themselves and others.

1. Avoid large gatherings and crowds as much as possible.

2. Keep at least 1-2 meters of distance from a person with respiratory symptoms.

3. Wash your hands often and thoroughly

4. Travel should be reduced to a minimum.

5. Use a mask if travelling by bus, train or plane. If masks are not available or affordable, cover your nose and mouth with a cloth or similar.

1. If you are prescribed penicillin injection, keep getting these every 21 days

2. Keep looking out for signs of streptococcus germs-skin sores or sore throat, get treatment if those happens

3. Keep looking for the signs of rheumatic fever like sore joints and go to the clinic if that happens

4. Keep having your check ups at the local clinic. Echocardiography may not be easy during pandemic since travel is restricted and health services has less capacity, but physical check up, ECG, Blood tests, throat swabs and other checks can still be done