 Good morning. I am Dr. Pradeep Harnanalli, Constituent Cardiologist at Manipal Hospital, Whitefield. Lockdown largely has impacted cardiac patients quite a lot. In the early stages of lockdown, we saw a sudden drop in number of patients visiting with cardiac issues to the emergency department. This gave us a feeling maybe the lockdown or reduced people movement had indirectly and actually impacted the drop in cardiac emergencies. But slowly we realized that it was a false presentation. Slowly we started seeing cardiac emergency patients presenting with more complications, delayed presentation, for example complicated MIME or patients presenting with MIME out of window period, which in a general way if presented on time could have been better taken care wherein we landed up handling more complicated patients and even including catastrophes. The general COVID precautions apply here as well. Cardiac patients in particular because of their comorbid conditions like the age group, commonly cardiac issues are common among people more than years of age and also by virtue of their status of having diabetes and hypertension must take precautions in terms of social distancing which is very important. We are coming in contact with people who potentially could have been infected with COVID or going outdoor into public places or common places like a grocery shop or could be any gatherings or crowded park etc. And they must always follow hand sanitization precautions and also must wear a mask all the time in order to prevent themselves as well as people around them. For that matter any chest pain is an emergency because setting at home there is no clear cut way of differentiating heart related chest pain from that of other causes of chest pain. Until proved otherwise in a particular age group chest pain is an important symptom and has to be thoroughly evaluated on a priority. During lockdown we saw people taking minor symptoms or might chest pain lightly which eventually translated into major complications. The limitations could have been in terms of lack of transport facility or possibly notion that maybe emergency services would not be available and also notion that there are increased risk of catching COVID by visiting a hospital. All this led to more complicated cardiac emergencies arriving late to the hospital but on the contrary hospitals always have ran 24-7 emergency departments and were capable of taking care of all sorts of cardiac emergencies even through the lockdown period. With the lockdown being lifted we have resumed all our elective services like routine coronary angiogram, all elective coronary angioplasty, pacemaker implantation like procedures. We also have resumed our regular full-time OPD services and also emergency services have always been running even during the lockdown and also the ambulance services are there full-time available and can be accessed any moment for all sorts of emergency situations. Manipal Hospital Whitefield has always been in the front run as far as healthcare has been concerned and in this post-COVID situation we have taken at post-care and we are prepared for raising up to the situation wherein we have resumed our regular OPD services keeping in mind social distancing. We have made a lot of arrangements wherein the surface cleaning measures are taken for every OPD visit to the patient. After every patient coming out of the OPD chamber the surfaces are thoroughly cleaned on one-to-one basis and also the OPD lobbies, lifts everywhere could be the registration counters, pharmacies everywhere there are markings which guide people in achieving maintenance of social distancing. With the cooperation of our patients, we have resumed our full-fledged OPD services and for all patients who are in remote areas or don't have a transport facility and for their routine follow-up, if it is not for any active issues if it is for a routine follow-up, say like renewal of medications and all such concerns they can also approach our reaches through teleconcertation and video consultation we are available on daily basis both for regular OPD visits as well as for video consultations. Safety starts with us and we have to spread this information to everyone we should use hand sanitizers as frequently as possible and avoid touching the surfaces when really not needed and I urge everyone to use a mask every time whenever they are in the outdoors and any mask is sufficient for us and it helps us prevent and protect ourselves as well as people around us.