Introduction
The COVID-19 pandemic has hit hard all over. The current situation is
still complex. We will need time to evaluate the impact and consequences
in the years to come. The price to pay will be insurmountable. Many
ongoing social, economic and organizational changes will be profound and
possibly irreversible. It will not be for good. Responsibilities for
this medical and humanitarian disaster have to be defined. In any case,
those responsible at local, regional, national or international level
will likely never, as expected, pay for this (1).
The history of the pandemic is known. It enhanced the response of the
community in different ways. A simple literature search using the term
“COVID-19” yields (July 25, 2020) 35,054 citations from December 31,
2019 when China reported to the World Health Organization (WHO) the
first epidemic cluster of an unknown low respiratory infection in humans
at Wuhan (2). This was never seen in medical literature (3). The reasons
of why this happened must be discussed in the future.
Cardiovascular surgeons participated in the care of COVID-19 patients
like many other professionals, reconverted in emergency room or
intensive care physicians, being in the front line. The pandemic
represented a major disruption in cardiac surgical programmes worldwide.
WHO declared the outbreak a Public Health Emergency of International
Concern (PHEIC) on January 30, 2020 raising to “very high” level on
February 28. The new coronavirus, termed severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2) by the International Committee on
Taxonomy of Viruses (4). The coronavirus disease (COVID-19) was
officially named in the International Classification of Diseases (ICD)
on 11 February 2020 (5). The first three cases in Europe were confirmed
in France, on January 24, 2020 (6). Thirty-six additional cases were
soon confirmed Lombardy, Italy (7).
A basic reproductive number (R0) for COVID-19 of around
2-3, estimates a high rate of spread in the early stages of the
epidemic. A R0>1 indicates the likelihood
of increasing infected numbers and that control measures are needed to
limit the spread (8). Collaborative strategies were implemented
worldwide with stress on strength surveillance and tracing to identify
imported cases and avoid community transmission to reduce the disease
burden and mitigate the devastating effects of the pandemic.