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Thorac Cardiovasc Surg 2020; 68(06): 457-458
DOI: 10.1055/s-0040-1715890
Editorial

COVID-19, Naturally

Markus K. Heinemann
1   Department of Thoracic and Cardiovascular Surgery, Universitätsmedizin Mainz, Mainz, Germany
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There simply was no way around it any longer. Apparently “it is expected by the media” that “everybody of relevance” issues a statement, however vague, on the influence the coronavirus disease 2019 (COVID-19) pandemic has (had). This I learned from a serious-looking press officer during a recent briefing for a press conference. “Oh well,” I thought (Rest in peace, Peter Green!), let's get it done with—and here you are.

Faithful readers of this column will remember the Editorial in issue 8/2019 entitled “The End Is Nigh,”[1] in which I predicted that one of these days some bug or other would “start to successfully and persistently decimate mankind.”[1] Oh well—there you are again. I just did not expect it to happen so soon.

Meanwhile we have all had our experience with lockdowns and facemasks (easy for surgeons) and social distancing and what not. For many doctors, workload suddenly became overwhelming and there was and still is (!) every reason to believe that one might not get out of this alive or unharmed. Apparently, one-fifth of all COVID-19 patients treated in a German hospital died, more than half of those who needed ventilation.[2] Definitely a disease one should try to avoid by all means. The present, somewhat carefree attitude of many citizens is disturbing, and the relapses seen here and there should be ample proof that this menace has not blown over yet. It is cynical but probably true to suggest that we did not have enough of a catastrophe here in Germany to sensitize our people.

The cardiac surgical community became involved through ECMO (extracorporeal membrane oxygenation) therapy and intensive care, and otherwise wondered where all the cardiac patients had gone. The same is true for our colleagues from cardiology: less infarctions, less strokes, few malignant arrhythmias. Were patients simply too afraid to enter a hospital and died at home? This should then be reflected by an increase of casualties at home. True causes of death may remain obscure, however, because of the scarcity of postmortems. It remains doubtful if we shall ever get valid knowledge in this respect. But what if there was an unchanged number of deaths at home during and before the critical period? Did lockdown measures then actually lower the risk of fatal cardiovascular disease? So was it really the daily anger at work or in strenuous retirement that killed people before COVID-19, after all? Or the doctors in the hospital? It will take a while to get reasonable and reliable statistics investigating this. Maybe we'll never know.

On the other hand, new diseases were created, for instance, “Zoom-fatigue,” type I: a kind of burn-out, but caused by too many video conferences and their associated worries: what to wear, where to sit, what to do with the itch in your nose or the pee in your bladder? Troubles and sorrows – but still less infarctions. Type II: high blood pressure crises, caused by the university's demand to switch to virtual teaching instantaneously with an IT equipment based on something called Windows 7 and a computer which needs 10 minutes to boot. No camera, no mike, no WiFi, no nothing, but the first virtual seminar scheduled by the administration for next week. Enough to make you arrest on the spot—but it did not happen.

And the journal? ThCVS is currently processing a few manuscripts dealing with COVID-19 influences or incidences in cardiothoracic surgery. ThCVS Reports offers a 50% discount on the APCs for COVID-related papers, feeling that there might be a surge of individual and limited experience still worth to be published because of the general insecurity. On the other hand, it is exactly this insecurity that poses an enormous challenge to scientific publishing as we know it. It is understandable that everybody wants to get new information as fast as possible. But is it reliable? Very renowned journals were forced to retract or to put into recent perspective articles, which had hit the market early on but apparently prematurely.

The COVID-19 crisis very nicely points out the problems that serious peer review has run into with the need to rapidly inform on one side and keeping trustworthy standards on the other. It is a difficult balance to achieve. Our own policy is, as usual, to keep calm and carry on, but a cardiothoracic surgical journal is certainly and luckily not the primary target for pandemic-related content. This may not be the best situation to increase your journal impact factor this year, but, on the other hand, it takes a lot of stress off the Editor, perhaps extending his life expectancy for a change.



Publication History

Article published online:
17 September 2020

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