Editing from the dungeons of the pandemic; an editor's agonisingly painful battle with COVID-19

Lying in the high dependency unit along with one's family, with the uncertainty of being shifted any moment to the coronavirus disease intensive care unit (COVID ICU) looming over the head (as 25% of the lung volume is severely affected), is a dire situation that one can face during one's lifetime. Apprehensions get heightened when you faintly remember the glimpses of all such critical patients whom you had been managing for the last six months in your own critical care arena and few of which could not be saved from the clutches of COVID in spite of your best efforts. Harbouring COVID is like fostering a potential time bomb which can either slowly diffuse or blow up any time taking you also along with it. The penning down of this editorial is unique in the sense that it has been written by an editor who is in the strong grip of COVID, having his alveoli punctured by the sickles of the coronavirus and with biomarkers running amok, threatening to invade the remaining normal zone of the lungs and the internal milieu as well. When you are suffering severely from COVID, everything appears meaningless. The only immediate strong desire and wishful prayer at this stage which predominantly occupies your mind is to come out of the dungeon of COVID. The principles and priorities of life can suddenly get changed within 3–4 days. Further, the priorities of academic and editing duties seem to be tertiary and far from secondary at the moment with a sudden slaughter of interest in any activity of life. But sitting idle and doing nothing only kills the mind; I thought it would be prudent to divert my mind rather to some constructive and positive thoughts. Nothing brings in more positivity than the passions which you follow; but those too at the moment, seem nearly impossible for me, the exercises and workouts which are deeply relished by me. The only solace at this moment is that half of my family is by my side and it gives me ample courage to write this editorial and to carry on with academic work, to divert my mind from the thoughts of potentially dangerous COVID complications. Life is so contagious and passionate that it keeps bringing optimism from some end. The instinct to survive, to carry on with grit the other commitments and responsibilities of life and positive thoughts have kept my hopes afloat and alive. We are all currently sitting on the lap of the mother of all the pandemics, and she is uncontainable despite so many advances in the medical field. The administrative and the government machinery throughout the globe are also finding themselves in a very precarious situation to halt the spread of this pandemic. Everybody seems clueless at the moment with changing clinical scenarios and rapidly changing guidelines and advisories by the top health organisations of the world. This pandemic has invaded all the geographical, social, political and clinical boundaries to spread its fatal tentacles universally. The daily news of medicos, especially young ones, passing away while taking care of critically ill COVID patients, is leaving a permanent scar on the psyche of the rest of the frontline warriors. No substantial or concrete evidence has accumulated till date with the help of which we can assume or be certain to get rid of corona shortly. It appears as though the 'corona mela (fair)'is currently going on with enthusiastic vendors (journals) exhibiting and selling their coronavirus-related products (publications). The mad rush for coronavirus related publications only shows that all research activities being carried out currently in the universe mainly aim to get the material published first without much solid or concrete evidence in finding a rock solid answer to this peril which does not seems to end soon. Simple “jugaad (ideas)” are being projected as possible solutions without proper validation under different circumstances. Efforts are being projected by twisting the language of simply established maneuvers to make them look more presentable from the COVID aspect. Rather than helping, this chaotic research is creating a lot of confusion and the clinical applicability of such published material may pose a big question in the coming days. Almost every second manuscript is being written in alacrity without the authors even knowing the possible consequences of such manuscripts in the long run. The Clinical Trials Registry- India (CTRI) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) have also speeded up the registration process for COVID-19 related studies. Presently, working in isolation fields is not helping the cause either; rather it is delaying the ultimate solution to the COVID-19 menace. Many Phase II and III trials which were giving hopes up till now are fizzing out without providing any real-time therapeutic solutions. Even the advent of a permanent vaccine seems a distant dream at the moment. Whatever global evidence is getting published currently is not providing the accurate way forward. Considering the 'new normal' at the other end of the spectrum, life must go on. The zest has to be there and one should not get bogged down by the coronavirus. The essential activities of life have to continue albeit with cautions. Daily routines cannot be sacrificed but all our activities, including professional, should be carried out in a guarded manner. Editing is almost a full-time profession and for the Indian Journal of Anaesthesia (IJA), it is an honorary work associated with both pride and responsibility. As mentioned in a previous editorial, the work for the editors and reviewers is sometimes interesting and sometimes boring; but it is almost 7 days a week.1 However, in the last 6 months, COVID has taken away a lot of zeal from the editing process; truly enough, the things look less meaningful at present in a situation wherein everyone, including editors and reviewers, are fighting everyday for their own as well as their families' survival in addition to the survival of their critically ill patients. This honorary editing and reviewing work comes without any emoluments and at the cost of sacrificing precious family times and plucking the time out of professional busy schedules while performing all the day to day duties.2 Will it give any real satisfaction in the present scenario? The reply to this query will remain unanswered for a long time to come. To add insult to the injuries, many authors keep sending queries, answers to majority of which are available on the website of IJA. Some queries are genuine but the majority just want an update on the status of their manuscripts although they had submitted their manuscripts not so long ago. They do not realise that editors and reviewers are also human beings, passing through the turbulent phases of life which may be filled with a lot of turmoil, especially during the period of COVID dominance. Nonetheless, editors and reviewers expect good conduct from authors and it is least expected from the frontline corona warriors to ask these worthless queries.2 Self-interest at this stage should be given a low profile. Authors should remember that the promotional avenues will always remain open and asking such questions during these troubled times to hard-working editors and reviewers will certainly amount to mortifying their dedication and sincerity. I, on behalf of the editorial board, wish to assure all authors that at IJA, their articles are judged completely on merit; acceptance or rejection depends upon the quality of the articles from all aspects including technical and does not depend upon the reputation of the authors or the institution. As has been mentioned before, the quality of research articles in the IJA has been ever-improving and we have to maintain these standards.3 The frequency of the issues of the IJA has increased in the past few months. Thematic issues and zonal supplements are being released. All this has produced a lot of improvement in the quality and quantity of the research output from our nation, though at the cost of the comforts of the editorial board. It is difficult to determine who is suffering from COVID at present (editors and reviewers) but still it is expected from the frontliners that rather than expecting a quick reply for their manuscripts (many times these are the non-original articles), they should show camaraderie with the editorial board members. Every author is expected to have faith and belief in the timeliness and working of the IJA. Sending superfluous queries only decreases the credibility and respect towards the academic decorum of IJA. Peer review is a slow process, sometimes deliberate and is not suitable for the rapid dissemination of critical information during a pandemic crisis. Rapid dissemination of knowledge is of paramount importance provided it is evidence-based and concrete. At IJA, COVID-19 articles have been allotted a very rapid review process but the momentum of other articles has taken a back seat as other manuscripts are moving at a normal speed. The original research and other articles in this issue of the IJA are just an example, of how life can continue in the world of research academics even during these difficult COVID times.4567891011121314151617181920 Over the last 6 months, IJA has received almost 25–30% of the manuscripts on COVID. It is almost near to impossible for the editorial board members to do justice to such a huge deluge of academic material in a short period but still, somehow they are managing the academic load of IJA by taking the time out from their precious family and professional schedules. The number of submissions in the current year till date has crossed 1300 as against 980 till 31st December 2019 during the last year. However, not a single member of the editorial board has ever complained against the workload and is proficiently managing his or her editorial duties. IJA is meticulous in not printing any erroneous message or articles on COVID which serve no useful purpose other than the credit of publications for the authors. It is the prerogative of the IJA to publish those articles on COVID which establish trust amongst readers. Ideally speaking, if COVID articles get published with a rapid peer review, the reliability, going by the dynamic changing clinical scenario, at present may be limited apart from the doubts upon the scientific validity and correctness. However, IJA is still committed to publishing high-quality COVID articles on priority with a rapid review process. On the contrary, it also reserves the right to reject outright the gratuitous, already known and not so important information on COVID. It is with a sense of pride and honour that we, at the IJA have been able to keep up with the pace of a rapidly changing clinical scenario in our nation and bringing forth COVID publications including various advisories and guidelines at the earliest.21222324 Nonetheless, this issue of the IJA has six articles related to COVID -19.252627282930 IJA is trying hard to do away with the parsimoniousness and capriciousness of the peer review process to transform IJA into a trustworthy vehicle of knowledge dissemination through accurate, novel and sound scientific publications.31 IJA can be considered as a critical janitor of our anaesthesiology and intensive care community which is combating hard on the frontline for the very survival of humanity. The meticulous selection process of the articles makes it imperative that the data getting published in IJA is scientifically correct, reproducible and which can be easily imitated in all type of settings. The message from the editorial board is clear that at this stage, nothing is more important than taking care of your health, the health of your family, your peers and the health of everyone around you. Research work in the non-COVID area can wait and is not as essential as your survival. Even if the promotional avenues get delayed, life is not going to end. The enthusiasm for publishing manuscripts should not become the sole priority of the frontliners. Publications should be our priority, only if we have seen or achieved ground breaking results in the COVID treatment. The time is not for glorifying the individual self; multi-disciplinary teamwork is the need of the hour to approach and ensure safety by adopting the right direction. The unique ideas generated should have verification by a common national and international validity scale and the regimens proposed should have sound concrete evidence. In the coming months, once this pandemic is over, ventilatory management will have to be rewritten, redefined and reexplored. We should remind ourselves that life has to move on, treatment has to go on and research work on COVID also has to go on. Never give up the enthusiasm of life as it is this trigger which will create the fission of positivity. COVID-19 may or may not continue to remain with us, but life will continue and so will the academic journey of the IJA. An old quote goes 'You have to fight through some bad days to earn the best days of your life'. A Sanskrit quote says 'Na Kanchit Shaswatam' meaning 'Nothing is permanent'. So, I am certain that just as the dark night is followed by a brighter day, these dark COVID times for our editorial team members, reviewers and authors will soon be followed by brighter days ahead when we can say 'Happy days are here again'!