Coronavirus Disease 2019 Pandemic

To the Editor: T he emerging epidemiological data underscore the global impact of the coronavirus disease 2019 (COVID-19) pandemic. Since the first case was reported in December 2019, in Wuhan, China, the subsequent 4 months have seen the virus spread to every continent. In tandem with increasing infection rates, the mortality associated with the infection continues to rise, with over 90,000 deaths reported worldwide with most authorities recognizing that this does not reflect the actual level of infection or mortality. Research towards a vaccine and effective antiviral therapy is underway with much of the effort in the Western world being targeted towards manufacture of mechanical ventilators to ensure timely treatment of COVID-19 patients. The pandemic has, in addition, at least had significant shortto medium-term effects upon social activities, education, and the economy, although positive environmental effects have been noted. The initial and on-going media focus has predominantly and rightly focused upon tracking the spread of the virus, its associated health indices, and the ensuing economic downturn. With the focus continuing to be centered upon COVID-19 as a health emergency, sparse attention is currently being paid to the inevitable effects upon management of other diseases during this time. The rapidity of viral spread has forced a speedy redistribution of resources in almost all health care systems around the world with priority being centered on ensuring intensive care unit (ICU) capacity, which in some instances has meant that operating rooms are being used as additional ICU beds meaning that anesthetic staff are being deployed to care for these patients. As a result, surgical services have reduced their workload with most elective surgery being postponed. The 4 surgical Royal Colleges of the United Kingdom and Ireland have released a joint consensus statement providing guidance for emergency general surgery, but the same has not been published for cancer surgery. A negative effect can be anticipated for patients