Introduction
The recent history of Coronavirus disease 2019 (COVID-19) [1]. At
the end of February 2020, COVID-19 disease hit Europe with worst impact
on Italy’s northern regions. On February 28, the Italian Civil
Protection Bulletin confirmed 531 cases with 21 deaths [2].
In Switzerland, the first COVID-19 case was confirmed on February 25
[3]. Within a week, the virus was spread all over the country and
cases were reported from different Cantons [4]. The World Health
Organization (WHO) declared COVID-19 a pandemic on March 11, pointing to
118,000 cases in over 110 countries and the sustained risk of further
global spread [1]. This had obvious impact on local and national
clinical and academic activities all over Switzerland. Immediate
challenges were evident. Nobody was initially ready for this.
On February 28, the Swiss Federal Council, categorized the situation in
Switzerland as “special” [5], in terms of the Epidemics Act, in
force since \sout01.01.2016 January 1, 2016 [6]. Events involving
more than 1,000 people were banned with immediate effect. An
“extraordinary situation” was declared by the Swiss Federal Council on
March 16 also in terms of the Epidemics Act. All shops, restaurants,
bars and entertainment and leisure facilities had to remain closed. As
of midnight that day, checks on the borders to Germany, Austria and
France were introduced. The Federal Council authorized the deployment of
up to 8,000 members of the Armed Forces to assist the Cantons at
hospitals and with logistics and security [7]. Following strict
observance of measures at the national level, the Swiss Federal Council
declared that on April 27, hospitals could resume all medical
procedures, including non-urgent procedures, and outpatient medical
practices, with the proviso that protection of the public and of staff
must be assured. The declaration aimed at helping people and businesses
to plan by announcing its schedule for the further easing of lockdown
measures up to the start of June [8].
There was immediate local reaction on February 28. Contingency plans
were devised to tackle the sudden unexpected disruption of activities.
The University Hospital of Zürich (USZ) established a specific Task
Force led by the Hospital CEO. The Task Force established mandatory
basic hygiene measures, including different types of personal protection
equipment (PPE) in relation with different levels of patient care. USZ
staff was instructed to follow the recommendations issued by the
Regional Healthcare Department. Homework policies were issued. USZ
cancelled all already scheduled national and international academic
activities entailing close interpersonal contact. Attendance to
scientific events, national and internal, was forbidden. All elective
operations and procedures were postponed on March 16, as per the Federal
Council declarations. Academic activities were therefore heavily
affected. There was appropriate reaction as recently described [9].
The Swiss Federal Office for Public Health (BAG) daily updated data on
confirmed cases of COVID-19 and deaths due to infection, the national
epidemiological situation, the information on contact tracing, search
for antibodies and communication strategies on its website [4]. The
BAG relied on the cantonal authorities for tracing transmission. At the
time of writing this contribution on July 19, 2020 the BAG has
registered 33,431 confirmed cases with 1,687 registered COVID-19 deaths,
for a 5.0% death rate. This data summarize the epidemiological
situation in Switzerland and the Principality of Liechtenstein [10].
There has been massive impact of COVID-19 on the society. Switzerland
had one of the highest number of infections per capita in the world
during the initial wave, as reported by Salathé et al. [11]. In the
middle of March 2020, the authors confirmed that operational challenges,
rapid and determined prevention of transmission while minimizing the
damage to the health of the population were the objectives of testing,
contact tracing and isolation [11]. The following summarizes the
impact of COVID-19 on cardiac surgery.