The 2019 novel coronavirus disease (COVID-19) pandemic started in December 2019 in the city of Wuhan, Hubei province in China. It is a highly contagious zoonosis (with a reproductive number of 2.8, which means that under preexisting conditions one case generates 2.8 new cases) produced by a beta coronavirus (SARS-CoV-2) that is spread human-to-human largely by respiratory secretions and occasionally by feces.^1, 2 Over a few weeks the disease spread to other Asian countries, to Europe, to the Americas and finally across the world demonstrating a rapid doubling time (6.4 days) and an asymptomatic but highly infectious prodrome.^2, 3 On January 20, 2020 it was declared by the WHO to represent a public health emergency. According to the Johns Hopkins Dashboard, as of March 20, 2020, 166 countries and 274,180 patients had been confirmed to be infected, 11,375 have died and 87,991 have recovered. The infections occurred predominantly (87%) in people of 30-79 years-old.⁴ Most infections (81%) are asymptomatic or produce only mild symptoms, whereas 15% occur in severe form that has required hospitalization. Some 3-4% benefit from respiratory support in an intensive care unit (ICU).⁴ The death rate has been calculated between 0.39 - 4%, but this depends upon patient age and is much higher in those older than 70 years.^1, 4  The most likely population to require mechanical ventilation are the elderly and people with associated comorbidities (in particular cardiovascular disease and hypertension, followed by diabetes mellitus) with a predicted mortality of around 15-49%.⁴

Transmission is mainly produced by symptomatic patients, but it has been reported that even asymptomatic individuals and those in the incubation period (which can last longer than 14 days), can also be a source of occult transmission.⁴ Swab PCR results for most asymptomatic patients turn negative in about 3 days, while symptomatic patients typically have detectable virus for 12-20 days. ^3, 5  There is still little information about the transmission during the recovering phase.¹

Most patients treated by head and neck surgeons have cancer, the direct role of SARS-CoV-2 infection in their outcomes is unknown. To date, there is no clear evidence that cancer patients have an increased risk of infection or severe disease, beyond the immunosuppression caused by the malignancy itself.⁶ However, cancer patients have experienced a higher risk of death due to the limitations of access imposed by social distancing and the shortage of operating rooms and ICU beds.⁷