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.