LAUSR

‘Unprecedented’, ‘unexpected’ and ‘unique’: all words used around the world to describe the COVID-19 pandemic that is engulfing us. Reactions have been varied with statements of ‘I told you so’ and ‘predictions of disaster’ subsequently brought into sharp focus by the reality of shocking numbers and true events. Graphs depicting the number game based on doublings every 2, 3 or 4 days being proven unnervingly true in reality makes the maths of infections and events so very real. We watch the regular updates as each country strives for the plateau of infections and the elusive decline in numbers. The crisis generates many emotions in the caring profession, and most of those involved are very much outside their comfort zone with the management of this invisible enemy [3, 4]. We must balance our own protection and that of our family against the progressive nature of the shutdowns and lockdowns in our own, and now virtually every, country [2]. Through this event, we, as scientists and surgeons, have to draw on our experience and show leadership to our colleagues and to our country and ultimately to the world. Within each country, individuals have stood above the parapet and driven progress with policies and thought on the best way to tackle the rapid progression, as reality hits. The military consider disaster and event planning as normal and this strategic organisational role spreads to military medicine and on to civil medicine. As the military roll out field hospital capability across Europe, we face the stark possibility and probability of a different form of medicine with mass decision-making and the reality of harsh resourcebased discussions. Triage in Italy during the peak was a clear example of the hard-hitting nature of this pandemic with doctors facing decision that they may only have read about. The methods for considering innovative methods to cope have been impressive and the sharing of information for treatment and avoidance has been truly staggering. What is learnt from one area is freely shared by doctors with doctors they have never met, and the information is grasped with a keenness that only the gravity of this situation can explain. Science-based treatment strategies supplement creative thinking transferring disease knowledge to Coronavirus management, while formal trials are established [2, 5]. WhatsApp, Zoom and other social media platforms supplement the open news channels but provide the real detail in facts and recommendations. Policy documents and guidelines are rapidly spread, and we applaud the innovation and decisiveness. These new communication methods will have a lasting impact on how we handle medical situations and we have all learnt now the benefits of effective teamwork, while being flexible in tolerating updates. Humour, sometimes dark but mostly truly funny, has been widely spread as crisis comedy so often appears at these times. And through all this there has been innovation and lateral thinking. We await the breakthrough testing and vaccine solutions that will allow us to emerge from this cloud. The crisis has hit hard, however, at the personal level in all countries with the substantial impact on doctors, particularly the dramatic loss of life that has been seen in China and in Italy [1, 2]. All our thoughts go to the families and colleagues of all those who have given their lives in this * Tim Spalding [email protected]