key: cord-259269-hjmmn8xm authors: Nattel, Stanley; Graham, Michelle; Krahn, Andrew title: A Focus on Covid-19: Fast and Accurate Information to Guide Management for Pandemic-Related Issues in Cardiac Patients date: 2020-04-25 journal: Can J Cardiol DOI: 10.1016/j.cjca.2020.04.029 sha: doc_id: 259269 cord_uid: hjmmn8xm nan The Covid-19 pandemic is in "full flower", causing the shedding of many tears for the innocents who have suffered and died, despair over incomes lost and businesses endangered, and spilling of much ink (some of it useful). This new reality has set in much faster than we have been able to absorb it and adjust. The (Table 1) to digest the rapidly emerging information and provide prompt guidance through the CCS website (www.ccs.ca). Areas covered include the use of renin-angiotensin system inhibitingagents in Covid-19 patients, special considerations in managing cardiac implanted electronic devices (CIEDs), guidance on extracorporeal membrane oxygenation (ECMO), cardiac procedures, and the distinction between Covid-19 pneumonia and heart failure. A full list of CCS guidance documents is available in the editorial by Graham et al in this issue. 1 For its part, the CJC has developed a strategy to allow rapid review, dissemination and publication of manuscripts related to Covid-19. All relevant submissions are sent out for rapid review, aiming to provide an editorial decision within 7 days. Papers are then published rapidly in electronic form and designated for print publication in the next available issue. The first set of Covid-related papers appears in print form in this (June) issue of CJC, and is the focus of the issue. Several papers reflect a close collaboration between CJC and the CCS rapid response strategy. These articles provide detailed guidance from the CCS and affiliate societies on cardiac surgery during the Covid-19 epidemic, 2 minimizing the risk of drug-induced long QT Syndrome with QT-prolonging drugs used to treat Covid-19, 3 and post-discharge cardiac rehabilitation needs during the pandemic. 4 They are accompanied by an editorial by Graham et al, dealing with a crucial and too-easily overlooked matter: the psychological well-being of health-care workers. 1 This article deals with the risks of anxiety, insomnia, depression and burnout, and also with mitigation strategies to prevent them. Recognizing the problem is not enough; we all need to take active measures to handle it. These are followed by a compelling review by Peng et al, detailing the extensive early experience in China. 5 This article carefully reviews epidemiology, public health control and management issues. In many ways, the Chinese experience has become a template for Covid-19 control. The key (and to date only) method established to combat Covid-19 is prevention. The Chinese used vigorous case identification, along with tracking of contacts and isolation of sources of infection, to limit spread and eventually allow cautious resumption of activities. While one can argue about the precise details of the Chinese approach and its effectiveness, one must not ignore it and the many lessons that can be learned. China and other countries like South Korea that effectively controlled Covid-19 relied heavily on extensive screening followed by careful isolation/tracking of cases and contacts. Since effective broadscale vaccination is likely 12-18 months away, the only way that the public can be protected, while avoiding economic ruin, is to enforce strict public health measures. Any society that attempts to reopen economic activity without careful public health controls risks seeing rapid reactivation of widespread infection and death. patients, 11 reminding us that Covid-19 can produce serious cardiac complications. 5 Finally, Babu et al provide discuss approaches to maintaining cardiac rehabilitation services despite social distancing and limited institutional access. 12 Their suggestions for more effective use of technologically-driven remote rehabilitation may prove valuable outside the pandemic in underserviced areas of challenging environments like rural Canada. 13 CJC and CJCO are continuing to receive many submissions related to Covid-19, and to prioritize rapid editorial consideration and dissemination. Covid began as a sprint, but unfortunately is likely to play out as a marathon (and will feel still longer); optimizing the information base will help to deal with the cardiovascular complications along the way. Feel Better, Work Better -The COVID-19 Perspective Cardiac surgery in Canada during the COVID-19 Pandemic: A Guidance Statement from the Canadian Society of Cardiac Surgeons Guidance On Minimizing Risk of Drug-Induced Ventricular Arrhythmia During Treatment of COVID-19: A Statement from the Canadian Heart Rhythm Society Post-Discharge Cardiac Care in the Era of Coronavirus 2019: How Should We Prepare? Management and Treatment of COVID-19: The Chinese Experience Rapid Scholarly Dissemination and Cardiovascular Community Engagement to Combat the Infodemic of the COVID-19 Pandemic Considerations for scaling down fetal echocardiograms during the COVID-19 pandemic An In-hospital Pathway for Acute Coronary Syndrome Patients During the COVID-19 Outbreak: Initial Experience under Real-world Suboptimal Conditions What is the Role of Angiotensin Converting Enzyme 2 (ACE2) in COVID-19 Infection in Hypertensive, Diabetic Patients? Angiotensin converting enzyme 2 as the molecular bridge between epidemiologic and clinical features of COVID-19 Characteristic ECG Manifestations in Patients with COVID-19 COVID-19: A Time for Alternate Models in Cardiac Rehabilitation to Take Center Stage Cardiac Rehabilitation Availability and Delivery in Canada: How Does It Compare With Other High-Income Countries? No disclosures.