key: cord-0969644-tcc3xd12 authors: Steinmaurer, Martina; Bley, Maximilian title: The coronavirus disease 2019 proves transformability of the cardiac surgery specialty date: 2020-11-30 journal: Eur J Cardiothorac Surg DOI: 10.1093/ejcts/ezaa441 sha: 839fb416f96f4c70ca4addaf911773e84318ace7 doc_id: 969644 cord_uid: tcc3xd12 nan Forced by the implications of the coronavirus disease 2019 (COVID-19) crisis, the staff at the New York Presbyterian Hospital managed to rearrange their system of healthcare delivery to improve conditions to deal with the crisis [1] . They showed what potential for evolvement lies underneath the surface in a time of need. Even though this transformation came with an economic burden due to the loss of elective cases, this is an impressive development that shall serve as an example of transformation capacity within our specialty. This example shows that transformation of cardiac surgery is possible and makes one wonder where else our specialty could profit from this newly-found ability of transformation. One area that could profit from a change in perception as shown in the COVID-19 crisis is global cardiac surgery. In 2018, the 'Cape Town Declaration on Access to Cardiac Surgery in the Developing World' [2] encouraged commitment to increase the access to cardiac surgery. Cardiac surgery aims to facilitate a better and healthier world. Social components are a threat to this aim generated by inequality. The 2015 Lancet commission on Global Surgery showed that inequality can be fought by investing in global surgery. There is an estimated financial benefit of 12$ trillion for low-and middle-income countries based on an investment of 350$ billion over 15 years [3] . This includes the fight against burdens of society such as rheumatic heart diseases, which can affect over 80% of the world's population. COVID-19 proved the importance of global health in all parts of medicine and society. Therefore, we should take it as a trigger to deal with global health issues in a world where 93% still lack cardiac surgical care [4] . Hopefully, the ability of transformation prompted by the COVID-19 crisis as shown by George et al. will affect new aspects of our global cardiac community. The rapid transformation of cardiac surgery practice in the coronavirus disease 2019 (COVID-19) pandemic: insights and clinical strategies from a centre at the epicentre The Cape Town declaration on access to cardiac surgery in the developing world Global surgery 2030: evidence and solutions for achieving health, welfare, and economic development Global cardiac surgery: access to cardiac surgical care around the world Großambergstraße 110, 4040 Linz, Austria. Tel: +43-6506355241; e-mail: martina.steinmaurer@gmail.com (M. Steinmaurer)