Table of Contents  
EDITORIAL
Year : 2020  |  Volume : 7  |  Issue : 4  |  Page : 333-334

2020 – The year of COVID


Narayana Institute of Vascular Sciences, Narayana Hrudayalaya Hospital and Mazumdar Shaw Multispeciality Hospital, Bengaluru, Karnataka, India

Date of Submission06-Dec-2020
Date of Acceptance06-Dec-2020
Date of Web Publication24-Dec-2020

Correspondence Address:
Robbie K George
Narayana Institute of Vascular Sciences, Narayana Hrudayalaya Hospital and Mazumdar Shaw Multispeciality Hospital, Bengaluru, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-0820.304627

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How to cite this article:
George RK. 2020 – The year of COVID. Indian J Vasc Endovasc Surg 2020;7:333-4

How to cite this URL:
George RK. 2020 – The year of COVID. Indian J Vasc Endovasc Surg [serial online] 2020 [cited 2021 Jan 23];7:333-4. Available from: https://www.indjvascsurg.org/text.asp?2020/7/4/333/304627



As we complete the dubious 1-year anniversary of the first COVID case in Wuhan, it is time to look back on what COVID has meant for the medical and vascular community. Over the past 12 months, the disease and our response to it has changed from ignorance and disdain in November–March to the most extreme lockdown in March as fear and even panic spread across the country. The last few months have been dominated by what could be termed COVID fatigue – the populace seems to just accept it as part of the environment, and the paranoid fear of the second quarter of the year has given way to an almost-callous disregard.

India has been remarkably fortunate, in comparison to Western populations, in how COVID has affected the nation. If we recall the time when COVID was first detected in the slums of Dharavi – we all feared for the worst and could imagine the dead bodies piling up. For some unknown reason, despite our overrun and underfunded health-care system, we just didn't see the catastrophe on the scale of Italy, Spain, etc. Whether we can attribute this to better immunity as a consequence of the poorer hygiene levels, bacillus Calmette–Guérin vaccine, or perhaps a different genetic predisposition from Caucasian populations is yet unknown.

The COVID crisis has certainly had certain unforeseen benefits. For starters, the whole world has realized the value and courage of the health-care sector – how long this recognition lasts is of course another question. Scientific thoughts and research awareness of ventilators, oxygen therapy, antivirals, vaccines, and the very concept of evidence-based medicine have all gained a huge popularity. Compared to past pandemics, the effect of coronavirus has been hugely blunted by our application of science. Our responses have evolved very rapidly and the medical community should take pride in how it has stepped up. Perhaps, all of these will inspire the next generation to become scientists and doctors to achieve even greater heights.

Vascular surgery has suffered and benefitted during this crisis. We have suffered as victims of the disease even as we have learned its biology. We have suffered with being some of the first teams to operate on COVID-positive patients. At the same time, the very term vascular has entered the common lexicon. The awareness that microvascular and macrovascular thrombosis as a major driver in the progression of the disease has brought a renewed focus on anticoagulation.[1] The need for anticoagulation in the management of sick patients with COVID has been established beyond doubt.[2] The result is an awareness of the role of anticoagulation for sick patients is far beyond what many years of campaigns could achieve – the benefits of this new knowledge will hopefully change long-term clinical practice for the better. There has been a lack of clarity regarding the appropriate prophylactic and treatment regimes and many guidelines are available.[3] Within the Indian context, the usage of newer oral anticoagulants has exploded – with its attendant benefits and complications.

Today, as vascular surgeons, we keep coming face to face with the vascular complications of COVID [Figure 1] and [Figure 2]. This has pushed the specialty to greater innovation with increased use of minimally invasive techniques for both arterial and venous thrombosis.
Figure 1: Clot occluding the entire popliteal artery trifurcation in a COVID patient

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Figure 2: An ischemic “trash foot” in a COVID patient

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The other unintended consequence of COVID and the associated lockdowns has been the absolute explosion in digital education. This has ranged from innumerable webinars to the very successful virtual VSICON 2020. This period has exposed us to the benefits of virtual education but also to the limitations of virtual conferences. The experience and knowledge sharing and the benefits of social interaction are a significant loss in a virtual world – we have perhaps begun to appreciate it more than ever.

This issue of the IJVES comes out as humanity waits to say goodbye to a most challenging year. This is a time to reflect on the mixed outcomes of the coronavirus pandemic – it has exposed our human frailties but has also brought out the best in humanity. Wishing all of us a safe and happy 2021.



 
  References Top

1.
Suresh K. COVID and the clots. Indian J Vasc Endovasc Surg 2020;7:205.  Back to cited text no. 1
    
2.
Obi AT, Tignanelli CJ, Jacobs BN, Arya S, Park PK, Wakefield TW, et al. Empirical systemic anticoagulation is associated with decreased venous thromboembolism in critically ill influenza A H1N1 acute respiratory distress syndrome patients. J Vasc Surg Venous Lymphat Disord 2019 1;7:317-24.  Back to cited text no. 2
    
3.
Barnes GD, Burnett A, Allen A, Blumenstein M, Clark NP, Cuker A, et al. Thromboembolism and anticoagulant therapy during the COVID-19 pandemic: Interim clinical guidance from the anticoagulation forum. J Thromb Thrombolysis 2020;50:72-81.  Back to cited text no. 3
    


    Figures

  [Figure 1], [Figure 2]



 

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