All elective surgeries (such as total knee replacement) have been postponed indefinitely, while surgeons using full protective gear will perform high-risk aerosol-generating procedures (such as extensive burring/drilling). A geriatric hip fracture case was actually confirmed to be COVID positive after her hemiarthroplasty, fortunately, none of the medical staff was infected.

Samuel Ling, MD

Assistant Professor of Orthopaedics & Traumatology

The Chinese University of Hong Kong

Hong Kong, China

Currently, as on 17/03/2020, there have been 4 deaths reported in India, and the number of infected cases in India have reached 149. Pune has reported 16 cases already. In my opinion, we are in the 2nd phase of this pandemic and there is a possibility that further spread may occur and the scenario may worsen if we enter the 3rd phase wherein communities may get infected.

Parag Sancheti, MD, FRCS (Ed), MS, DNB, MCh ,Ph.D

Professor & Chairman Sancheti Institute

For Orthopaedics & Rehabilitation

Pune, India

It is crucial to enhance international communication and collaboration to fight the disease. The key message is to alert the mass of common people, globally, to do their best to prevent infection. I estimate that the pandemic of COVID-19 might end in June this year. However, if not all the countries take this seriously and put in action interventions, the anticipated turning point of its pandemic will postpone.

Nanshan Zhong, MD

Professor, Chinese epidemiologist and

pulmonologist who discovered

the SARS coronavirus in 2003

The steady declination of cases in recent two weeks in China has been credited to the effective national interventions. We need to keep the data open and transparent, enhance sensitivity of early nucleic acid testing is important. Any intervention strategies should be evidence-based. Policy-makers should take actions based on the local public health experts’ opinion. Community isolation is probably inevitable. Every area should try efforts to find the best model fitting to local condition. Lastly, it is valuable to enhance international communication of researches and experiences on the pandemic control.

Guang Zeng, MD

Professor, Chinese Epidemiologist

Chief Scientist from the Chinese Center for Disease

Control and Prevention (Chinese CDC)

In Mexico, COVID -19 cases are just starting to climb, with around 120 cases reported so far. Streets are empty and misinformation is climbing. Our politicians are not doing their part- only thinking about re-election maneuvers. The healthcare system is preparing for the worst-case scenarios and are trying to learn from other countries experience. Young doctors are ready to fight, while older doctors try to dig into there experience to fight against this virus. We as a society have to be brave and strong to be able to get a victory around this scary situation

Edmundo Berumen, MD, FRCSC

Orthopaedic Surgeon

University of Mexico

...the Division of Trauma at R Adams Cowley Shock Trauma Center are into our second week of significant changes to mitigate the impact of COVID-19...we conduct our daily Morning Report virtually—each member of the team in a different office. Clinically, we have split our service into three teams working 3 days at a time. We are making all these changes to prevent the spread of the novel coronavirus within the team, and most importantly, to ensure we have sufficient personnel once members get infected. Will this work? The uncertainty is quite unnerving.

Gerard Slobogean, MD, MPH, FRCSC

Associate Professor, Department of Orthopaedics

University of Maryland

With time and implementation of a lot of drastic policies & stringent measures, Hong Kong has been able to prevent major outbreak in the community....gradual resumption of elective surgeries, increasing outpatient attendance, more interactive educational activities, and progressive normalisation of all the research works have been coming back gradually since early March 2020. Having said that, because of the outbreak in America & Europe in the recent few weeks, Hong Kong is again at threat of another wave because of infected cases from overseas...

Professor YUNG Shu Hang Patrick JP

Chairman, Department of Orthopaedics & Traumatology, Faculty of Medicine, The Chinese University of Hong Kong

President, Asian Federation of Sports Medicine

In consequence of COVID-19, the orthopaedic community has come to a standstill in Canada, with most centres acting responsibly by cancelling all elective surgery and nonessential clinical visits to limit interactions…. Throughout Canada, responsible orthopaedic surgeons are exclusively treating urgent cases and adopting strict safety protocols to avoid further spread of COVID-19 while delivering emergency care… we commend your efforts and are grateful for your contributions.

Mark Glazebrook, MD, FRCSC, PhD

President

Canadian Orthopaedics Association

The COVID-19 is also increasing in Germany with a current number of infected cases around 58.000. Fortunately, the mortality rate in Germany is with 0.77% signifcantly lower compared to other countries. One reason for the lower mortality might be the fact, that the German government started early with preventive policies to avoid the corona virus spread. In Germany, the vast majority of hospitals have postponed elective surgeries, interventions and admissions in order to have free capacity for COVID-19 patients. In our arthroplasty center, we only perform cases such as periprosthetic fractures, dislocations of the hip prosthesis, periprosthetic joint infections or acute spinal disorders.

Mustafa Citak MD, PhD, CPT

Hamburg, Germany

As of March 28, there are 1909 COVID cases in Chile with 6 deceased people. The highest percentage of cases (56.8%) is concentrated in the Metropolitan Region… In conversation with some orthopedic colleagues, only emergency surgeries are being performed at various healthcare centers. All elective surgeries have been postponed until further notice.... Also, in the centers where I work, the teams have been divided so that one group is active and the other group is in preventive quarantine for 2 weeks. At the end of this period we will make the respective change.

Fernando Vargas, MD

Foot and Ankle Surgeon

Clinica Santa Maria

Hospital Mutual de Seguridad

In Amsterdam the COVID19 situation is still under control. The hospitals are preparing for a worst case scenario. All elective cases are postponed. OR staff is trained to use ventilators in ICU setting. The OLVG hospital launched a smartphone app to monitor inhabitants of Amsterdam who have minor symptoms. In this way the hospital is able to gauge the situation and is prepared to scale up. All residents - including ortho - are taking shifts to answers questions from app users and give advise. Never waste a good crisis. This gives us opportunities to speed up digital consultations with patients. We hope to find smart solutions working towards a digital hospital.

Rudolf W. Poolman MD PhD

Orthopedic Surgeon-Scientist

Leiden University Medical Centre

Leiden, Netherlands

SARS-CoV-2 coronavirus has crossed all borders. In Spain, the coronavirus is growing exponentially. Radical measures that the situation demanded have been taken late. Data from 7 April report more than 140,511 confirmed Covid-19 cases and more than 13,897 deaths. Tests are not done on all symptomatic patients, so it is considered that only 20% of cases are being diagnosed. Around 12% of Health personnel has been infected. Since March 14 the radical measures were taken and confinement is rigorously controlled, probably this is the reason why new infected cases and new deaths are decreasing. Data that should be taken with caution.

Ernesto Guerra

Vall d´Hebron University Hospital

Barcelona, Spain