“They are strange times, times of beginnings and endings. Dangerous and powerful. And we feel it even if we don’t know what it is. These times are not necessarily good, and not necessarily bad. In fact, what they are depends on what ‘we’ are.” The author Terry Pratchett could have just as well been referring to our current global COVID-19 pandemic when he penned these words in 2010. As the coronavirus spread out from Wuhan China in late 2019, it has unleashed a crisis upon the world, the likes of which have not been seen since the Spanish Flu pandemic of 1918. It is a crisis that has been amplified by global miscommunication and mistrust. Here in the United States, at a time where it seems the basic foundations of scientific methods come under question daily, the virus has landed in the hotbed of an ultra-polarized democracy. It seems even a pandemic where lives are at stake can be a political football to be tossed around. The world's initial response has been hindered by incomplete data, political posturing, and a lack of unified, fact-based leadership.
Fortunately, science and medicine have once more stepped up to the challenge, rising above the fray. Who could have guessed even 4 months ago, new national heroes in the United States would be the likes of Dr. Anthony Fauci or Dr. Amy Acton, not to mention countless nurses, paramedics, ER doctors, and the front-line health care workers battling the ravages of the virus daily, or politicians who took early and decisive action to limit the outbreak? Health care workers from Wuhan, Italy, and Spain, both the early heroes and casualties in the fight against the disease, shared vital information. Early data from these countries highlighting the unique dangers faced by Otolaryngologists changed our behaviors and undoubtable saved the lives of many health care providers and colleagues from around the world. To those brave individuals, we all owe an enormous debt of gratitude.
This issue of Otology & Neurotology features our subspecialty's initial public response to COVID-19. It includes a joint statement from the American Neurotology Society, the American Otological Society, and the American Academy of Otolaryngology–Head & Neck Surgery that focuses on the delivery of otologic and neurotologic care during these times. Given the rapidly changing understanding of the pandemic and ability of the virus to spread, this document is by definition not intended to prescribe a definitive response. It is a snapshot of current thinking and how we can continue to care for our patients in these extraordinary times, based on the best available data and evidence from around the world. As such it is a work of history, since it may even be outdated by the time this comes to print. Yet we shouldn’t be held back by these limitations, but embrace the fact that we are learning more about the virus every day—how it replicates, how it spreads, and how it causes disease. This is the nature of science, and this is how we will overcome this global scourge.