found to be unprepared to deal with this new, unknown disease. Despite the reaction of the scientific world is planetary with more than 2000 trials started in a few months, so far there are neither specific treatments nor vaccines. The virus and its effects remain unknown and shrouded in mystery. There is not a clear enemy to combat such as a coronary plaque or a leaking or stenotic valve (Figure 1). Psychologically, the unknown generates fear and anxiety. It follows that perception of the COVID-19 pandemic is worse than that of CVD although the consequences and the number of victims between the 2 are incomparable.The COVID-19 outbreak, often concentrated in limited areas, has rapidly transformed individual undertakings to a mass scenario which is communicated daily in numbers of infected or deaths on television and social media with the result that everybody has lost sight, significance, and importance of every single death within an epidemiological forest of numbers. In front of this, the medical-scientific world remains stunned. It implodes, with a lack of ideas on how to react. The defence strategy consists of hiding and shutting down society, despite the knowledge that this cannot last, and the price might be even higher than the disasters caused by the virus which, in any case, are significantly less than those of other epidemics, as the one of CVD. However, CVD does not reach the interest of the media. We are simply used to it.
Two epidemics at the same time are too much: the collateral damageEmphasis on COVID-19 has created concerns about contracting the infection during a hospital stay, ultimately causing a series of collateral damages. 4 This is true for all diseases, but particularly so for CVD and more specifically, for acute coronary syndromes (ACS), a timedependent pathology.All over Europe and the USA, during the early days of the epidemic, fewer patients reached the hospitals for ACS and. . .ACS were not prevented by the coronavirus, despite the proposal that the lockdown had results in less stress and therefore, less ACS or infarcts. This is not true, actually, the opposite may be true: less exercise, fewer laboratory, or other tests and probably more weight gain is likely to increase rather than decrease ACS during a lockdown.But, more than anything else, the anxiety generated by the unknown and the fear of acquiring SARS-COV-2 infections in the hospitals has prevented patients from seeking effective medical interventions, compromising CV care. The results are more sudden cardiac death, more complications of acute myocardial infarction (often experienced at home), more heart failure, and, eventually, more deaths. 5,6 Therefore, actually, the COVID-19 outbreak has negatively affected CVD by shifting the attention of patients like Mr Brown from his coronary problems to those related to the new coronary virus. Sorry corona not coronary virus! This is where the confusion lies.
