To the Editor: According to the Global Healthcare Security (GHS) Index, the United States was the most prepared nation in the world to deal with pandemics (October, 2019).1 Now in the midst of the COVID-19 crisis, it is ironic that the United States has had more cases and deaths than any other nation.2 The same report found that other countries were even less prepared and there were major gaps in global healthcare security.1,2 Governments have had to make difficult decisions during this pandemic, balancing health against economic collapse. The decision to proceed with social distancing, banning nonessential travel, and closing large portions of the economy has been widely adopted around the world recognizing this will likely have longstanding economic consequences.3-5 The aim of our study was to explore the impact of this pandemic on neurosurgeons with the hope of improving preparedness for future crisis. We created a 20-question survey designed to explore demographics (nation, duration and scope of practice, and caseburden), knowledge (source of information), clinical impact (elective clinic/surgery cancellations), hospital preparedness (availability of personal protective equipment [PPE] and cost of the supplies), and personal factors (financial burden, workload, scientific and research activities). The survey was first piloted with 10 neurosurgeons and then revised. Surveys were distributed electronically in 7 languages (Chinese, English, French, German, Italian, Portuguese, and Spanish) between March 20 and April 3, 2020 using Google Forms, WeChat used to obtain responses, and Excel (Microsoft) and SPSS (IBM) used to analyze results. All responses were crossverified by 2 members of our team. After obtaining results, we analyzed our data with histograms and standard statistical methods (Chi-square and Fisher’s exact tests and logistic regression). Participants were first informed about the objectives of our survey and assured confidentiality after they agreed to participate (Helsinki declaration).6 We received 187 responses from 308 invitations (60.7%), and 474 additional responses were obtained from social mediabased neurosurgery groups (total responses = 661). The respondents were from 96 countries representing 6 continents (Figure 1A-1C).

中文翻译：

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信件：冠状病毒 (COVID-19) 大流行对全球神经外科医生的影响

致编辑：根据全球医疗保健安全 (GHS) 指数，美国是世界上应对大流行病准备最充分的国家（2019 年 10 月）。1 现在正处于 COVID-19 危机之中，它是具有讽刺意味的是，美国的病例和死亡人数比任何其他国家都多。 2 同一份报告发现，其他国家的准备甚至更不足，全球医疗安全方面存在重大差距。 1,2 在此期间，各国政府不得不做出艰难的决定大流行，平衡健康与经济崩溃。继续保持社交距离、禁止非必要旅行和关闭大部分经济部门的决定已在世界范围内广泛采用，因为这可能会产生长期的经济后果。3-5 我们研究的目的是探讨这种流行病对神经外科医生的影响，以期提高对未来危机的准备。我们创建了一个包含 20 个问题的调查，旨在探讨人口统计学（国家、实践的持续时间和范围以及病例负担）、知识（信息来源）、临床影响（选择性诊所/手术取消）、医院准备情况（个人防护设备的可用性 [ PPE] 和用品成本），以及个人因素（经济负担、工作量、科研活动）。该调查首先由 10 名神经外科医生进行试点，然后进行了修订。2020 年 3 月 20 日至 4 月 3 日期间，调查以 7 种语言（中文、英文、法文、德文、意大利文、葡萄牙文和西班牙文）以电子方式分发，使用 Google 表格、微信获取回复、Excel (Microsoft) 和 SPSS (IBM) 用于分析结果。我们团队的 2 名成员对所有回答进行了交叉验证。获得结果后，我们使用直方图和标准统计方法（卡方和费舍尔精确检验和逻辑回归）分析我们的数据。参与者在同意参与后首先被告知我们的调查目标并保证保密（赫尔辛基声明）。6 我们收到了来自 308 份邀请的 187 份回复（60.7%），另外还有 474 份回复来自基于社交媒体的神经外科团体（总回复） = 661）。受访者来自代表 6 大洲的 96 个国家（图 1A-1C）。我们使用直方图和标准统计方法（卡方和费舍尔精确检验和逻辑回归）分析了我们的数据。参与者在同意参与后首先被告知我们的调查目标并确保保密（赫尔辛基声明）。6 我们收到了来自 308 份邀请的 187 份回复（60.7%），另外还有 474 份回复来自基于社交媒体的神经外科团体（总回复） = 661）。受访者来自代表 6 大洲的 96 个国家（图 1A-1C）。我们使用直方图和标准统计方法（卡方和费舍尔精确检验和逻辑回归）分析了我们的数据。参与者在同意参与后首先被告知我们的调查目标并保证保密（赫尔辛基声明）。6 我们收到了来自 308 份邀请的 187 份回复（60.7%），另外还有 474 份回复来自基于社交媒体的神经外科团体（总回复） = 661）。受访者来自代表 6 大洲的 96 个国家（图 1A-1C）。并且从基于社交媒体的神经外科小组获得了 474 个额外的回复（总回复 = 661）。受访者来自代表 6 大洲的 96 个国家（图 1A-1C）。并且从基于社交媒体的神经外科小组获得了 474 个额外的回复（总回复 = 661）。受访者来自代表 6 大洲的 96 个国家（图 1A-1C）。