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Change is everything
  1. Felipe C Albuquerque
  1. Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
  1. Correspondence to Dr Felipe C Albuquerque, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ 85013, USA; Felipe.Albuquerque{at}

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As we endure another winter surge of the coronavirus, I reflect on what we’ve learnt about the pandemic and its impact on our field. Many important trends were published and debated on the pages of JNIS.1–3 These include the global decline in the presentation of patients with stroke, unique challenges in the triaging of emergently ill patients with cerebrovascular disease, workplace fatigue and burnout among interventional surgeons and support staff and, most disturbingly, disparities in mechanical thrombectomy (MT) rates in our minority communities.

In their prospective analysis of the Stroke Thrombectomy and Aneurysm Registry (STAR) database, Al Kasab and co-authors reported a significant decline in African American patients undergoing MT during the pandemic.4 Their analysis also revealed global increases in MT times and worse outcomes among all patient demographic groups undergoing thrombectomy. The issue of treatment disparities in the African American population is multifactorial and insidious. This is a population already more adversely affected by cerebrovascular disease. Delays in presentation for reasons that include greater financial constraints during the pandemic, an overall mistrust of the healthcare system, and a higher incidence of COVID-19 infection contribute to this disparity and cloud our understanding of it.4 The last 2 years have shown with …

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  • Contributors FCA is the sole contributor.

  • Funding The author has not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.