Although severe public health measures have brought infection rates under control in China, where the COVID-19 novel coronavirus began in December 2019, cases in Italy and Iran have increased exponentially.
In response, the journal Radiology has published the policies and recommendations of a panel of experts on radiology preparedness during the ongoing public health crisis. The article outlines priorities for handling COVID-19 cases and suggests strategies that radiology departments can implement to contain further infection spread and protect hospital staff and other patients.
Other countries have had about two months to prepare their responses to the coronavirus epidemic. These responses are led by public health authorities in coordination with local governments and hospitals. Now that chest CT findings are no longer part of diagnostic criteria for COVID-19, the focus of most radiology departments has shifted from diagnostic capability to preparedness.
WHAT'S THE IMPACT?
Radiology preparedness during this outbreak requires radiology department policies and procedures designed to have enough capacity for continued operation during a healthcare emergency of unprecedented proportions – and to support the care of patients with COVID-19 while maintaining radiology support for the entirety of the hospital and health system.
Because of varying national and regional infection control policies, steps for radiology preparedness for COVID-19 will vary between institutions and clinics. The Radiology Editorial Board has assembled a team of radiologists who are active in coordination, development and implementation of radiology-preparedness policies for COVID-19 at institutions or healthcare systems in Washington, New York, Georgia, California, Wisconsin and Singapore. Their policies have been developed in conjunction with infection control experts within their institutions.
In the article, each panel member describes their department's top priorities for COVID-19 preparedness in their environment and the steps that have been implemented to address those priorities.
Priorities for COVID-19 preparedness vary among health systems, but focus on early detection, limiting virus exposure to others, safety precautions, cleaning protocols, training, and maintenance of operations and staffing.
Western Washington State is the epicenter of the COVID-19 outbreak in the U.S. At University of Washington Medicine, the hospitals have begun screening at the high-flow main hospital entrances to check those coming in for symptoms that could be related to coronavirus infection, or with risk factors related to travel or exposure.
With the radiology front desk doubling as a screening site, with similar screening taking place at the hospital's front door, the policy has been to cancel imaging exams for patients with respiratory symptoms who are undergoing outpatient imaging or procedures. Those patients are then asked to follow up with their primary care physician.
Even after the outbreak subsides, radiology departments must continue to plan and prepare for future outbreaks and pandemics. At Singapore General Hospital, long-range planning for COVID-19 is considered a new norm for radiology operations.
THE LARGER TREND
Healthcare workers on the front lines of treating the disease are at risk of exposure due to the nature of their jobs, and there are things they can be doing to protect themselves. As care teams come to terms with the nature of the coronavirus and its spread, best practices are starting to emerge.
Those strategies will become increasingly important as healthcare organizations look to protect their staff members from contracting the disease. They are vital components in ensuring that workforce shortages don't make the situation worse.