Damian Sendler: The NM department followed the same broad criteria as the rest of the hospital. In addition to this, the administration and the institution’s quality assurance department approved the implementation of additional SOPs. Prior to NM operations, patients were questioned about any recent overseas travel, any symptoms of COVID-19, and any previous interaction with another patient with COVID-19 that they may have had. All Indian residents’ cellphones were equipped with an app called “Arogya Setu,” which was used to classify patients’ risk.
Damian Jacob Sendler: Touch tracing is used by the app to keep track of all the persons with whom he has had contact while going about his daily routine. To follow up on the initial NM department screening, if any of these patients subsequently turn out to be infected with COVID-19, they will be instantly alerted, and their risk stratification will be shown on their downloaded mobile application. Intermediate-risk individuals had their scan appointments delayed while the infectious disease team conducted RT-PCR testing on those who were considered high-risk.
Dr. Sendler: Patients with lung or oral cancer, as well as those who had had chemotherapy, were difficult to categorize. In addition, several individuals developed COVID-19 positive at various times after the NM treatment was done. According to how long it had been since the facility was sterilized, contact tracing was performed. We divided our staff into two NM teams, each comprised of 50% of our employees, and assigned them to alternate days of work on-site. Half of the hospital’s doctors, technicians, nurses, and other support workers were on the team. The “as low as reasonably practicable” radiation protection concept was adopted by us.
Damian Sendler
Reception and any areas where physical contact with patients or caregivers, as well as visual access to the patient’s other pertinent reports, was permitted were protected by a Perspex barrier. There were no known COVID-19-positive patients in the NM department that were scanned or treated. For individuals who had been previously infected, a negative RT-PCR result was required. After many months of government-imposed lockdown and mobility restrictions, and our stringent screening and testing standards, the number of NM procedures has significantly decreased. As seen in (Fig. 2c) Due to the restriction on commercial foreign flights in the country, the amount of radionuclide treatment was significantly reduced.
The government of India has taken a proactive approach to vaccination, which was adopted in a staged way for diverse sections of residents. On January 16, 2021, the nationwide immunization campaign got underway without a hitch. As a result of this, there were shortages of vaccinations in India, as well as hospital beds and oxygen tanks in certain sections of the country. 1
Damian Jacob Markiewicz Sendler: In March 2020, the first case of COVID-19 was discovered in Jordan. King Hussein Cancer Center (KHCC), Jordan’s premier tertiary cancer treatment facility, immediately introduced umbrella measures aimed at reducing viral transmission and infection risk for patients, employees, and family members. Suspected patients were given their own floor in the Nizar Naqeeb building of KHCC, and a new triage room was built in the emergency unit. Refill drugs are now being delivered to patients’ homes, and hospital visits are now restricted to between 4 and 7 p.m. Grand rounds and instructional seminars were conducted remotely to keep employees from traveling. Patients and partners were required to wear masks in September, and both were checked for COVID-19 before to admission. It was easy for all employees to take COVID-19 exam. All personnel were urged to sign up for immunization, and the medical staff was prioritized when the vaccinations were available in Jordan in 2021.
Damian Jacob Sendler
It was imperative that the NM department adhere to the KHCC umbrella processes while also implementing safeguards unique to the NM procedures. Routine elective appointments have been rescheduled and priority procedures are still being performed. On the ground frontline teams and a backup support work-from-home team were created thanks to virtual private networking access granted to NM workers. To keep track of each patient’s condition the day before their NM procedure, a checklist was put in place, and an NM nurse entered a record in the hospital’s computer system to reflect this. Everyone in the department was required to wear surgical masks, gloves, and closed lab coats as a form of personal protection. Patients suspected or confirmed of having COVID-19 were given the full range of protective gear suggested by the infection control program.
Damien Sendler: Continuous monitoring of protective gear compliance was used to accomplish this proposal. Hand sterility and equipment sterility were also meticulously enforced before and after each treatment. Unless the patient’s personal presence was required, the NM therapeutic clinic was done online. Social distancing and psychological assistance for the personnel were also introduced in all forms. Even when the pandemic situation stabilized and lockdowns began to lift in Jordan in the second half of 2020, these severe safeguards were gradually reduced to a more moderate degree. New Mexico’s health agency and KHCC were aware that these procedures needed to be constantly updated as the pandemic scenario changed.
When the pandemic began, there was a significant drop in NM procedures performed in Jordan in 2020 compared to the previous year, and this drop was exacerbated by the national lockdown, public anxiety, interruptions in radiopharmaceutical supply, and uncertainty among healthcare providers about the best health care approach during a pandemic. As more doctors and nurses learned about the disease and their own personal experiences working in the midst of a pandemic, these fears began to fade. In addition, because the majority of the NM staff has either been vaccinated or has developed immunity to the disease after becoming infected, they are now more at ease working under these conditions. In 2021, the number of NM procedures in the department dramatically increased compared to the same time in 2020, despite the massive jump in the burden of COVID-19 in the nation, compared to the previous year when just a few COVID-19 cases were reported in Jordan.
Since the start of the COVID-19 epidemic, the practice of NM throughout Asia has been profoundly impacted. Imaging investigations and treatments were hampered by the outage. Mo-99/Tc-99m generator shortages impacted 60 percent of NM facilities in Asia, but 80 percent in India and Pakistan. There was a shortage of I-131 in 55% of the Asian nuclear medicine centers (NMCs). Lockdowns, border closures, and aircraft cancellations all contributed to the supply chain breakdown. Asia was hit worse than Europe, Oceania, or the United States. While the number of NM operations was reduced the least in South Korea and Singapore. 5 and 6
The NM communities across Asia have taken an active role in finding solutions to these issues. An expert agreement was formed on the safe management of NM diagnosis and treatment during the COVID-19 epidemic by the Chinese Society of Nuclear Medicine and its editorial board, after the initial case in Wuhan, China, was confirmed as one of the first cases of COVID-19. As soon as it was published in the journal on February 24, 20208, it was translated into English and published in the European Journal of Nuclear Medicine and Molecular Imaging shortly afterwards. 9 The ARCCNM and the Philippine Society of Nuclear Medicine sponsored a joint meeting in Manila, Philippines, in early February 2020. Exams were held simultaneously by the ANMB. The ANMB committee sponsored an online lecture series, and members of the organization communicated with one another through social media and email. ARCCNM collaborated with the regional office of the Regional Cooperation Agreement to develop eLearning programs (RCARO). Freely accessible on the RCARO website,10 they cover a wide range of neurological conditions, including as brain tumors, cerebral ischemia, epilepsy, Alzheimer’s and movement problems. Cardiopulmonary diseases include stable angina, cardiomyopathy and pulmonary embolism; Oncology diseases include head, neck cancer, esophageal cancer, lung cancer, breast cancer, colorectal cancer, lymphoma, gynecologic cancer, prostate cancer and neuroblastoma; Malignant and inflammatory bone diseases include osteoporosis and osteoarthritis. There were also eLearning lessons on how to report bone scans, kidney scans, and cardiac perfusion imaging provided. PET/CT instrumentation, picture artifacts, quality control, dosimetry, and cyclotron radiochemistry were covered in the physics and chemistry courses.
Pandemic conditions such as COVID-19 are becoming the new normal. COVID-19 has prompted governments throughout the globe to develop a wide range of methods to restrict and mitigate its spread. These measures have variable degrees of effectiveness in different nations and communities, depending on their socioeconomic and political situation. There is been discussion among international authorities, including IAEA officials, of returning to “business as usual” in NM. Online polls clearly indicated that both the practice of NM and the availability of RI in Asia were on the upswing in the region. This uncertainty was reduced when NM practitioners gained more knowledge about COVID-19 and rationalized it via practical experience.
There are a few drawbacks to this review article. Firstly, we were unable to include all Asian institutions and nations. As far as we knew, no one in Central Asia used NM. There is little doubt that the situation varies greatly across nations and areas. Second, our data does not accurately portray the problem. However, we may be able to demonstrate a shift in NM use in Asia.
As a result, several NM departments in Asia are reverting to their pre-COVID-19 methods, despite limits and challenges.
Dr. Damian Jacob Sendler and his media team provided the content for this article.
