Damian Sendler: It was discovered in China at the end of 2019 and quickly spread to adjacent Asian nations in the beginning of 2020 of the Coronavirus Disease 2019 (COVID-19). Before the COVID-19 pandemic, outbreaks occurred in numerous countries and had a substantial impact on nuclear medicine (NM) practice. It has been a team effort from the start of the epidemic. This organization’s last face-to-face gathering took place from January 28 to February 2, 2020, in Manila, Philippines, thanks to the Asian Regional Cooperative Council for Nuclear Medicine annual general meeting and Asia Nuclear Medicine Board examination. COVID-19 material was disseminated both in person and online throughout the meeting.
Damian Jacob Sendler: The Asian Regional Cooperative Council for Nuclear Medicine and the Asia Nuclear Medicine Board conducted web-based questionnaires from March to April 2020 and found a substantial decrease in NM practice and radioisotope supply (RI) during the start of the COVID-19 pandemic. Following a study from March to April 2021, it was obvious that both NM practice and RI supplies had returned to pre-crisis levels. Depending on the organizations and nations involved, the rehabilitation process might be very different. These are the operational histories of four typical institutions in East, Southeast, South, and West Asia that we have presented here. An alarmingly large second epidemic has been reported in India. During the epidemic, members of the Asian NM community engaged in a variety of online interactions and instructional programs.
Dr. Sendler: The first case of Coronavirus Disease 2019 (COVID-19) was discovered in Wuhan, China in December of that year. It first extended to nations in East and Southeast Asia, and then to West Asia, in that order. The first instances of COVID-19 were found in January 2020 in Japan, Thailand, South Korea, Taiwan, Macau, Nepal, Singapore, Vietnam, Malaysia, Cambodia, Sri Lanka, UAE, India, and the Philippines in sequence of occurrence. 1 In March 2020, the World Health Organization declared a pandemic of COVID-19. 2
Damian Sendler
The COVID-19 epidemic has sparked worldwide concern about health care. In each area and nation, the strengths and weaknesses of health care systems emerged. The field of nuclear medicine (NM) is no exception. “COVID-19 pandemic: difficulties for the NM departments” was the headline of many IAEA human health division webinars. These conversations were provided as a guideline. 4 COVID-19’s worldwide effect on NM departments was also assessed and reported. In addition, a group of IAEA Noninvasive Cardiology Protocols Study evaluated the influence of COVID-19 on worldwide cardiovascular diagnostic procedure volumes and safety procedures, including nuclear cardiology. 5
As the COVID-19 epidemic spread over the globe, the use of NM decreased drastically. On the one hand, the infections caused by COVID-19 resulted in the loss of expertise and even the death of several NMs. 6
Since the onset of the COVID-19 outbreak, the Asian community in NM has worked together. Unfortunately, the Asian Regional Cooperative Council for Nuclear Medicine (ARCCNM) annual general meeting and the Asia Nuclear Medicine Board (ANMB) coaching and examination programs were held in Manila, Philippines in conjunction with the 35th Philippine Society of Nuclear Medicine convention from January 28 to February 2, 2020; these were the last face-to–face conferences of these organizations to date. COVID-19 material was sent to members during the meeting and on the Internet thereafter,
Online Questionnaire: NM Practice and RI Supply
H.H.B., a co-author of this study, prepared questionnaires and distributed them between March and April 2020 and the same time in 2021. Two questions were asked in the first questionnaire: For the months of February and March of 2020, how did your department’s NM practice compare with that of 2019? Among the five options: increased (more than 5% rise), no change (less than 5% change), moderately (5%-30%) declined, substantially (more than 30%) decreased, and shut down. (2) What is the difference between last year’s and this year’s RI supply? New items, same, decreased by 1–2 item reduction, reduced 3 or more item reduction, and no supply are all options. (a) How was your practice this year throughout January to February 2021 as compared to the same period of time in 2020? (b) Secondly, how did the RI supply work out? Following their distribution over WhatsApp and email, questionnaires were returned within a few days. A Chi-square test was used to compare NM practice and RI supply over time. The significance of a P-value less than 0.05 was considered.
Damian Jacob Markiewicz Sendler: The operational histories are presented here with the help of each author’s own perspective. They are a cross-section of Asia’s east, south, southeast, and west. The Chonnam National University Hospital in South Korea (East Asia), four hospitals in the southern Philippines (Southeast Asia), the Rajiv Gandhi Cancer Institute and Research Center in India (South Asia), and the King Hussein Cancer Center in Jordan (West Asia) describe the conditions and activities of NM departments during the COVID-19 pandemic……….
Gwangju, South Korea’s Chonnam National University Hospital
After the first case of COVID-19 was discovered in South Korea on January 20, 2020, and the first big outbreak occurred in Daegu at the end of February 2020, the amount of NM procedures, including imaging examinations, in vitro testing, and radiation treatment, rapidly declined. Patients canceled their appointments due to public fear, which resulted in a decrease in NM practice. The Korean government established the test, trace, and treat policy known as the 3T policy about this time. Real-time reverse transcription polymerase chain reaction (RT-PCR) kits created by Korean businesses have allowed for bulk screening.
To track confirmed cases, a widely used epidemic investigation support system was used. Credit card data, public transit, medical visits, and closed-circuit TV information were all tracked by the system. Residential treatment centers were used for those infected with SARS-COV-2 who had no symptoms, while negative-pressure isolation chambers were used for those infected with respiratory symptoms. The world’s first drive-through COVID-19 testing facility opened its doors to the public in late February 2020 and quickly grew to 50 sites. From March 2020, the number of verified COVID-19 cases started to decline.
Damien Sendler: A spike in the number of instances was precipitated, however, when the Korean government loosened laws to promote the economy during the summer. First and second epidemics occurred in August and November 2020. In November 2020, SARS-COV-2 infected numerous employees and patients at the Chonnam National University Hospital (CNUH), resulting in the closure of multiple wards at CNUH. Accordingly, the NM department’s practice volume dropped significantly. Although some NM employees offered to serve as screening sites for COVID-19, it recovered slowly in 2021. CNUH’s NM department developed the original set of standard operating procedures (SOPs). The Korean Society of NM developed a new set of guidelines in their place of these. 7 At CNUH, no COVID-19 patients have been evaluated and no NM staff members have acquired the disease. In March 2021, all NM employees were vaccinated.
Damian Jacob Sendler
In order to fulfill basic needs like food shopping and medical attention, the general public was forced to stay inside throughout the quarantine. Some departments saw a dramatic drop in patients requiring imaging and treatment. The radioimmunoassay methods proceeded until kits were once again accessible. Some NM services were stopped down or staff members were relocated to other departments, including as logistics and triage sections, in government hospitals. The hospital personnel was placed on a minimal workforce. COVID-19 safeguards and new recommendations for NM operations were revised in the hospital. New infectious disease guidelines failed to prevent the COVID-19 outbreak, which led to the temporary closure of New Mexico Medical Center (NMMC) until a sufficient supply of healthy workers could be found. Due to a shortage of radiopharmaceuticals, only a few treatments were completed between March 2020 and September 2020. NM imaging and treatment census results revealed a drop of 50-90 percent across the board.
Public transit in the National Capital Region was halted during the first few days of the outbreak. All NM center activities have been ceased after the lockout on March 16, 2020. Hospitals shifted staff to the skeleton workforce or to triage sections, depending on where they were located. COVID-19 procedures have evolved in a dynamic way over time. Tc-99m and RI were no longer available. All that was left to be completed by June 2020 was the radioimmunoassay lab, which only contained a few kits. The hospitals began getting radioactive material in little amounts as the months passed, starting around the middle of May. At the time, private hospitals insisted on only treating patients who did not have COVID, but the government hospital treated those with COVID-19. Since the general public was apprehensive about visiting the hospital, radionuclide treatment was delayed until June 29, 2020.
In the wake of India’s first COVID-19-positive case, which was reported in February 2020, the Indian Council of Medical Research, the highest organization for research in such instances, issued rules and regulations for the health sector. India’s capital city of New Delhi is home to the Rajiv Gandhi Cancer Institute and Research Centre (RGCIRC), a cutting-edge tertiary cancer hospital for treatment, research and training. A flu corner was set up at the hospital’s main entrance where all visitors were required to have their temperature taken and to report any symptoms that may indicate the presence of COVID-19. N-95 masks were unavailable at the time, and even the most common surgical masks were becoming scarce.
People were instructed and urged to utilize foot-operated hand sanitizer dispensers in public locations. The hospital’s public rooms, offices, and wards were thoroughly cleaned and disinfected on a regular basis. If RT-PCR testing revealed that a patient had not been infected with COVID-19, they were sent to a more general cancer treatment institution. Patients who tested positive for infection were sent to a specialized COVID-19 unit for further treatment and monitoring. RT-PCR results that were negative were required for all patients requiring hospitalization for different surgical and interventional procedures, such as biopsy and endoscopy. On April 24, 2020, the first COVID-positive case was found at RGCIRC.
To date, a total of 367 employees have been affected at RGCIRC after contracting the virus for the first time on June 9, 2020. Doctors and nurses had infection rates of 21.6 and 26.5 percent, respectively, for the overall staff infection rate. Only 123 of the company’s employees needed to be admitted to the hospital; the remainder were kept in home isolation. There was a fatality among the administrative employees. Two doctors, one technician, and another member of the NM department were infected with COVID-19 at various points throughout the epidemic.
Dr. Damian Jacob Sendler and his media team provided the content for this article.
