Global Impact of COVID-19 on Nuclear Medicine Departments: An International Survey in April 2020

Abstract

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has placed significant challenges on health care systems worldwide, whether in the preparation, response, or recovery phase of the pandemic. This has been primarily managed by dramatically reducing in- and outpatient services for other diseases and implementing infection prevention and control (IPC) measures. The impact of the pandemic on nuclear medicine departments and their services has not yet been established. The aim of this online survey was to evaluate the impact of COVID-19 on nuclear medicine departments. Materials and Methods: A web-based questionnaire, made available from April 16 to May 3, 2020, was designed to determine the impact of the pandemic on in- and out-patient nuclear medicine departments; including the number of procedures, employee health, availability of radiotracers and other essential supplies, and availability of personal protective equipment (PPE). The survey also enquired about operational aspects and types of facilities, as well as other challenges. Results: A total of 434 responses from 72 countries were registered and analysed. Respondents reported an average decline of 54% in diagnostic procedures. Positron emission tomography / computed tomography (PET/CT) scans decreased by an average of 36%, while sentinel lymph-node procedures decreased by 45%, lung scans by 56%, bone scans by 60%, myocardial studies by 66%, and thyroid studies by 67%. Out of all participating centres, 81% perform radionuclide therapies, and they reported a reduction of 45% on average in the last four weeks, ranging from over 76% in Latin America and South East Asia to 16% in South Korea and Singapore. Survey results showed that 52% of participating sites limited their ^99mTc/⁹⁹Mo generator purchases and 12% of them temporarily cancelled orders. Insufficient supplies of essential materials (radioisotopes, generators, and kits) were reported, especially for ^99mTc/⁹⁹Mo generators and ¹³¹I, particularly in Africa, Asia, and Latin America. Conclusion: Both diagnostic and therapeutic nuclear medicine procedures declined precipitously with countries worldwide being affected by the pandemic to a similar degree. Countries that were in the post-peak phase of the pandemic when they responded to the survey, such as South Korea and Singapore reported a less pronounced impact on nuclear medicine services however, the overall results of the survey showed that nuclear medicine services worldwide had been significantly impacted. In relation to staff health, 15% of respondents experienced COVID-19 infections within their own departments.