Living with COVID-19 pandemic – Emerging challenges for ultrasound physicians and their suggested solution

Background: The recent coronavirus disease (COVID-19) pandemic is a serious health concern with far-reaching implications in every facet of human life. New challenges have emerged for ultrasound physicians engaged in diagnostic ultrasound examinations. Methods: Based on a comprehensive literature review the author has suggested a few precautionary measures that should be incorporated by the ultrasound physicians in their practice against the spread of coronavirus disease. Suggestions: Multi-level safeguard checks before, during, and after the ultrasound examination are suggested to protect ultrasound physicians, staff, and patients from COVID-19. The importance of triage for patient screening is stressed.  Also, limiting patients by deferring non-urgent cases and cancelling aerosol-generating procedures is recommended. The need of counselling of patients and staff is stressed regarding the importance of facemasks, hand hygiene, and safe distancing. Incorporating different types of barriers against the virus such as facemasks, face-shields, personnel protective suits for ultrasound physicians and staff, and shielding the equipment and transducer with disposable or wipeable plastic sheets is suggested. Besides, the significance of cleaning and disinfection of the examination room and equipment by suitable disinfectants after each patient and at the end of the day is highlighted.  Conclusion: Learning to live with the COVID-19 pandemic is the need of the day both for the general public and medical community. Being members of the medical community ultrasound physicians should gear up to the emerging challenges of COVID-19 to protect themselves, their patients, and allied healthcare staff from coronavirus infection

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Living with COVID-19 pandemic – Emerging challenges for ultrasound physicians and their suggested solution

Background: The recent coronavirus disease (COVID-19) pandemic is a serious health concern with far-reaching implications in every facet of human life. New challenges have emerged for ultrasound physicians engaged in diagnostic ultrasound examinations.&#x0D; Methods: Based on a comprehensive literature review the author has suggested a few precautionary measures that should be incorporated by the ultrasound physicians in their practice against the spread of coronavirus disease.&#x0D; Suggestions: Multi-level safeguard checks before, during, and after the ultrasound examination are suggested to protect ultrasound physicians, staff, and patients from COVID-19. The importance of triage for patient screening is stressed.  Also, limiting patients by deferring non-urgent cases and cancelling aerosol-generating procedures is recommended. The need of counselling of patients and staff is stressed regarding the importance of facemasks, hand hygiene, and safe distancing. Incorporating different types of barriers against the virus such as facemasks, face-shields, personnel protective suits for ultrasound physicians and staff, and shielding the equipment and transducer with disposable or wipeable plastic sheets is suggested. Besides, the significance of cleaning and disinfection of the examination room and equipment by suitable disinfectants after each patient and at the end of the day is highlighted.  &#x0D; Conclusion: Learning to live with the COVID-19 pandemic is the need of the day both for the general public and medical community. Being members of the medical community ultrasound physicians should gear up to the emerging challenges of COVID-19 to protect themselves, their patients, and allied healthcare staff from coronavirus infection.</jats:p

The Safeguard measures for mitigating the impact of COVID-19 on radiotherapy services in a Cancer Hospital: A resource-constrained approach

This article suggests the preventive measures for healthcare department (particularly radiotherapy department) to reduce the probability of corona virus transmission with a resource constrained approach without affecting the work flow. COVID-19 has affected the patients as well as staff of radiotherapy department leaving a severe negative impact on the financial resources of INOR cancer hospital, Abbottabad. Multiple preventive measures have been taken to reduce the probability of spreading the coronavirus while pursuing the timely treatment of radiotherapy patients without compromising their oncological outcomes. In this context, a triage center was established to filter out the Covid suspected/confirmed patients to reduce the risk of infection to other patients and staff.  Social distancing was ensured by making amendments in patient gathering areas. Also extensive ventilation and disinfection procedures were adopted to clean the surfaces.  Following these measures, patient flux did not show any considerable decrease in second, third and fourth wave as compared to first wave when patient flux reduced to about less than 25 %.  Preventive measures were also taken for the employees by ensuring them to wear personal protective equipment during office hours. To further reduce the probability of contact, telemedicine was adopted for patients where possible. All employees were made to be fully vaccinated by July 2021 resulting in 100 % reduction in new cases among INOR employees in the following fourth COVID wave.  Owing to these stringent measures taken to fight against coronavirus, ratio of contracting the coronavirus among the employees and patients of INOR has been found &lt;10% overall in this pandemic, While no mortality has been reported so far. Full Tex

The Safeguard measures for mitigating the impact of COVID-19 on radiotherapy services in a Cancer Hospital: A resource-constrained approach

This article suggests the preventive measures for healthcare department (particularly radiotherapy department) to reduce the probability of corona virus transmission with a resource constrained approach without affecting the work flow. COVID-19 has affected the patients as well as staff of radiotherapy department leaving a severe negative impact on the financial resources of INOR cancer hospital, Abbottabad. Multiple preventive measures have been taken to reduce the probability of spreading the coronavirus while pursuing the timely treatment of radiotherapy patients without compromising their oncological outcomes. In this context, a triage center was established to filter out the Covid suspected/confirmed patients to reduce the risk of infection to other patients and staff.  Social distancing was ensured by making amendments in patient gathering areas. Also extensive ventilation and disinfection procedures were adopted to clean the surfaces.  Following these measures, patient flux did not show any considerable decrease in second, third and fourth wave as compared to first wave when patient flux reduced to about less than 25 %.  Preventive measures were also taken for the employees by ensuring them to wear personal protective equipment during office hours. To further reduce the probability of contact, telemedicine was adopted for patients where possible. All employees were made to be fully vaccinated by July 2021 resulting in 100 % reduction in new cases among INOR employees in the following fourth COVID wave.  Owing to these stringent measures taken to fight against coronavirus, ratio of contracting the coronavirus among the employees and patients of INOR has been found &lt;10% overall in this pandemic, While no mortality has been reported so far. Full Tex

Reduction of cardiac imaging tests during the COVID-19 pandemic: The case of Italy. Findings from the IAEA Non-invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Background: In early 2020, COVID-19 massively hit Italy, earlier and harder than any other European country. This caused a series of strict containment measures, aimed at blocking the spread of the pandemic. Healthcare delivery was also affected when resources were diverted towards care of COVID-19 patients, including intensive care wards. Aim of the study: The aim is assessing the impact of COVID-19 on cardiac imaging in Italy, compare to the Rest of Europe (RoE) and the World (RoW). Methods: A global survey was conducted in May–June 2020 worldwide, through a questionnaire distributed online. The survey covered three periods: March and April 2020, and March 2019. Data from 52 Italian centres, a subset of the 909 participating centres from 108 countries, were analyzed. Results: In Italy, volumes decreased by 67% in March 2020, compared to March 2019, as opposed to a significantly lower decrease (p &lt; 0.001) in RoE and RoW (41% and 40%, respectively). A further decrease from March 2020 to April 2020 summed up to 76% for the North, 77% for the Centre and 86% for the South. When compared to the RoE and RoW, this further decrease from March 2020 to April 2020 in Italy was significantly less (p = 0.005), most likely reflecting the earlier effects of the containment measures in Italy, taken earlier than anywhere else in the West. Conclusions: The COVID-19 pandemic massively hit Italy and caused a disruption of healthcare services, including cardiac imaging studies. This raises concern about the medium- and long-term consequences for the high number of patients who were denied timely diagnoses and the subsequent lifesaving therapies and procedures