Interventional Radiology Preparedness in the Time of the COVID-19 Pandemic: Is there a Gold Standard?
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COMMENTARY
COVID-19
Interventional Radiology Preparedness in the Time of the COVID-19 Pandemic: Is there a Gold Standard? Bien-Soo Tan1
•
Kiang-Hiong Tay1
Received: 18 April 2020 / Accepted: 28 April 2020 Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2020
The Coronavirus disease 2019 (COVID-19) pandemic has continued to worsen and has reached a scale that has not been seen since the Spanish Flu pandemic over a hundred years ago in 1918 [1]. As of 15 Apr 2020, there are more than 1.9 million cases with more than 125 000 deaths worldwide [2]. Health care worker (HCW) infections resulting from caring and treating COVID-19 patients have also occurred in large numbers in some countries and many have perished [3, 4]. Protecting patients and HCWs from getting infected while maintaining high-quality care are key considerations for any interventional radiology (IR) service during this pandemic. Since the outbreak, several manuscripts, guidelines and checklists on IR preparedness and COVID-19 have been published [5–18]. Many IR webinars on COVID-19 have also been broadcasted. This rapid sharing of information, experiences and best practices is unprecedented and bodes well for our specialty. It has undoubtedly helped many IR services throughout the world to prepare and deal with the COVID-19 pandemic. The principles of managing a highly infectious disease with significant morbidity and mortality like COVID-19 are universal. Strict adherence to hand hygiene practices, proper use of appropriate personal protective equipment (PPE) and implementation of team segregation and social distancing are critical in preventing intra-hospital transmission and cross-infection of patients and HCWs. Other & Bien-Soo Tan [email protected] 1
Department of Vascular and Interventional Radiology, Singapore General Hospital, SingHealth Duke-NUS Academic Medical Centre, 20 College Road, Academia Level 4, 169856 Singapore, Singapore
strategies to minimise cross-transmission include segregating patients of different infection risks, identifying and isolating COVID-19 patients early and minimising their movement, and when necessary, performing procedures for COVID-19 patients either at the bedside or in pre-designated interventional suites. It is therefore important to have detailed, well-rehearsed IR protocols for dealing with COVID-19 patients, as described by many of these publications. While these principles are universal, they may not be uniformly implementable due to local constraints like PPE supply or the extent of the COVID-19 load within the institution. Hence each IR service may have to modify their protocols to cater to their own unique circumstances. The N95/FFP 2/3 mask is generally recommended when coming in close contact with COVID-19 patients. There are reports of inadvertent exposure of HCWs wearing only surgical masks to undiagnosed COVID-19 patients, with no transmission to the HCWs [19]. This suggests that surgica
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