Amid calls from the Centers for Disease Control & Prevention that Americans limit social gatherings to less than 10 people, avoid restaurants and bars, and travel as little as possible, radiology experts are also releasing their own guidance.
In an article published Monday, March 16, in Radiology, departmental leaders from across the country, at the request of the journal’s Editorial Board, shared the policies and procedures currently in place at their own institutions to treat patients with suspected COVID-19 infection and control further contamination as much as possible. These actions go beyond social-distancing, providing personal protective equipment, and canceling travel.
“The Editorial Board hopes that readers may find similarity of the highlighted healthcare systems to their own environment, providing impetus for action or confirmation of their current preparedness activities,” said David A. Bluemke, M.D., Ph.D., Radiology editor and radiology professor at the University of Wisconsin School of Medicine and Public Health.
To limit the interaction between radiologists and patients with potential infection, several institutions have moved image reading either off-site or to less crowded areas. According to Mahmud Mossa-Basha, M.D., associate professor and vice chair of operations at the major-metropolitan University of Washington Medicine, the department is maximizing providers’ ability to be mobile.
“We have focused on providing the ability for radiology faculty to work from home if needed for isolation,” he said. “For those that are not suspected of having been exposed or infected, but are concerned about potential exposures, we have created radiology outposts and isolated reading rooms across our enterprise, including single-state reading rooms in our hospitals, as well as in our outpatient imaging centers.”
Large, urban academic medical centers Emory University School of Medicine and New York University (NYU) Langone Health are also actively working to deploy more home workstations that would allow asymptomatic radiologists to continue to work from home.
“In our department, a significant number of the clinical faculty already have home workstations as part of our clinical wellness program,” said Danny C. Kim, M.D., associate professor and associate chair of quality and safety at NYU Langone Health. “Prior to the travel ban, radiologists returning from high-risk areas were asked to self-quarantine and interpret cases from home.”
Now, the facility has ordered additional workstations, as well, to enable at-home work as the specter of more COVID-19 quarantines continues to grow.
Identifying patients with respiratory symptoms is critical to separating them from a healthier population. To do so, most institutions have implemented screening protocols upon patient arrival.
For example, Washington screens patients for symptoms that could be related to SARS-Cov-2 infection, recent travel, or any potential exposures when they arrive at the hospital. The radiology department is the second line-of-defense, canceling procedures for outpatients with symptoms and asking them to follow-up with their primary care providers. Non-emergent imaging for inpatients has been postponed.
Outpatients at NYU who have traveled to countries with widespread transmission or who have had contact with infected individuals are referred to the hospital’s Infection Prevention and Control team to determine the need for testing. Given the pervasiveness of the virus, the threshold for calling the team continues to drop, Kim said.