Since the discovery of coronavirus disease (COVID 19) in the city of Wuhan, China, hospitals all over the world have been trying to deal with this serious pandemic. COVID-19 has already infected hundreds of healthcare workers and has resulted in some deaths. Since healthcare workers, including radiologists, have to constantly interact with patients suspected of having COVID-19, it is vital to have preventive measures in place to reduce cross-infection and protect healthcare workers. At the moment, there are no universal guidelines regarding this issue, but from recent cases, the authors of this study make  some recommendations.

The first loophole that needs to be closed is in patient triage. The key here is to obtain a good history of fever, travel to China, cough, or dyspnoea; if the history is suspicious for an infection, the patient should be isolated and transported via a private channel to the different departments including radiology. If an infection is suspected, the medical staff should adopt WHO grade 1 protective criterion (eg gown, face mask, gloves, eye protection). If the patient needs imaging, mobile techniques are recommended if the patient is in the intensive care unit, emergency room or in isolation.

The primary protection is focused on controlling transmission routes such as droplets, constant surface, and aerosol transmission. All areas should be divided in zones such as clean, suspected contaminated, and contaminated to accommodate different types of patients.

The contaminated areas should be well ventilated with ventilation equipment. After every exam, the air and contact surfaces must be sterilised. At least 30 minutes should expire before examining the next patient to minimise transmission. At all times, the healthcare worker must be protected by at least WHO grade I or ll protective measures.

Medical personnel who have come into close physical contact with a suspected patient or infected equipment should follow strict antiseptic procedures before entering and exiting contaminated or suspected areas. Once they have been exposed, they must report the incident and need to be isolated immediately. 

In addition, it is recommended that paperless systems should be utilised to lower risk of exposure. Electronic recording and documentation is encouraged and if possible, remote diagnosis is highly recommended. Radiologists should be encouraged to perform  remote diagnosis using a variety of digital devices.

To date, the majority of COVID-19 cases in healthcare workers have been due to poor understanding of the newly emerged coronavirus. The disease can be handled better if healthcare workers are better protected, provided more training, hospitals establish protocols for managing suspected and infected patients, and implement a paperless system.

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References:

Yu J et al. (2020) Infection Control against COVID-19 in Departments of Radiology. Academic Radiology, 27(5):614-617. 



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