A Path to New Normal of Nuclear Medicine Facilities: Considerations for Reopening

Document Type : Letter to the editor


1 Department of Infectious Diseases, Bushehr University of Medical Sciences, Bushehr, Iran

2 Department of Diagnostic Radiology, Keck School of Medicine, University of Southern California, Los Angeles, USA

3 Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran


The stormy clouds of the coronavirus disease 2019 outbreak caused a rapidly spreading epidemic still hanging over the sphere. Any steps to transition toward a new normal should be guided by health authorities, together with economic and societal considerations. There are various items mainly falling into three classifications, including patient worry, clinical demand, and economic recession. Social distancing, lay-offs, and decreased number of patients with health insurance may lead to a prolonged period to retrieve normalcy. To return to a new normal, an individualized management model should be developed for each laboratory based on staff, instruments, services, crowding, physical space, hospital base unit, or outpatient clinic. Continuous training of different occupational staffs is among the key parameters in maintaining this readiness. The proposed response model should have internal and systemic integrity as well as coherence among the included items in two intra- and inter-unit management categories, namely thinking globally and acting locally.


1. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations - Covid-19 in Jails and Prisons. N Engl J Med. 2020; 382:2075-7.
2. Berwick DM. Choices for the “new normal”. Jama. 2020; 323(21):2125-6.
3. Gandhi M, Yokoe DS, Havlir DV. Asymptomatic Transmission, the Achilles ‘heel of Current Strategies to Control Covid-19. N Engl J Med. 2020; 382:2158-60.
4. Arons MM, Hatfield KM, Reddy SC, Kimball A, James A, Jacobs JR, et al. Presymptomatic SARS-CoV-2 Infections and Transmission in a Skilled Nursing Facility. N Engl J Med. 2020; 382:2081-90.
5. Chen RC, Tan TT, Chan LP. Adapting to a new normal? 5 key operational principles for a radiology service facing the COVID-19 pandemic. European Radiology. 2020; 30:4964–4967.
6. Skulstad H, Cosyns B, Popescu BA, Galderisi M, Salvo GD, Donal E, et al. COVID-19 pandemic and cardiac imaging: EACVI recommendations on precautions, indications, prioritization, and protection for patients and healthcare personnel. Eur Heart J Cardiovasc Imaging. 2020; 21:592-8.
7. Huang H, Gnanasegaran G, Paez D, Fanti S, Hacker M, Sathekge M, et al. Nuclear medicine services after COVID-19: gearing up back to normality. Springer; 2020; 47: 2048–2053.
8. Loke KSH, Tham WY, Bharadwaj P, Keng FYJ, Huang Z, Idu MB, et al. Adapting to a novel disruptive threat: Nuclear Cardiology Service in the time of the Coronavirus (COVID-19) Outbreak 2020 (SARS REBOOT). J Nucl Cardiol. 2020;27:1005–9
9. Hosseiny M, Kooraki S, Gholamrezanezhad A, Reddy S, Myers L. Radiology Perspective of Coronavirus Disease 2019 (COVID-19): Lessons From Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome. AJR Am J Roentgenol 2020; 214: 1078-82.
10. Sethuraman N, Jeremiah SS, Ryo A. Interpreting Diagnostic Tests for SARS-CoV- 2. JAMA. 2020; 323(22):2249-2251.
11. Sutton D, Fuchs K, D'Alton M, Goffman D. Universal Screening for SARS-CoV-2 in Women Admitted for Delivery. N Engl J Med. 2020; 382:2163-4.
12. Daniel F. Gudbjartsson, Gudmundur L. Norddahl, Pall Melsted, Kristbjorg Gunnarsdottir, et al. Humoral Immune Response to SARSCoV-2 in Iceland, the new England journal of medicine.2020.
13. Larochelle MR. "Is It Safe for Me to Go to Work?" Risk Stratification for Workers during the Covid-19 Pandemic. N Engl J Med 2020; 383:e28.
14. Paez D, Gnanasegaran G, Fanti S, Bomanji J, Hacker M, Sathekge M, et al. COVID-19 pandemic: guidance for nuclear medicine departments. Eur J Nucl Med Mol Imaging. 2020; 47:1615-9.
15. Skali H, Murthy VL, Al-Mallah MH, Bateman TM, Beanlands R, Better N, et al. Guidance and best practices for nuclear cardiology laboratories during the coronavirus disease 2019 (COVID-19) pandemic: An InformationStatement from ASNC and SNMMI. J Nucl Cardiol. 2020: 1–8.
16. Assadi M, Gholamrezanezhad A, Jokar N, Keshavarz M, Picchio M, Seregni E, et al. Key elements of preparedness for pandemic coronavirus disease 2019 (COVID-19) in nuclear medicine units. Eur J Nucl Med Mol Imaging. 2020; 47:1779–1786.
17. Rose S. Medical Student Education in the Time of COVID-19. JAMA. 2020; 323(21): 2131-2132.
18. Luker GD, AN. B. Transitioning to a New Normal after COVID-19: Preparing to Get Back on Track for Cancer Imaging. Radiology:Imaging Cancer. 2020; 2:1-13.
19. Azam SA, Myers L, Fields BKK, et al. Coronavirus disease 2019 (COVID-19) pandemic: Review of guidelines for resuming non-urgent imaging and procedures in radiology during Phase II [published online ahead of print, 2020 Jun 1]. Clin Imaging. 2020;67:30‐36
20. Ghaedi H, Nasiripour AA, Tabibi SJ, Assadi M. Pillars of Hospital Preparedness in Radiation Emergency Management. Health Phys. 2020; 119(3): 306-314.