An evaluation of the experiences of radiography students working on the temporary HCPC register during the COVID-19 pandemic

IntroductionThe COVID-19 pandemic has changed the world's perspective and had a profound impact on all those residing in the United Kingdom, resulting in unprecedented changes being made to the education and training of healthcare students. Universities and practice partners had to respond quickly and work in close collaboration with their wider system partners, Health Education England and the Department of Health, to ensure the changes made within the Health and Care Professions Council (HCPC) emergency measures were implemented.The aim was to explore the experiences of final year diagnostic and therapeutic radiography students who joined the HCPC temporary register during phase one of the COVID-19 pandemic.MethodsThis study was informed by a phenomenological approach, in which a purposeful sample of seventeen participants comprising of nine students, six practice educators and two academics were chosen to participate. Semi-structured interviews and focus groups were conducted to collect the data via a virtual platform.ResultsThe results highlighted three themes, professionalism and transition to registration, benefits and challenges of working through a pandemic, and emotional impact. Students described how they gained confidence and competence during their time on the temporary register and suggested that professional bodies could consider curriculum changes to encompass a final transitional placement similar to their experience. They said they had been well supported but felt a sense of loss having been denied the normal rite of passage associated with completion of their course and graduation.ConclusionThe results provide insight into how students, practice educators and academics transformed their practice to meet the necessary requirements whilst working during the first phase of the COVID-19 pandemic. They highlight the importance of having good support mechanisms in place and the rewards and challenges for students joining their professional register early.Implications for practiceSome consideration could be made to changing the curriculum in the future to allow for early temporary registration and paid Band 4 final placements for students working as assistant practitioners.     

Transitioning into the workforce during the COVID-19 pandemic: Understanding the experiences of student diagnostic radiographers

IntroductionThe COVID-19 pandemic, with associated pressures on healthcare services and workforce, had implications for final year Diagnostic Radiography students completing their training and transitioning into employment. The aim of this study was to explore their experience as novice practitioners starting work and integrating into the workforce during a time of national crisis.MethodsFive early career Diagnostic Radiographers, eligible to join the temporary HCPC register, were recruited. One to one interviews were completed online exploring their thoughts, feelings and experiences. Participants had the option of using photographs to aid communication.ResultsInterviews were transcribed, emerging themes identified and coded. Four main themes emerged specifically related to the COVID-19 pandemic, (i) perceived challenges associated with joining the workforce, (ii) managing expectations and unexpected outcomes during transition, (iii) adapting to changes in systems and structures, (iv) sense of uncertainty relating to professional identity. The impacts were experienced beyond the work environment into social and personal lives. Participants demonstrated resilience as they adapted to their shifting lives and drew on the support of clinical colleagues and University academics for help. They did report feelings of concern and anxiety. The participants all expressed a sense of feeling valued and supported in their new roles.ConclusionThe Pandemic was unprecedented and created uncertainty in terms of workforce requirements. This study highlights the personal impact and professional responses of novice practitioners, who felt a sense of duty and care to help support the NHS and others.Implications for practiceThis will help in the understanding of the transition of student into employment and what wider support needs to be in place prior, during and after this phase.     

A review of the impact of the COVID-19 pandemic on pre-registration medical radiation science education

ObjectiveThe COVID-19 pandemic has changed traditional ways to provide pre-registration medical radiation science (MRS) (medical imaging and radiation therapy) education. This literature review explores the published pre-registration MRS education curriculum adaptations implemented in response to the pandemic and effects of the adaptations on stakeholders.Key findingsEleven articles were identified through a systematic literature search. The included articles covered the pre-registration MRS curriculum adaptations implemented in response to the pandemic in 12 countries of five continents. Through changing content delivery and assessment modes from face-to-face to online, non-practical classes and academic assessments could continue without significant interruptions. However, cancellation/postponement of practical classes and clinical placements was common during COVID-19 lockdown. Simulated learning was used by some institutions to replace some practical classes and placements. Among the stakeholders of MRS education (students, academics and clinical educators), the students were most affected. The main impacts were negative psychological effects and learning experiences. For the academics, they had common concerns about online learning quality and assessment integrity.ConclusionThis review of the early publications in the first year of the pandemic provides an illustration of the MRS curriculum adaptations implemented in five continents covering both English and non-English speaking countries and their effects on the stakeholders as yet. It is expected that more articles on this area will be published over time and hence allowing a more comprehensive review in the future.Implications for practiceThe included articles show provision of wellbeing support, good planning of online content delivery based on sound pedagogical approaches, implementation of computer-based simulation tools suitable for home-based learning environment and use of authentic online assessments would address the impacts on the students and academics.     

Expectations of therapeutic radiography students in Wales about transitioning to practice during the Covid-19 pandemic as registrants on the HCPC temporary register

IntroductionThe Covid-19 crisis continues to profoundly impact on radiotherapy practice in the UK. We explore the views of therapeutic radiographer students on entering their first post in unique circumstances as a means to evaluate the support that may minimise negative impacts on their transition to practitioners.MethodFocus groups were conducted outside of students’ final year educational programme and immediately prior to them starting work. Qualitative data were analysed using a framework analysis.ResultsEmergent themes from the eleven participants were: Covid-19 as a layer on top of underlying anxieties; Degree of readiness for imminent psychological, emotional and practical challenges; Feeling valued as a health professional/radiographer at this time; A mixed student and qualified staff professional identity as HCPC temporary registrants.ConclusionUncertainties related to Covid-19 were seen to add a destabilising component to existing anxieties and challenges. In this context, there are significant risks of impaired professional socialisation due to incongruence between students’ expectations and the reality in clinical departments.Implications for practiceInformed academic support and flexible clinical preceptorship that address anxieties and congruence barriers are vital to guide new practitioners through a health crisis that presents significant challenges but also opportunity for professional development.     

COVID-19: A literature review of the impact on diagnostic radiography students

IntroductionCOVID-19 is a highly contagious viral disease declared a global pandemic in March 2020. Throughout the pandemic, radiography students have been working in hospitals on the frontline. The review aimed to search for evidence of the impact COVID-19 has had on diagnostic radiography students and consider whether additional support and learning needs to be implemented.MethodsA literature search strategy applied keywords, BOOLEAN search operators, and eligibility criteria on PubMed, Medline, and Google Scholar databases. Cormack's (2000) critique framework was chosen to methodologically appraise the mixed-method studies to evaluate the quality, validity and rigour.ResultsThe search decisions were displayed in a PRISMA flowchart to evidence the process to identify the found articles comprised of two surveys, two semi-structured interviews and one case study. The findings identified common and reoccurring themes of personal protective equipment, mental wellbeing, accommodation and travel, assessments and learning, and transitioning to registration.ConclusionThe literature suggests that students felt positive impacts of the pandemic, such as being prepared for registration. However, negative effects included the fear of contracting the virus, anxieties of working with ill patients, impracticalities of accommodation and travel during clinical placement, and the adaption to online learning.Implications for practiceClinical staff and universities need to work together to ensure students are mentally and physically supported during the pandemic. Regular meetings and agreed channels of communication with students will allow any issues to be brought to attention and addressed. In addition, employers should recognise that newly qualified radiographers will need extra support.     

The global impact of the COVID-19 pandemic on clinical radiography practice: A systematic literature review and recommendations for future services planning

IntroductionWorldwide, reports and experiences indicate that there has been extensive re-organisation within diagnostic imaging and radiotherapy departments in response to the COVID-19 pandemic. This was necessary due to changes in workload and working practice guidelines that have evolved during the pandemic. This review provides a comprehensive summary of the global impact of the COVID-19 pandemic on radiography practice, service delivery and workforce wellbeing.MethodsA systematic review methodology was adopted to obtain data from primary studies of qualitative, quantitative, and mixed methods designs from databases (PubMed, Science Direct, Cumulative Index of Nursing and Allied Health Literature [CINAHL], and SCOPUS: all 2020 to present). The included articles were subjected to information extraction and results-based convergent synthesis.ResultsThe electronic database search yielded 10,420 articles after removal of duplicates. Of these, 31 articles met the final inclusion criteria with some (n = 8) fully focussed on radiotherapy workforce and service delivery. The pandemic impact on radiography practice is broadly themed around: training, communication, and information dissemination; infrastructure, technology, and clinical workflow; and workforce mental health and well-being.ConclusionGlobally, most radiographers received inadequate training for managing COVID-19 patients during the initial acute phase of the pandemic. Additionally, there were significant changes to clinical practice, working patterns and perceived increase in workload due to surges in COVID-19 patients and the consequent strict adherence to new infection protocols. These changes, coupled with fear emanating from the increased risk of the workforce to contracting the infection, contributed to anxiety and workplace-related stress during the pandemic.Implications for practiceLocal pandemic response strategies must be appropriately developed from standard protocols in readiness for safe clinical practice and well-being management training of practitioners.     

The radiology workforce's response to the COVID-19 pandemic in the Middle East,North Africa and India

IntroductionThis study aimed to investigate the response of the radiology workforce to the impact of the coronavirus disease 2019 (COVID-19) pandemic on professional practice in India and eight other Middle Eastern and North African countries. It further investigated the levels of fear and anxiety among this workforce during the pandemic.MethodsA quantitative cross-sectional study was conducted using an online survey from 22 May-2 June 2020 among radiology workers employed during the COVID-19 pandemic. The survey collected information related to the following themes: (1) demographic characteristics, (2) the impact of COVID-19 on radiology practice, and (3) fear and (4) anxiety emanating from the global pandemic.ResultsWe received 903 responses. Fifty-eight percent had completed training on infection control required for handling COVID-19 patients. A large proportion (79.5%) of the respondents strongly agreed or agreed that personal protective equipment (PPE) was adequately available at work during the pandemic. The respondents reported experiences of work-related stress (42.9%), high COVID-19 fear score (83.3%) and anxiety (10%) during the study period.ConclusionThere was a perceived workload increase in general x-ray and Computed Tomography imaging procedures because they were the key modalities for the initial and follow-up investigations of COVID-19. However, there was adequate availability of PPE during the study period. Most radiology workers were afraid of being infected with the virus. Fear was predominant among workers younger than 30 years of age and also in temporary staff. Anxiety occurred completely independent of gender, age, experience, country, place of work, and work status.Implications for practiceIt is important to provide training and regular mental health support and evaluations for healthcare professionals, including radiology workers, during similar future pandemics.     

A qualitative analysis of radiography students' reflective essays regarding their experience of clinical placement during the COVID-19 pandemic

BackgroundThe COVID-19 pandemic significantly impacted healthcare services and clinical placement for healthcare students. There is a paucity of qualitative research into radiography students’ experiences of clinical placement during the pandemic.MethodStudents in stages three and four of a 4-year BSc Radiography degree in Ireland wrote reflective essays regarding their experience of clinical placement during the COVID-19 healthcare crisis. Permission was granted by 108 radiography students and recent graduates for their reflections to be analysed as part of this study. A thematic approach to data analysis was used, allowing themes to emerge from the reflective essays. Two researchers independently coded each reflective essay using the Braun and Clarke model.ResultsFour themes were highlighted; 1) Challenges associated with undertaking clinical placement during the pandemic, such as reduced patient throughput and PPE-related communication barriers; 2) Benefits of clinical placement during the pandemic, in terms of personal and professional development and completing degree requirements to graduate without delay; 3) Emotional impact and 4) Supporting students in clinical practice. Students recognised their resilience and felt proud of their contribution during this healthcare crisis but feared transmitting COVID-19 to family. Educational and emotional support provided by tutors, clinical staff and the university was deemed essential by students during this placement.ConclusionsDespite the pressure hospitals were under during the pandemic, students had positive clinical placement experiences and perceived these experiences to have contributed to their professional and personal growth.Implications for practiceThis study supports the argument for clinical placements to continue throughout healthcare crisis periods, albeit with additional learning and emotional support in place.Clinical placement experiences during the pandemic prompted a deep sense of pride amongst radiography students in their profession and contributed to the development of professional identity.     

Quantifying Impact of Disruption to Radiology Education During the COVID-19 Pandemic and Implications for Future Training

PurposeThe aim of this study was to assess the impact on radiology resident education due to the COVID-19 pandemic in order to inform future educational planning.MethodsDuring a 10-week study period from March 16 to May 22, 2020, changes to educational block-weeks (BW) of first through fourth year residents (R1-4) were documented as disrupted in the setting of the COVID-19 pandemic. The first 5 weeks and the second 5 weeks were evaluated separately for temporal differences. Overall and mean disrupted BW per resident were documented. Wilcoxon rank-sum tests were used to assess pairwise differences between classes with Bonferroni-adjusted P-values, as well as differences in the early versus later phase of the pandemic.ResultsOf 373 BW, 56.6% were assigned to virtual curriculum, 39.4% radiology clinical duties, 2.9% illness, and 1.1% reassignment. Scheduling intervention affected 6.2 ± 2.3 (range 1-10) mean BW per resident over the 10-week study period. The R3 class experienced the largest disruption, greater than the R2 classes, and statistically significantly more than the R1 and R4 classes (both P < 0.05). The second half of the pandemic caused statistically significantly more schedule disruptions than the first half (P = 0.009).DiscussionThe impact of COVID-19 pandemic varied by residency class year, with the largest disruption of the R3 class and the least disruption of the R4 class. To optimize future educational opportunities, shifting to a competency-based education paradigm may help to achieve proficiency without extending the length of the training program.     

Trends in Academic Productivity Among Radiologists During the COVID-19 Pandemic

PurposeThere is a scarcity of literature examining changes in radiologist research productivity during the COVID-19 pandemic. The current study aimed to investigate changes in academic productivity as measured by publication volume before and during the COVID-19 pandemic.MethodsThis single-center, retrospective cohort study included the publication data of 216 researchers consisting of associate professors, assistant professors, and professors of radiology. Wilcoxon’s signed-rank test was used to identify changes in publication volume between the 1-year-long defined prepandemic period (publications between May 1, 2019, and April 30, 2020) and COVID-19 pandemic period (May 1, 2020, to April 30, 2021).ResultsThere was a significantly increased mean annual volume of publications in the pandemic period (5.98, SD = 7.28) compared with the prepandemic period (4.98, SD = 5.53) (z = ?2.819, P = .005). Subset analysis demonstrated a similar (17.4%) increase in publication volume for male researchers when comparing the mean annual prepandemic publications (5.10, SD = 5.79) compared with the pandemic period (5.99, SD = 7.60) (z = ?2.369, P = .018). No statistically significant changes were found in similar analyses with the female subset.DiscussionSignificant increases in radiologist publication volume were found during the COVID-19 pandemic compared with the year before. Changes may reflect an overall increase in academic productivity in response to clinical and imaging volume ramp down.     

Re-initiation of CT colonography services during the COVID-19 pandemic: Preliminary evaluation of safety

Objective:The COVID-19 pandemic has led to cancellation and deferral of many cancer investigations, including CT colonography (CTC). In May 2020, BSGAR and SCoR issued guidelines outlining steps for conduct of CTC in the early recovery phase. We evaluated the implementation of these in four English hospital trusts.Methods:Ethical permission was not required for this multicentre service evaluation. We identified patients undergoing CTC over a 2-month period from May to July 2020 at four Trusts. We recorded demographics, scan indications, colonic findings, and incidental lung base changes compatible with COVID-19. A subset of patients were contacted via telephone to document new symptoms 2 weeks following their scan. Staff were contacted to determine if any acquired COVID-19 during the period.Results:224 patients (118 male, 52.7%) were scanned during the period. In 55 patients (24.6%), CTC showed a ≥6 mm polyp. 33 of 224 (14.7%) scans showed incidental lung base changes felt unrelated to COVID-19, and only one patient had changes indeterminate for COVID-19; no classic COVID-19 pulmonary changes were found. Of 169 patients with telephone follow-up, none reported any new symptoms of COVID-19 (cough, fever, anosmia, ageusia) within 14 days of CTC. None of the 86 staff contacted developed COVID-19.Conclusion:We found no cases of patients or staff acquiring COVID-19 infection following CTC; and no evidence of significant asymptomatic COVID-19 patients attending for CTC appointments based on lung base changes.Advances in knowledge:Our findings suggest that current practice is unlikely to contribute significantly to spread of SARS-nCOV2. Cancer and significant polyp detection rates were high, underlining the importance of maintaining service provision.     

Brachytherapy care during the COVID-19 pandemic: Practice statement from a cancer center in Wuhan,China

PurposeCOVID-19 broke out in late 2019 and rapidly spread around the world and became a pandemic. This highly contagious disease affects routine health care services and patients with cancer who are susceptible to it. Delivering brachytherapy on time is critical for patients with cancer to get better prognosis. The purpose of this study is to present workflow and standard for radiation centers to deliver brachytherapy and avoid cross-infection during the COVID-19 pandemic.Methods and MaterialsThis study combined previous literature and guidelines of precaution with clinical experience in the COVID-19 pandemic.ResultsA workflow covering patients' screening, health care workers’ precaution, training, and other aspects of the whole brachytherapy procedure was established.ConclusionsFrom the reopening of radiation center to mid-May in 2020, there is no hospital infection of COVID-19 in patients or health care workers. This recommendation is effective and helpful to other cancer centers.     

The impact of COVID-19 upon student radiographers and clinical training

IntroductionTo investigate student clinical placement concerns and opinions, during the initial COVID-19 pandemic outbreak and to inform educational institution support planning.MethodsBetween mid-June to mid-July 2020, educational institutions from 12 countries were invited to participate in an online survey designed to gain student radiographer opinion from a wide geographical spread and countries with varying levels of COVID-19 cases.Results1277 respondents participated, of these 592 had completed clinical placements during January to June 2020. Accommodation and cohabiting risks were identified as challenging, as was isolation from family, travel to clinical placements, and to a lesser extent childcare. Students stated they had been affected by the feeling of isolation and concerns about the virus whilst on placement. Overall 35.4% of all respondents were ‘Not at all worried’ about being a radiographer, however, 64.6% expressed varying levels of concern and individual domestic or health situations significantly impacted responses (p ≤ 0.05). Year 4 students and recent graduates were significantly more likely to be ‘Not worried at all’ compared to Year 2 and 3 students (p ≤ 0.05). The need for improved communication regarding clinical placements scheduling was identified as almost 50% of students on clinical placements between January to June 2020 identified the completion of assessments as challenging. Furthermore, only 66% of respondents with COVID-19 imaging experience stated being confident with personal protective equipment (PPE) use.ConclusionStudent radiographers identified key challenges which require consideration to ensure appropriate measures are in place to support their ongoing needs. Importantly PPE training is required before placement regardless of prior COVID-19 imaging experience.Implications for practiceAs the next academic year commences, the study findings identify important matters to be considered by education institutions with responsibility for Radiography training and as students commence clinical placements during the on-going global COVID-19 pandemic.     

Supporting radiography clinical placements in Ireland during the COVID-19 pandemic: The practice educators perspective

IntroductionThe COVID-19 pandemic has significantly impacted healthcare services and the clinical learning environment. Several studies have investigated radiography students' experiences of clinical placement during the pandemic; however, few have investigated the Clinical Practice Educator's (CPEs) perspective. CPEs play a pivotal role in supporting clinical education.MethodA qualitative study was conducted using a purposeful sample of twenty-two CPEs, each working in a different Irish hospital. Four semi-structured focus groups were used to gather data. To maintain reasonable homogeneity, CPEs who were new to the role (n = 8) were assigned a separate focus group from experienced CPEs (n = 14). Inductive thematic analysis was applied.ResultsCPEs experienced role expansion, particularly in managerial and administrative aspects of the role. They described arranging COVID-19 vaccinations locally for radiography students and the complexities of student rostering during the pandemic. CPEs perceived the pandemic to have impacted students' emotional wellbeing with ‘high anxiety levels’ and ‘loneliness’ being reported. They also perceived issues with clinical readiness and the student transition to clinical practice. Many challenges were faced by CPEs including arranging clinical recovery time for numerous students when sites were already at full capacity, fewer learning opportunities due to decreased patient throughput and range of imaging examinations, social distancing constraints, resistance from staff to student placements, and a shortage of staff for student supervision. Flexibility, communication, and multi-level support helped CPEs to fulfil their role.ConclusionThe results provide insight into how CPEs supported radiography clinical placements during the pandemic and into the challenges faced by CPEs in their role. CPEs supported student placement through multi-level communication, teamwork, flexibility, and student advocacy.Implications for practiceThis will aid understanding of the support mechanisms needed by CPEs to provide quality clinical placements.     

Radiology Imaging Volume Changes During Discrete COVID-19 Pandemic Waves: Implications for the Delta Variant of Coronavirus and Future Pandemics

PurposeThe aim of this study was to evaluate radiology imaging volumes at distinct time periods throughout the coronavirus disease 2019 (COVID-19) pandemic as a function of regional COVID-19 hospitalizations.MethodsRadiology imaging volumes and statewide COVID-19 hospitalizations were collected, and four 28-day time periods throughout the COVID-19 pandemic of 2020 were analyzed: pre–COVID-19 in January, the “first wave” of COVID-19 hospitalizations in April, the “recovery” time period in the summer of 2020 with a relative nadir of COVID-19 hospitalizations, and the “third wave” of COVID-19 hospitalizations in November. Imaging studies were categorized as inpatient, outpatient, or emergency department on the basis of patient location at the time of acquisition. A Mann-Whitney U test was performed to compare daily imaging volumes during each discrete 28-day time period.ResultsImaging volumes overall during the first wave of COVID-19 infections were 55% (11,098/20,011; P < .001) of pre–COVID-19 imaging volumes. Overall imaging volumes returned during the recovery time period to 99% (19,915/20,011; P = .725), and third-wave imaging volumes compared with the pre–COVID-19 period were significantly lower in the emergency department at 88.8% (7,951/8,955; P < .001), significantly higher for outpatients at 115.7% (8,818/7,621; P = .008), not significantly different for inpatients at 106% (3,650/3,435; P = .053), and overall unchanged when aggregated together at 102% (20,419/20,011; P = .629).ConclusionsMedical imaging rebounded after the first wave of COVID-19 hospitalizations, with relative stability of utilization over the ensuing phases of the pandemic. As widespread COVID-19 vaccination continues to occur, future surges in COVID-19 hospitalizations will likely have a negligible impact on imaging utilization.     

Running behavior and symptoms of respiratory tract infection during the COVID-19 pandemic: A large prospective Dutch cohort study

ObjectivesTo explore changes in running behavior due to the Coronavirus Disease 2019 (COVID-19) pandemic, assess presence of symptoms suggestive for COVID-19 and identify whether there is an association between running behavior and COVID-19.DesignProspective cohort study.MethodsFor this study we used a cohort of runners participating in an ongoing randomized controlled trial on running injury prevention among recreational runners. At baseline, demographic and training variables were collected. Seven weeks after starting the lockdown, information on running behavior (interval training, training with partner and physical distancing during training) and running habits (training frequency, duration, distance and speed) were obtained. Furthermore, healthcare utilization and symptoms suggestive for COVID-19 were assessed. To determine the association between running and symptoms suggestive for COVID-19, univariate and multivariate logistic regression analyses were performed.ResultsOf the 2586 included participants, 2427 (93.9%) participants continued running during lockdown with no significant changes in mean weekly training variables. A total of 253 participants (9.8%) experienced symptoms suggestive for COVID-19 and 10 participants tested positive for COVID-19. Two participants were admitted to hospital due to COVID-19 with both one day of admission. Running behavior and running habits were not associated with the onset of symptoms suggestive for COVID-19.ConclusionsThe large majority of runners in the Netherlands did not change their running habits during lockdown. No association between running behavior or running habits and onset of symptoms suggestive for COVID-19 was identified. This implicates that running outdoor during lockdown does not negatively affect health of runners.     

Management of patients with suspected or confirmed COVID-19, in the radiology department

ObjectivesFrom December 2019, a novel coronavirus disease named COVID-19 was reported in China. Within 3 months, the World Health Organization defined COVID-19 as a pandemic, with more than 370,000 cases and 16,000 deaths worldwide. In consideration of the crucial role of diagnostic testing during COVID-19, the aim of this technical note was to provide a complete synthesis of approaches implemented for the management of suspected or confirmed COVID-19 patients.Key findingsThe planning of a robust plan to prevent the transmission of the virus to patients and department staff members should be fundamental in each radiology service. Moreover, the speed of spread and the incidence of the pandemic make it necessary to optimize the use of personal protective devices and dedicated COVID-19 equipment, given the limited availability of supplies.ConclusionIn the management of radiographic and CT imaging, staff should take special precautions to limit contamination between patients and other patients or professionals.Implications for practiceAn isolated imaging room should be dedicated to suspected or confirmed COVID-19 cases, including radiography and CT scanners. This paper will provide guidance concerning disposable protective gear to be utilized, as well as on the cleaning and sanitation of radiology room and equipment.     

Impact of the COVID-19 pandemic on corticosteroid injection services: A National Survey of Members of the British Society of Skeletal Radiologists (BSSR)

ObjectiveTo describe the restructuring of services by British radiologists in response to evolving national guidelines and highlight the impact of the COVID-19 pandemic on the treatment of musculoskeletal (MSK) conditions.MethodsAn online anonymised survey was distributed via the British Society of Skeletal Radiology (BSSR) members forum in November 2020. Responses were collated using a standardised Google form including 21 questions.Results135 members of the BSSR completed the survey. 85% of respondents stopped performing corticosteroid injections (CSI) during the initial lockdown of the pandemic. This was primarily influenced by national guidelines. The majority of respondents initially abstained from offered CSI procedures, then by November 2020, 69% of respondents were providing CSI for high and low risk patients, 23% were only providing CSI for low-risk patients with 8% still not performing any CSI. 40% of respondents reported routinely obtaining specific written consent regarding the risk of COVID-19. Approximately, 11,000 CSI were performed by respondents between March and November 2020 with no reported significant COVID-19-related complications. Over 80% of BSSR members reported that the number of CSI procedures that they performed dropped by more than 80% compared to usual. 73% of respondents reported an increased backlog of patients awaiting treatment. The average waiting time for routine outpatient CSI treatment was > 12 weeks in 53% of responses, compared to 34% the previous year.ConclusionThe COVID-19 pandemic has had a significant impact on the clinical practices of MSK radiologists in the UK. Our survey highlights the rapid response of BSSR members as national guidelines evolved. Currently, the majority of respondents are performing CSI for musculoskeletal conditions when clinically indicated, with enhanced consent. However, the pandemic has resulted in increased waiting times – delaying the treatment of patients who may be suffering with significant pain and disability. Further research is warranted to provide guidance around both service recovery and provision of CSI around COVID-19 vaccination schedules.Advances in knowledgeBSSR members responded rapidly to changing guidelines during the COVID-19 pandemic. The majority of respondents are currently performing CSI when clinically indicated. The pandemic has resulted in a significant increase in waiting times which will have a significant impact on UK musculoskeletal services.     

Brachytherapy during the coronavirus disease 2019 – Lessons from Iran

PurposeCOVID-19 outbreak is not a short-time crisis, and discontinuing or postponing life-saving treatments is not logical. Brachytherapy is one of the important treatment modalities for some subsites of cancers. Therefore, we decided to consider some of the best feasible brachytherapy regimes during the pandemic.Methods and MaterialsWe considered brachytherapy guidelines and landmark trials and selected the most efficacious indications of brachytherapy, considering the best regimens to minimize the risk of exposure to the novel coronavirus.ResultsWe developed appropriate recommendations amid the COVID-19 pandemic for brachytherapy management of cervical, endometrial, breast, prostate, head and neck, and soft-tissue sarcomas.ConclusionsBrachytherapy provides an opportunity for the patients and the physicians during the COVID-19 outbreak; it can retain the patient's chance for treatment while limiting the chance of exposure and transmission of infection.