Dear EFOMP Colleagues,

We are in the midst of an unprecedented challenge to the health systems in Europe and this is a worrying time for all of us. As medical physicists we have a role to play in helping patients and staff. This is in both maintaining existing patient service needs and dealing with the service demands of the novel coronavirus.

Some of us have already experienced the manifestation of the COVID-19 virus in our hospitals and clinics where we provide services. We have decided to share some approaches to providing physics services through this crisis. We recognise that local regulatory and other arrangements and strategies may differ and that we should follow the advice of infection control and public health experts. The approach shared below is designed to make treatment and diagnosis safely available and minimise risk to ourselves, family and colleagues.

1. Prioritise: Services need to prioritise tasks that are essential and urgent and postpone those tasks which can tolerate delays with a lesser risk to patients and staff. Such services that may be considered for postponement after risk assessment are those which are scheduled annually: Quality assurance in imaging systems or assessment of lead aprons.
2. Maintain services that cannot be postponed e.g. quality control on radiotherapy equipment and dosimetric checks connected with advanced radiotherapy treatments (VMAT/IMRT, SBRT, SRS, IGRT), dosimetric assessment associated with radiotherapy treatment planning, pre discharge assessment of patients who undergo brachytherapy treatments, certain weekly or monthly checks on gamma cameras, nuclear medicine therapies, pre discharge assessment of radioiodine for iodine cancer patients, or safety checks after major maintenance e.g. tube changes in diagnostic or interventional radiology.
3. Protect workers and staff by risk assessment e.g., infection control of equipment and test objects before testing, waiting adequate times, care handling dosimetry badges from different areas in the hospital and isolation wards.
4. Prevent the spread of the virus further by working from home if possible and only attending clinical locations if necessary and ensuring that staff resources are available for whenever service demands stabilise. This also includes vigilant handwashing, use of personal protective equipment and respiratory etiquette where appropriate. It also includes following public and occupational health guidelines around symptoms and isolation. EFOMP scheduled events as well as National Member Organisations meetings have already been cancelled or postponed (further information will be released soon). Online tools for training and meetings are useful during this period.
5. Prepare for the anticipated needs of the diagnostic, intensive and critical care services in dealing with this serious respiratory virus. Such examples would be risk assessment for the use of mobile radiography or CT scanning in new locations in or out of hospitals. Testing and commissioning of additional portable equipment, scanners or bringing back old equipment into service, assessing safety of face masks in MRI scanners. Physicists may be involved in biomedical engineering departments providing assistance with patient monitoring and organ supporting equipment, e.g. ventilators. Physicists may have to collaborate closely with the infection control and administration departments of the hospital for prioritising treatments, eliminating waiting times for cancer patients in critical clinical conditions (stretcher, wheelchair), closely monitoring any changes in cancer patients – under treatment condition. There also may be a call on us to use our scientific skills to come up with innovative solutions to assist in diagnosis and treatment of this virus.
6. Share your experiences through your National Member Organisation to EFOMP for further dissemination via EFOMP’s digital communications tools will help in this regard too.
7. Support our frontline colleagues who may be undergoing unprecedented workloads in stressful conditions.

We hope in our hearts that most of you will not get to experience the effects of the coronavirus as has been experienced in some member countries already. However, emerging data suggests that this may not be possible, and we are aware that advice and guidance around this area changes every day.

Stay Healthy and Stay Safe.

Best Wishes
Marco Brambilla
President of EFOMP