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AimAs a follow-up to the international survey conducted by the International Atomic Energy Agency (IAEA) in April 2020, this survey aims to provide a situational snapshot of the COVID-19 impact on nuclear medicine services worldwide, 1 year later. The survey was designed to determine the impact of the pandemic at two specific time points: June and October 2020, and compare them to the previously collected data.Materials and methodsA web-based questionnaire, in the same format as the April 2020 survey was disseminated to nuclear medicine facilities worldwide. Survey data was collected using a secure software platform hosted by the IAEA; it was made available for 6 weeks, from November 23 to December 31, 2020.ResultsFrom 505 replies received from 96 countries, data was extracted from 355 questionnaires (of which 338 were fully completed). The responses came from centres across varying regions of the world and with heterogeneous income distributions. Regional differences and challenges across the world were identified and analysed. Globally, the volume of nuclear medicine procedures decreased by 73.3% in June 2020 and 56.9% in October 2020. Among the nuclear medicine procedures, oncological PET studies showed less of a decline in utilization compared to conventional nuclear medicine, particularly nuclear cardiology. The negative impact was also significantly less pronounced in high-income countries. A trend towards a gradual return to the pre-COVID-19 situation of the supply chains of radioisotopes, generators, and other essential materials was evident.ConclusionThe year 2020 has a significant decrease in nuclear medicine diagnostic and therapeutic procedures as a result of the pandemic-related challenges. In June, the global decline recorded in the survey was greater than in October when the situation began to show improvement. However, the total number of procedures remained below those recorded in April 2020 and fell to less than half of the volumes normally carried out pre-pandemic.

So far, The Archivist has not reported any COVID-19-related publications. It has been over 4 years since the pandemic hit the world. At the time of the pandemic, the publications were coming in thick and fast and there was an ever-changing evidence base. It was a quick-moving area of science, as we discovered more about the epidemiology of the acute disease and how to treat it and how to prevent it with public health measures and vaccination. Fortunately, the acute pandemic has slowed down and the virus(es) has(ve) mutated to a less virulent strain. What is apparent that for some who survived the infection, they have been left with long-term, sometimes debilitating, symptoms. So far, these symptoms have been mainly described in adults. Gross et al (on behalf of the RECOVER-Pediatrics Consortium) (JAMA. Published online 21 August 2024. doi:10.1001/jama.2024.12747) have described the prolonged symptoms experienced, most associated with SARS-CoV-2 infection in the cohort of the 5367 children and adolescents who were in the RECOVER-Pediatrics cohort study. This was a multicentre longitudinal observational cohort study from the USA and patients were recruited from 60 healthcare settings between March 2022 and December 2023, and included school-age children and adolescents with and without SARS-CoV-2 infection history. They have defined Long COVID, or postacute sequelae of SARS-CoV-2 infection, as symptoms, signs and conditions that develop, persist or relapse over time after SARS-CoV-2 infection. They are not specific about the time part of the definition. In their cohort, a total of 898 school-age children (751 with previous SARS-CoV-2 infection (referred to as infected) and 147 without (referred to as uninfected)) and 4469 adolescents (3109 infected and 1360 uninfected) were included. Median time between first infection and symptom survey was 506 days for school-age children and 556 days for adolescents. There were a huge range of symptoms reported and you will need to tread the article to see them all. The key thing is that the symptoms appeared to affect most organ systems and there were distinct clusters of symptoms with each age group but also the patterns were different in the younger children compared with the adolescents. This is a large methodologically rigorous generalisable study but has some limitations (five well described in the article), but it is the first large study to delineate the clinical pattern of Long COVID. They used models adjusting for gender, race and ethnicity and identified 14 symptoms in both school-age children and adolescents were more common in those with SARS-CoV-2 infection history compared with those without infection history. There was also with four extra symptoms in school-age children only and three extra symptoms in adolescents only. So, this study has developed research indices for characterising Long COVID in children and adolescents. The symptom patterns had similarities but were distinguishable between the two age groups. This will be relevant for further research. This paper did not go on to describe intervention or outcomes but does establish the clinical phenotypes which will help those further study designs.

PurposeThe coronavirus disease 2019 (COVID-19) pandemic reshaped the usual risk: benefit equilibrium that became a trade-off between the infection exposure risk for the patient (and for staff) and the risk associated with delaying or cancelling the nuclear medicine examination. This study aimed at quantifying the impact of the first COVID-19 lockdown in France on nuclear medicine examination volume together with volume of examination cancellation and non-attendance.MethodsWe retrospectively assessed the volume of planned examinations from 1 month before to 1 month after the first lockdown in French high-volume nuclear medicine departments (NMD) sharing the same information management system including both university hospitals, UH (n = 7), and cancer centres, CC (n = 2).ResultsThe study enrolled 31,628 consecutive patients referred for a nuclear medicine examination performed or not (NMEP or NMEnP). The total volume of NMEP significantly dropped by 43.4% between the 4 weeks before and after the starting of the lockdown. The comparison of the percentage of NMEP and NMEnP between UH and CC is significantly different (p < 0.001). The percentage of NMEP during the study was 67.9% in UH vs 84.7% in CC. Percentages of NMEnP in UH and CC were due respectively to cancellation by the patient (14.9 vs 7.4%), cancellation by the NMD (9.5 vs 3.4%), cancellation by the referring physician (5.1 vs 4.4%) and non-attender patients (2.7 vs 0.2%).ConclusionThe study underlines the public health issue caused by COVID-19 above the pandemic itself and should be useful in preparing for potential resource utilisation and staffing requirements.

The COVID-19 pandemic changes and challenges daily. The race between vaccine development, vaccination rates and viral mutations continues and vaccine hesitancy is prevalent. Even more reason to make sure our other vaccination programmes continue, without interruption and at acceptable rates. Jarchow AA et al. [Lancet Infectious Disease 2021; doi:10.1016/S1473-3099(20)30991-9] have published a simple letter but it has important considerations. There have been concerns about ensuring stable childhood immunisation rates once the local COVID-19 outbreaks turned into national outbreaks. This group in the Lothian area of Scotland has a population of around 900 000 people and around 10 000 births per year. In previous years, attendance at the five routine vaccination appointments in children (aged 0–5 years) has been very high, leading to coverage of more than 95% for most vaccines. It was noted that at the beginning of the pandemic, nearly a quarter of infants in Europe had their vaccination courses interrupted. This drop was also noted in almost 20% during the first UK lockdown was reported in England. This group, in Scotland showed no similar drop. So they have commented on the possible reasons why. Several adaptations had an important role in keeping attendance rates stable. Vaccinations were delivered via fixed-point clinics at various locations that were accessible by public transport. Children who could not attend clinics, due to shielding could be vaccinated by mobile teams. All vaccinations were delivered with appropriate personal protective equipment in place. Changes were made to how data were collected. All vaccination data are held centrally in the Scottish Immunisation Recall System. Data published in previous years began with vaccinations completed when children reached 12 months of age. By contrast, during the pandemic, much shorter periods of time were required to monitor immunisation clinic attendance and uptake of vaccinations. Efforts were made to establish trust and ensure that children and their families felt looked after. All families received a personal reminder via telephone from a trained operator on the day before their vaccination date. Families were asked not to attend if they were displaying any signs of COVID-19. Any concerns were discussed, questions answered, and arrangements made if an interpreter was required. If a child could not be accompanied to the clinic, the option of a visit to the child’s home by a mobile team was offered. In addition, postcards were handed out by health visitors to families, to remind them of upcoming vaccinations. This effort was supported by national communication teams through messages on printed media, social media, and a dedicated homepage for families. Funding of the immunisation programme was secure as the Scottish Government reconfirmed its commitment to support all vaccination efforts during lockdown via a letter from the chief medical officer in Scotland. Staff were protected to continue in their existing roles and were not added to the COVID-19 response staff pool. These adaptations ensured the safe and successful delivery of vaccinations to children as shown by stable clinic attendance rates in the region. Some useful lessons, for all of us.

La letteratura dedicata alla pandemia di COVID-19 è in continua crescita. Questo saggio esplora un campione diversificato di testi scritti durante la prima fase della pandemia da intellettuali occidentali di diverso orientamento culturale e discute alcune delle idee e degli atteggiamenti emotivi maggiormente diffusi in quei testi. L'analisi si sofferma su quattro temi principali: 1) gli usi politici e ideologici del virus; 2) le immagini della natura e del rapporto dell'uomo con essa; 3) le discussioni sulla paura dell'infezione e della morte nelle società secolarizzate e medicalizzate; 4) il senso di estraneazione sperimentato da molti intellettuali durante la quarantena. Nella conclusione, queste tendenze sono discusse nel contesto della crescente diffusione, nelle nostre società, di varie forme di pessimismo culturale. The literature on the COVID-19 pandemic is expanding daily. This essay explores a diverse range of texts written by Western intellectuals of different backgrounds during the first phase of the pandemic and discusses some of the most widespread ideas and emotions conveyed by these texts. Four major themes are addressed: 1) political and ideological uses of the virus; 2) conceptualizations of nature and of humanity's relationship to it; 3) discussions surrounding the fear of infection and death in secular and medicalized societies; 4) the sense of estrangement expressed by many intellectuals during home confinement. In the conclusion, these views are placed in the context of the increasing popularity, in our societies, of various forms of cultural pessimism.