Lessons learned: What SARS taught the Singapore radiology community

As the spread of the Ebola virus continues to dominate headlines around the world, a group of radiologists in Singapore have offered a few takeaway lessons they learned during the spread of severe acute respiratory syndrome (SARS) more than a decade ago.

“Our experience with SARS has shaped and changed our daily practice of radiology,” wrote lead author Apoorva Gogna, MD, of Singapore General Hospital, and colleagues in an article published in the October issue of American Journal of Roentgenology.

More than 8,000 cases of SARS were documented in 26 countries worldwide—China and Singapore had the largest number of reported cases of the ailment, respectively. There were 238 probable SARS cases in Singapore and 33 of those patients died.

Gogna wrote that the pandemic served as a wake-up call for medical services and the lessons learned now make up part of a contagion response plan implemented in recent disease outbreaks like the H1N1 outbreak in 2009.

One lesson Gogna and his team took away from the SARS outbreak was that hospitals are amplifiers of disease transmission and that equipment in their radiology department was often bulky and difficult to clean, despite its frequency of use. Gogna suggests other organizations educate staff about standard infection control protocols and reinforce the use of protective equipment during outbreaks.

A second takeaway was the importance of organizing radiologic facilities with events like SARS in mind.

“If space allows, a separate facility in the department of emergency medicine for conventional radiography and emergency CT examinations should be considered,” the team wrote. They argue having separate facilities in emergency rooms limits contact between emergency department patients with potentially significant infection risks and hospital inpatients.

Additionally, Gogna and team found that infection control “must be considered in the daily scheduling of radiological examinations and procedures.”

At Singapore General Hospital, examinations are scheduled with particular care paid to a patient’s infection status.

“Certain radiology procedure rooms are dedicated for outpatients and noninfectious inpatients,” Gogna and colleagues wrote.

The team also reported that enhanced infection control measures should be planned and in place prior to an actual outbreak.

“Conventional infection control measures are typically designed to prevent transmission via contact and droplets,” the authors wrote. “These measures alone may not be adequate during an outbreak of an infectious disease.”

Gogna and colleagues suggested enhanced measures like isolation policies, protective gear and rigorous contact tracing be implemented during outbreaks to slow the spread of disease.

“The tiniest of creatures do and will continue to challenge us, and we must continue to respond to protect ourselves, our patients, and the community,” they wrote.