Christoph Trauernicht
Department Medical Imaging and Clinical Oncology
Universiteit Stellenbosch University and Tygerberg Hospital
Cape Town; South Africa

Covid-19 was declared a national disaster in South Africa in mid-March and a national lockdown was put in place from 26 March – 16 April. Health workers are classified as “essential”, but it was decided to allow a “work-from-home” strategy in the medical physics division where possible, which was in line with notices issued by head office. Deliverables during the “work-from-home” period could e.g. include the writing and submission of research papers, remote treatment plan checking or compiling the portfolios of evidence in the case of medical physics interns.

A roster was introduced where medical physics staff was staggered, so that not all staff members were on site all the time, but that at least two medical physicists were in the division on any given day, so that all essential services could be covered. QA/QC schedules were also adjusted to take the skeleton staffing into account. Mould room requests are dealt with by the RTTs or the medical physicists as far as possible. Personnel radiation exposure monitoring continues. Patient specific QA or linear accelerator QC can be done after hours. The administration of Lu-177, done by nuclear medicine staffs in this hospital, and the related patient specific internal dosimetry, also proceeded as planned.

Radiation oncology services continue normally, to date no Covid-19 patients have been treated. However, we have started screening all patients at the front door with a questionnaire asking about travel history and Covid-19 symptoms (fever, dry cough, sore throat or similar) or sick family members. We have also introduced patient visitation restrictions and are only allowing at most one relative per patient in the building. We have started hypo-fractionation regimes already to reduce the number of times patients have to come to the hospital during the lockdown. One of our linear accelerators will become a dedicated “Corona-Linac” should the need arise, and provisions were made in the ward as well.

At the time of writing we are in week 1 of the national lockdown, but this system seems to be working.