key: cord-0731446-586mxgsj authors: Carlos, Ruth C. title: Pandemic date: 2020-04-22 journal: J Am Coll Radiol DOI: 10.1016/j.jacr.2020.04.017 sha: 7504f2b7f0277eb79faf47e1515df94e959afc3b doc_id: 731446 cord_uid: 586mxgsj nan "All models are wrong but some are useful." --George Box "No matter how much falls on us, we keep plowing ahead. That's the only way to keep the roads clear." Our understanding of the clinical and imaging manifestations of COVID-19 continue to evolve. Liu et al summarize the early literature on CT findings associated with COVID-19 infection [1] . Since the first reported case of COVID-19 in the United States, multiple projections of cases, deaths and health system capacity have been devised and revised as states implemented physical distancing policies, the Centers for Disease Control and Prevention recorded confirmed and suspected cases and hospitals sought to increase equipment and redeploy personnel. While each model's estimate of future cases may have been inaccurate, each prediction acted to spur action. And action we got. The rate and level of response of the medical and scientific community represents some of the most heroic and innovative interventions outside of war. Leadership at all levels accelerated response. Song et al [2] and Goh et al [3] provide examples of Chinese and Singaporean institutional responses from countries initially hit by the pandemic. More locally, Myers et al frame the current coronavirus outbreak as a test of institutional mass casualty incident planning [4] . Prabhakar et al describe early strategies in an academic radiology department as the acuity of the outbreak increased [5] . Where lack of subspecialty expertise threatened to limit care, Davarpanah et al summarize Iran's experience with remote CT consultation using a social media platform [6] . Resource diversion, patient acuity and increased stress in the work environment has consequences beyond patient care. Chen et al remind us of the toll of physical distancing on morale and suggest ways to promote team cohesiveness [7] . Slanetz et al discuss mitigating impact on the resident education [8] . Fessell et al provide micro-practices to promote wellness. To "flatten the curve" and reserve capacity for COVID-19 patients, practices rapidly moved to reschedule elective care and plan for staff redeployment leading to downstream economic concerns. The Journal hosted a webinar to present the range of responses across a diverse group of practices, both academic and private, summarized by Lee et al [10] . By the time this editorial reaches you, the impact of the pandemic will have changed again. Our focus now should be on the "crisis" after the crisis as articulated by Thomas et al [11] . The current pandemic has changed us in profound ways that we are only beginning to quantify. Some represent expedited implementation of planned practice management change. Others are specific to or adapted for the pandemic. Many will have lasting impact on care provision and workflow, such as the expansion of telehealth and deimplementation of lower value care. None of us will remain unaffected. Prior pandemics such as SARS have taught us that we will have to do battle once again. Perhaps the most positive outcome from the current COVID-19 crisis is to develop system and individual resilience after having been severely tested. COVID-19 Computed Tomography Findings: A Systematic Review and Meta-Analysis The Battle Against Coronavirus Disease 2019 (COVID-19): Emergency Management and Infection Control in a Radiology Department Operational Strategies to Prevent COVID-19 spread in Radiology: Experience from a Singapore Radiology Department after SARS Coronavirus Outbreak, is Radiology Ready? Mass Casualty Incident Planning JACR 2020: xx-xx Academic Radiology Departmental Operational Strategy Related to the COVID-19 Pandemic Screening and Triage Strategies in Iran During COVID-19 Epidemic Using Humanitarian Teleconsultation Services Touch Me Not: Physical Distancing in Radiology during COVID-19 COVID-19 and Radiology Education †COVID-19 & Beyond: Micro-practices for Burnout Prevention and Emotional Wellness The "crisis" after the crisis