key: cord-1039571-7bzi678s authors: Blankstein, Ron title: President’s Page: The Impact of the COVID-19 Pandemic on Cardiac CT date: 2020-05-06 journal: J Cardiovasc Comput Tomogr DOI: 10.1016/j.jcct.2020.05.001 sha: d016748a6dfac8654a4d4754275d9e64a6747e85 doc_id: 1039571 cord_uid: 7bzi678s nan It is astounding to think about how much and how quickly all of our lives have changed in the last few months. By the time the World Health Organization declared the COVID-19 outbreak as a pandemic on March 11, 2020, our hospitals were already preparing for an unprecedented crisis. Travel restrictions were being imposed, social distancing measures implemented, and academic conferences cancelled. Elective outpatient care was being cancelled, while healthcare providers were learning new telemedicine skills or preparing to be redeployed as COVID care providers. The single most important lesson from this experience has been the fact that healthcare workers are heroes. Indeed, many of our SCCT members -ranging from radiologists and cardiologists to technologists and early career trainees --have been working tirelessly on the frontlines. We cannot thank them enough for all their selfless contributions during this time. However, a few other lessons have now been realized by all of us. (1) the battle against COVID-19 will not be a quick one; (2) The "the new normal" -whenever it might arrive -will be very different and is likely here to stay; (3) Despite all the challenges that we are facing, there is a unique opportunity to redefine (and hopefully improve) how we do things! Given SCCT's mission to improve health outcomes through effective use of cardiovascular CT, education has always been an integral part of our society. Yet, during the peak of the COVID-19 pandemic, educational opportunities for cardiovascular fellows and radiology residents essentially disappeared. In response, the Board of Directors put together a 7-week series, "Cardiac CT Live Reading Sessions with the Experts." These free sessions were designed to simulate the experience of an in-person reading session -with faculty that included Maros Ferencik, Chris Maroules, Jeff Carr, Brian Ghoshhajra, Jonathon Leipsic, Kavitha Chinnaiyan, Ahmad Slim and myself. At the same time, cardiac CT providers and clinicians across the world had to determine how to deliver cardiac CT services in the new era. Questions that arose included: Which tests should be deferred? Can the effective use of coronary CTA reduce admissions and conserve hospital resources? When is cardiac CT helpful in the evaluation of COVID-19 patients? How can we minimize risk of viral exposure to our technologists, physicians, and patients? Accordingly, SCCT quickly put together an interactive live webinar on the "Effective Use of Cardiac CT Amidst the COVID-19 Pandemic" (if you missed it, no worries. It is still available for viewing on www.scct.org) Faculty members for this popular event included Gianluca Pontone, Kavitha Chinnaiyan, Deepak Bhatt, Andrew Choi, and Dustin Thomas. Topics discussed included the role of coronary CTA in evaluating patients with acute coronary syndrome vs. COVID-19 myocarditis, the use of cardiac CT as an alternative to transesophageal echocardiography, and the role of coronary CTA in avoiding hospital admissions. In addition, we have published a guidance statement "Society of Cardiovascular Computed Tomography Guidance for Practitioners of Cardiovascular Computed Tomography Amidst the COVID-19 Pandemic"[1] which discusses topics ranging from safety considerations, suggestions on how to decide on timing of various CCT tests, and guidance on the specific role of cardiac CT in COVID-19 patients. Importantly, this document -which was also endorsed by the American College of Cardiology -is a "live document" and will be continuously updated on the SCCT website as our collective expertise and clinical needs evolve. The topics covered by this document were also featured in lively episodes of two of SCCT's podcasts, JCCT Pulse, hosted by Kavitha Chinnaiyan and Donut of Destiny, hosted by Jonathan Weir-McCall and Praveen Ranganath. Perhaps the most challenging part of transitioning to our "new normal" is the fact that we had to cancel some of our in-person meetings and plan for new virtual events. Our first virtual meeting was the Artificial Intelligence and Machine Learning in Cardiovascular CT meeting which was held on April 24. This outstanding six-hour on-line meeting offered up-to-date lectures on cutting edge advances in radiomics and machine learning, as well as their implications on the field of coronary CTA. Due to the COVID-19 pandemic, we also had to transition our Annual Scientific Meeting 2020 to a virtual event. The virtual conference will be held Friday, July 17 and Saturday, July 18 and will offer a comprehensive program on all the latest advances in cardiac CT, including dedicated sessions on clinical guidelines, prevention, machine learning, plaque analysis, advocacy, and much more. Of course, we will also have sessions on how cardiac CT and cardiovascular imaging can be used to evaluate COVID-19 patients. Importantly, there will be several advantages to our new on-line format. Participants will be able to select between different "channels" and will not feel that they have to miss-out by having to choose between 2 different rooms, as is sometimes the case during a live meeting. There will be several opportunities for participants to interact with each other and with SCCT leaders, and we will also deliver some of the signature SCCT games so popular at previous meetings. With no need for travel, we anticipate that this will be our highest attended meeting, and look forward to welcoming individuals from all over the globe! Finally, we have to realize that the current pandemic offers an opportunity for all of us to reexamine how we deliver care. This is especially important for the field of cardiac CT, as we now have an even greater opportunity and need to demonstrate the value and efficiency of our services. Whether it is avoiding invasive angiography, reducing the need for other cardiac tests, reducing hospital admissions, or simply identifying individuals who can be safely managed with medical therapy [2] , the role of cardiac CT has never been so important. [3, 4] Nevertheless, even though cardiac CT is an essential test in hospitals who care for patients with COVID-19, access to this test is often limited. As a result, the current benefits of cardiac CT can only be realized by institutions that have invested in such programs. We as a society must help eliminate barriers for cardiac CT delivery and ensure that reimbursement for our services correctly reflects the costs. [5] To that end, perhaps one thing that has not changed in the last few months is that advocacy for cardiac CT has never been more important. Society of Cardiovascular Computed Tomography guidance for use of cardiac computed tomography amidst the COVID-19 pandemic Endorsed by the American College of Cardiology Ischemia trial: Implications for coronary CT angiography Management of Acute Myocardial Infarction During the COVID-19 ESC Guidance for the Diagnosis and Management of CV Disease during the COVID-19 Pandemic Advocacy for Cardiac CT: The time is now!