• Nuclear medicine expert from Charles Sturt tasked with advising government agency working to identify and resolve shortages of nuclear medicine during COVID-19 international and domestic transport disruptions
• Australia has experienced shortages of the imported radioactive isotope iodine-123 medicine, which is sourced from Japan, due to disruptions to supply chains
• Dr Geoff Currie is part of a working group tasked with developing solutions to import the medicine and then overcome domestic transport disruptions spurred by the pandemic

A nuclear medicine expert from Charles Sturt University in Wagga Wagga is part of working group tasked with developing solutions to solve Australia’s recent COVID-19-induced nuclear medicine shortages.

Australia’s supply chains for the radioactive isotope iodine-123 – a medicine imported from Japan that is used to diagnose and guide treatment for children’s cancer – have experienced major disruptions in recent months due to the pandemic.

Associate Professor in nuclear medicine in the Charles Sturt School of Dentistry and Health Sciences Dr Geoff Currie (pictured above) is part of a team advising Australia's Nuclear Science and Technology Organisation (ANSTO) to develop solutions to transport and supply disruptions that have caused the nation’s shortages.

According to Dr Currie, the pandemic has redefined the way nuclear medicine is practiced and the threat from COVID-19 to health and to the nuclear medicine community is still rapidly changing.

“With borders closed and many flights grounded, Australia’s nuclear medicine is vulnerable to radionuclide shortages,” Dr Currie said.

“An example is the iodine-123 medicine supplied from Japan. This is a really critical medicine used to change the child cancer patient’s management and guide how that patient undergoes therapy.

“The solution we came up with during the height of the pandemic was for the government to charter flights every couple of weeks from Japan to Australia to secure the supplies.”

According to Dr Currie, even though flights between Japan and Australia have now resumed, once the medicine is in Australia there are still many logistical issues spurred by COVID-19 to overcome before the medicine arrives to a patient.

“The challenge with many nuclear medicines is the short life span, with half lives of just hours,” he said.

“Domestically, significant disruption to Australia’s aviation and road transport network has made transporting nuclear medicines very challenging and caused widespread delays in deliveries and increased costs.

“We’ve had to use road freight and charter domestic flights to transport the medicine from Sydney to our other capital cities and rural and regional communities. 

“We really need regular flights for these products, otherwise patients can be left scrambling.”

Despite the best efforts of government agencies and nuclear medicine professionals, Dr Currie warns widespread delays in deliveries and increased costs of nuclear medicine have become the “new normal”.

He said rural and remote sites that rely on fly‐in staff for nuclear medicine services and patients flying into hubs from remote locations will likely experience the most challenges and delays securing the medicine.

“What we don’t know is whether life and nuclear medicine practice will return to normal, or, more likely, if COVID-19 will define a ‘new normal’ adopted as best practice moving forward,” Dr Currie said.

Dr Currie’s involvement advising ANSTO on the current shortages comes off the back of driving the working party through the 2018 and 2019 radionuclide molybdenum-99/technetium-99m shortages at ANSTO.

Last year, Australia’s only nuclear reactor was forced to stop production of generators for 99mTc due to a mechanical fault at the facility that extracts the medical isotope.

“If Australia’s supply of the molybdenum is compromised, which could happen due to scheduled or unscheduled maintenance, we are very vulnerable to shortages,” Dr Currie said.

“We’re in an even more vulnerable position if we have to import molybdenum and we experience the disruptions caused by COVID-19. 

“Fortunately, we have a fantastic reactor and extraction plant in Sydney and we are actually in a position to supply other countries with molybdenum.

“But the facility that produces the end product for distribution in Australia, and which caused the 2018 shortage, is 60 years old and in desperate need of replacement.”

Although Australia’s molybdenum supplies are currently strong, Dr Currie said the COVID-19 pandemic has also exposed some more vulnerabilities with the single-supplier model Australia uses.

“In any number of processes, if a single staff member was suspected of being COVID-19 positive, the entire supply chain would be disrupted,” Dr Currie said.

“To address this, ANSTO split process staff into two teams with no crossover between the teams.

“The challenges that have been overcome to get nuclear medicine to patients in need during the COVID-19 pandemic is a testament to the resilience and collegiality of the entire nuclear medicine community.”