How a Contrast Media Shortage Is Affecting Medical Scans in the U.S.

A COVID-19 lockdown in China temporarily shut down an important production facility for iodinated contrast media, a drug commonly used to enhance medical scans. Here’s how the shortage is impacting health care.

Fact checked on May 24 2022 by Vivianna Shields, a journalist and fact-checker with experience in health and wellness publishing.
Hospitals across the United States are being impacted by a recent shortage of iodinated contrast media (ICM). Given to patients intravenously during certain medical scans, this type of medication enhances the ability to see blood vessels and organs, helping health care professionals diagnose potential problems—such as infection, inflammation, and cancer—based on those images.
 
“Imaging is a multidisciplinary consult service that extends to impact most areas of medicine,” Laveil Allen, MD, executive medical director of the Vanderbilt University Medical Center Radiology Department, told Health. The contrast is what allows providers to see clearly through a patient’s body, much like eyeglasses can assist our vision. “Imaging services are the eyes of medicine, and preserving our vision is an essential component to providing care,” he adds.

The shortage is being caused by the temporary shutdown of a GE Healthcare production facility for ICM in Shanghai, China, due to a COVID-19 lockdown. The company is one of the major contrast media manufacturers, alongside Bracco, Bayer, and Guerbet. “When that plant was shut down, GE was suddenly unable to meet the supply-demand of its existing customers,” Matthew Davenport, MD, FACR, vice-chair of the American College of Radiology (ACR) Commission on Quality and Safety, told Health.


“They have since moved up the production capability in their facility in Cork, Ireland, and began airlifting contrast media to the United States. Nonetheless, there’s still an acute supply chain shortage,” said Dr. Davenport. He added that GE has informed that a level of normalcy should be reached by June 30, but considering the backlog and potential shipping challenges the crisis could continue throughout the summer.

Affected Hospitals and Health Systems
The shortage is affecting all hospitals that relied on GE Healthcare as their preferred vendor. According to Dr. Davenport, most health systems have agreements to buy contrast from specific manufacturers. “Any place that had preferred vendor contracting with GE was massively affected because they didn’t have any redundancy in their supply,” he said.
 
The extent to which each institution will be impacted also depends on how much stockpile of ICM they had before the shortage. “I’m familiar with some institutions which had a pretty large stockpile, so they’re going to be able to ride this out without too much effect,” said Dr. Davenport. “Others do not have much contrast available, and they will not necessarily make it to the end of the shortage. So, it is a serious issue.”
Mitigation Strategies
In an attempt to avoid a situation where the contrast media simply runs out, institutions around the country are adopting strategies to reduce its use to the minimum amount necessary. The ACR recently released a statement recommending a series of mitigation strategies.
The committee includes using alternative exams that don’t require ICM, such as magnetic resonance imaging (MRI) or ultrasound. In certain cases, providers may opt to perform a CT scan without contrast.
“Appendicitis is a good example,” said Dr. Allen. “We routinely scan the patient with contrast to identify if they have appendicitis. It can increase the sensitivity and specificity of the exam. But we can also identify it on a non-contrast CT exam.”
It is also possible to reduce the dose of contrast based on the patient’s weight. Another measure that has been adopted is to repackage contrast media into smaller volumes to eliminate waste. Non-urgent exams and procedures may also be postponed.
According to Dr. Allen, he and his colleagues at the Vanderbilt University Medical Center immediately formed a radiology command center to develop a series of tactics to handle the shortage when they were first alerted. The changes, according to an article accepted for publication by the Journal of the American College of Radiology, reduced contrast usage by about 50% in less than seven days at their health system.
 
“The big thing is that we want to make sure we have contrast for our most critically ill patients to perform life-saving imaging or procedures that require contrast,” said Dr. Allen. The use of ICM is indispensable, for example, in cases of stroke, when it is used to diagnose the condition through a CT scan and to potentially treat it through neurointervention. Contrast is also necessary in cases of a heart attack during cardiac catheterization, a procedure that is used both to diagnose and treat the condition.
Impact on Patients
With these measures in place, patients with scheduled exams or procedures may get a call from their hospital to postpone their appointment. Or they may learn they will undergo a different imaging technique than what was originally planned.
“These decisions are being made thoughtfully by physicians and other health care providers who have the patient’s best interests in mind,” said Dr. Davenport. “They never want to be in the situation where they have to make these decisions, but they’re doing it in a way that is as thoughtful as possible and putting the patient first. So, I think there is some amount of reassurance to this.” Dr. Davenport noted that it is always a good idea to talk to your health care provider to discuss the alternatives.
“Because your examination is altered from what it was originally scheduled to be, it does not mean that your care will be any less,” added Dr. Allen. “We will not sacrifice our patients’ care. Just be cognizant that you may have been scheduled for one exam, and you may be contacted and instructed that you’re going to get an alternate exam to find an answer to the same problem.”

How to Lose Your Gut in 10 Days

Yeah, we know: A headline like “How to lose your gut  in 10 days” screams “bullshit.”

But, truth be told, it’s actually quite possible to burn belly fat  in just a week and a half. The key to success is in the details, and you’ll need to follow them meticulously. But don’t stress: This is a short-lived emergency shred, not a long-term lifestyle plan. So whether you’re prepping for a party or a vacation, we’ve got you covered.

Note: Depending on the circumference of your gut, results may vary.  

1. Go to bed

Exhaustion can give you a gut. “Sleep deprivation disrupts your metabolism, seriously sabotaging efforts to maintain an ideal weight,” says Jana Klauer, M.D., an obesity researcher at NYC’s St. Luke’s-Roosevelt Hospital. Here’s how it works: Fat cells produce a hormone called leptin, which tells the body how much potential energy it has stored. Since leptin production peaks at night, when you’re asleep, sleep deprivation can throw levels of the hormone out of whack. The end result? Your body has no idea how much energy it has banked, so you end up storing fat instead of burning it.

Consider a full night’s rest an integral part of any weight-loss regimen. Getting sufficient sleep will prevent lags in energy and help reduce carb cravings, adds Klauer. It’ll also help build gut-busting muscle. “Sleep deprivation causes a drop in the production of human growth hormone,” says Klauer. (This ensures the fat your body stores will make a beeline for your waistline.) “After a good workout, you get more deep, slow-wave sleep; and it’s this cell-repairing stage of sleep where up to 70% of daily growth-hormone secretion takes place in young men.” Meaning, even if you’re getting in your time at the gym, you still need to hit the sack to complete the biological process that makes muscles pop.

Get seven hours a night.

2. Power up with protein

Protein is the main component of muscle tissue, so it should be the primary focus of your muscle-building diet. Aim for 1.5g per pound of your targeted bodyweight during an emergency shred like this. Always have a form of protein in every meal to ensure muscles are being fueled with amino acids throughout the day and blood sugar levels are stabilized. Under normal conditions, you should eat about 1g per pound of bodyweight. Always consume protein post-workout.

3. Have a carb strategy

We’ve heard it all before: “Carbs are the enemy.” Well, not really. Completely slashing your carb intake will certainly help with dropping the pounds (and fast) but you’ll also be left feeling cranky, tired, and lethargic. “Carbs are essential for life as our brain and central nervous system require them to work properly. Forgoing carbs can force your body to metabolize muscle for energy,” says Tim McComsey, R.D., P.T. It all comes down to using carbs correctly, not cutting them completely. “To get lean, a balance of the right amount of carbs in the morning and post-workout is ideal,” he says.

4. Lift for nine days

Most people believe cardio paves the way for six-pack abs, but lifting is really the crucial element. For the next week and a half, you’re going to lift for nine days.

Perform your lifting workouts at night, as interval training will be a part of your morning routine.

Here are your splits:

Day 1: Legs
Day 2: Chest
Day 3: Back
Day 4: Shoulders
Day 5: Arms
Day 6: Off
Day 7: Legs
Day 8: Chest
Day 9: Back
Day 10: Shoulders

5. Do seven days of intervals

If your goal is to burn fat, intervals better be part of your program. Besides being a quick method to get in a great workout, intervals are extremely effective for transforming your physique. By incorporating intense periods of work with short recovery segments, intervals allow you to keep the workout intensity high while still maintaining form. The magic of high-intensity interval training lies in its ability to keep you burning fat even after you leave the gym. In short, your body isn’t able to bring in enough oxygen during periods of hard work. Therefore, you accumulate a “debt” of oxygen that must be repaid post-workout in order to get back to normal. The result: Your metabolism is revved for hours after you leave the gym.  

Perform interval workouts in the morning on an empty stomach. Here are 8 of our favorite fat-burning intervalsOpens a New Window. .

Day 1: On
Day 2: On
Day 3: Off
Day 4: On
Day 5: On
Day 6: Off—perform a paced run at 60 minutes
Day 7: On
Day 8: On
Day 9: Off
Day 10: On

6. Get laid

Testosterone, perhaps the most widely known hormone, is responsible for helping lifters put on more muscle and recover faster from workouts. Other hormones such as growth hormone, insulin-like growth factor (IGF-1), and hCG also play a huge role in recovery and seeing jumps in size and strength (not to mention your mood and sex life). Increasing your hormone levels to the optimal numbers involves balancing your lifestyle, perfecting your nutrition, and training at the right intensity. Too much stress in day-to-day activities can release more catabolic hormones (like cortisol), which break down muscle and make it tough to build the physique you want. “Our best evidence identifies regular exercise, a good night’s sleep, and plenty of sex as our best bets at increasing our muscle-building hormone king (aka testosterone),” says Yoni Freedhoff, M.D., family physician and assistant professor at the University of Ottawa.

7. Use a supplement stack

There’s no secret elixir or magic pill, just the basics.

Supplement with caffeine (200mg pre-workout) and beta-alanine (2g in the a.m., 2g post-workout).

A 2008 study at the College of New Jersey examined collegiate football players on a 30-day schedule of beta-alanine supplementation. The players were randomly divided into a supplement or placebo group three weeks before preseason football training camp. Performance was measured on the first day of camp by a 60-second anaerobic power test and three line drills. Throughout the duration of camp, logs recorded resistance training volumes, and subjects completed questionnaires on feelings of soreness, fatigue, and practice intensity. The group that took the beta-alanine supplements had a lower fatigue rate and a higher training volume throughout the exercises.

Researchers in the UK found athletes who ingested caffeine had a rate of perceived exertion that was 5.6% lower than athletes who were given placebos. The researchers also found that caffeine improved overall exercise performance by 11.2%. Imagine getting 11% more out of every workout, just because you had a shot of caffeine before you hit the gym.