Response to: The practicalities of COVID's impact on nuclear cardiology.

We would like to thank Drs Lee and Baer for their interest and thoughtful comments regarding our Multisociety Update on Guidance and Best Practices for Nuclear Cardiology Laboratories During the COVID-19 Pandemic.[1,2] Their letter emphasizes an important point —that the changed circumstances should indeed dictate how we approach the challenges of this worldwide disease. As Drs Lee and Baer also mention, there are a number of important factors to consider in determining the stress test modality. The writing committee discussed this particular issue at some length. We concluded that rapid antigen testing (RAT) prior to exercise testing is reasonable, but certainly not always helpful nor even necessarily available. The experience with RAT prior to stress testing also seems to be mixed. For example, recent data show that in certain countries with a highly vaccinated population, the yield from pre-event testing for COVID-19 in asymptomatic patients before stress testing is often extremely low and, on the whole, not useful, considering the extra cost to the patient and inconvenient test delay. Thus, we did not include this suggestion in Table 3 of the guideline document. However, we concur that this approach might certainly be useful in specific circumstances.

For the authors of, Update on guidance and best practices for nuclear cardiology laboratories during the coronavirus disease 2019 (COVID-19) pandemic.