Complementary lessons learned from the testing strategies used for radiation emergencies and COVID-19: A white paper from The International Association of Biological and Electron Paramagnetic Resonance (EPR) Radiation Dosimetry (IABERD)

As COVID-19 emerged, there are parallels between the responses needed for managing SARS-CoV-2 infections and radiation injuries. While some SARS-CoV-2-infected individuals present as asymptomatic, others exhibit a range of symptoms including severe and rapid onset of high-risk indicators of mortality. Similarly, a variety of responses are also observed after a radiological exposure depending on radiation dose, dose heterogeneity, and biological variability. The impact of acute radiation syndrome (ARS) has guided the identification of many biomarkers of radiation exposure, the establishment of medical management strategies, and development of medical countermeasures in the event of a radiation public health emergency. Biodosimetry has a prominent role for identifying exposed persons during a large scale radiological emergency situation. Identifying exposed individuals is also critical in the case of pandemics such as COVID-19, with the additional goal of controlling the spread of disease. Conclusions and significance: IABERD has taken advantage of its competences in biodosimetry to draw lessons from current practices of managing the testing strategy for nuclear accidents to improve responses to SARS-CoV-2. Conversely, lessons learned from managing SARS-CoV-2 can be used to inform best practices in managing radiological situations. Finally, the potential need to deal with testing modalities simultaneously and effectively in both situations is considered.