Canada, relied upon as a leader in isotope production, is seen as having reneged on its responsibility to the medical world.
The isotope-producing NRU reactor at Chalk River, Ont. will stay shut down until the spring of 2010, at least - marking the third time Crown corporation Atomic Energy of Canada Ltd. has pushed back its estimated restart date since the aging reactor was taken offline in late May when a heavy water leak was discovered.
The news was met with frustration yesterday, and a growing sense among the international medical community that Canada has bungled its nuclear file.
The federal government has convened an expert panel, appointed a special adviser on isotopes and has invested $6-million toward research into alternatives to Chalk River.
But by failing to plan for or respond quickly to the failure of a reactor at the end of its lifespan, Canada is going back on its "implied contract" to provide scarce and much-needed medical isotopes, said Robert Atcher, president of the international Society of Nuclear Medicine.
Now doctors, researchers and members of the international nuclear-medicine community are starting to prepare for an outcome they say is becoming inevitable: The Chalk River reactor will never come back online, period.
"We do expect further delays, and [there are]major fears the NRU reactor will never be able to be put back in service," said Jean-Luc Urbain, president of the Canadian Association of Nuclear Medicine.
Rather than a short-term scramble as hospitals contort staffing and scheduling and mutilate budgets to stretch isotope supplies as far as they will go, the effective closing of NRU will mean a race to reorganize global supply chains for years while reactors now in the planning stage are built.
A dozen years ago, the United States shelved plans to build an isotope reactor of its own because Canada said it had its own new reactors under way. But Ottawa cancelled plans to bring Maple 1 and Maple 2 online last May - leaving other countries in the lurch, Dr. Atcher said.
"It's an implied contract and now we're basically being victimized because we did put our trust in the fact that there was going to be this capability," he said.
Dr. Atcher, Dr. Urbain and their counterparts in other nuclear-medicine associations have called on Ottawa to get an independent panel to take a second look at the mothballed Maples. So far Ottawa has refused.
Plans are under way for a new reactor in the United States, and the University of Saskatchewan hopes to build one in Saskatoon. But those are several years away at best.
In the short term, officials are discussing irradiating targets at facilities in Canada and the United States and processing isotopes at Chalk River - a process that would involve the inconvenient and time-consuming transportation of short-lived radioactive material, but better than nothing. Pressure is on Belgium's BR-2, used primarily for research, to keep pumping out isotopes when the Dutch Petten reactor - the biggest producer in the world, after Chalk River - goes down again for six months in February, 2010.
What's disappointing about the crisis isn't so much that the Chalk River reactor sprung a leak (or, rather, several of them) - that's what happens to a 52-year-old reactor, said Norman Laurin, a nuclear physician at the Trois-Rivières Regional Hospital in Quebec.
What's frustrating, he said, is that the ensuing crisis was entirely avoidable.
"Those are very, very complex technical issues. I don't blame them for taking the amount of time that is necessary," Dr. Laurin said. "It's not the government's fault that the NRU reactor is broken. … It's the management of the crisis that should have been a lot better."
In a statement released late Wednesday, AECL said high-resolution probes of the leaky vessel had revealed thinned and pitted walls and nine damaged areas. Continued inspection of the reactor and investigation into repair methods is ongoing, said AECL communications manager Robin Forbes.
"Our evidence that we have today indicates we will be able to repair the reactor and get it back up and running," he said.
Speaking to reporters in Kitchener, Ont., yesterday, Prime Minister Stephen Harper said he's "disappointed" in the delay, and hopes AECL can pick up the pace on its repairs.
"We do hope there will be more action, more quickly, on the part of Atomic Energy of Canada," Mr. Harper said.
Crisis has become the new normal for the nuclear medicine department at the Trois-Rivières regional hospital, Dr. Laurin said.
But the scramble is taking a toll on the hospital's bottom line. Dr. Laurin said Quebec hospitals may end up paying as much as $10-million more for their isotopes. The ramped-up costs could mean services cut in the coming months when money runs out.
The same is true for hospitals across Canada. Ontario Health Minister David Caplan has sent multiple letters to Health Canada requesting "assurance that your government will be providing compensation to Ontario to offset the higher-than-normal costs for the medical isotope."
Ottawa's response contained no indication such compensation will be forthcoming. A statement from Health Canada said "further study and analysis is required in order to understand the underlying cause and scale of price increases" for medical isotopes across Canada.
Even if patient access to treatment is maintained, Canada's once-respected place in the international nuclear-medicine community is likely gone, Dr. Urbain said.
"Canada was always looked at as the mecca of nuclear technology," he said. "With the events which have unfolded over the past 20 months, I think Canada has lost a lot of its lustre."