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. 2020 Dec;27(6):781-784.
doi: 10.1007/s10140-020-01797-y. Epub 2020 Jun 5.

Effect of shelter-in-place on emergency department radiology volumes during the COVID-19 pandemic

Roozbeh Houshyar  1 , Karen Tran-Harding  2 , Justin Glavis-Bloom  1 , Michael Nguyentat  3 , John Mongan  4 , Chantal Chahine  1 , Thomas W Loehfelm  5 , Marc D Kohli  4 , Edward J Zaragoza  6 , Paul M Murphy  7 , Rony Kampalath  1
Affiliations

Effect of shelter-in-place on emergency department radiology volumes during the COVID-19 pandemic

Roozbeh Houshyar et al. Emerg Radiol. 2020 Dec.

Abstract

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has led to significant disruptions in the healthcare system including surges of infected patients exceeding local capacity, closures of primary care offices, and delays of non-emergent medical care. Government-initiated measures to decrease healthcare utilization (i.e., "flattening the curve") have included shelter-in-place mandates and social distancing, which have taken effect across most of the USA. We evaluate the immediate impact of the Public Health Messaging and shelter-in-place mandates on Emergency Department (ED) demand for radiology services.

Methods: We analyzed ED radiology volumes from the five University of California health systems during a 2-week time period following the shelter-in-place mandate and compared those volumes with March 2019 and early April 2019 volumes.

Results: ED radiology volumes declined from the 2019 baseline by 32 to 40% (p < 0.001) across the five health systems with a total decrease in volumes across all 5 systems by 35% (p < 0.001). Stratifying by subspecialty, the smallest declines were seen in non-trauma thoracic imaging, which decreased 18% (p value < 0.001), while all other non-trauma studies decreased by 48% (p < 0.001).

Conclusion: Total ED radiology demand may be a marker for public adherence to shelter-in-place mandates, though ED chest radiology demand may increase with an increase in COVID-19 cases.

Keywords: COVID-19; Coronavirus; ER; Healthcare utilization; Predictive model; Trauma.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Daily mean ED study volumes significantly decreased at all five UC medical centers during the 2 weeks following the government-mandated shelter-in-place order compared with 2019 baseline. Error bars represent 95% confidence intervals
Fig. 2
Fig. 2
Daily mean ED study volumes by subspecialty aggregated for all five UC medical centers significantly decreased during the 2 weeks following the government-mandated shelter-in-place order compared with 2019 baseline. Error bars represent 95% confidence intervals
Fig. 3
Fig. 3
Daily mean ED non-trauma chest and all other non-trauma volumes aggregated across four UC medical centers (UCSF, UCD, UCLA, UCI), significantly decreased by 18% and 48% respectively during the 2 weeks following the 2 weeks following the government-mandated shelter-in-place order compared with 2019 baseline. Error bars represent 95% confidence intervals
See this image and copyright information in PMC

References

    1. Wu P, Hao X, Lau EHY, Wong JY, Leung KSM, Wu JT, Cowling BJ, Leung GM (2020) Real-time tentative assessment of the epidemiological characteristics of novel coronavirus infections in Wuhan, China, as at 22 January 2020. Euro Surveill. 25. 10.2807/1560-7917.ES.2020.25.3.2000044 - PMC - PubMed
    1. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506. doi: 10.1016/S0140-6736(20)30183-5. - DOI - PMC - PubMed
    1. Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020;20:533–534. doi: 10.1016/S1473-3099(20)30120-1. - DOI - PMC - PubMed
    1. The President’s Coronavirus Guidelines for America. https://www.whitehouse.gov/wp-content/uploads/2020/03/03.16.20_coronavir.... Accessed 3 Apr 2020
    1. Order of the State Public Health Officer (Stay home except for essential needs). https://www.cdph.ca.gov/Programs/CID/DCDC/CDPH Document Library/COVID-19/Health Order 3.19.2020.pdf. Accessed 3 Apr 2020