Early-Stage Radiology Volume Effects and Considerations with the COVID-19 Pandemic; Adaptations, Risks, and Lessons Learned

Abstract Objective The COVID-19 pandemic resulted in significant loss of radiologic volume as a result of shelter-at-home mandates, and by delaying non-time-sensitive imaging studies in order to preserve capacity for the pandemic. We analyze the volume-related impact of the COVID-19 pandemic on six academic medical systems (AMSs), three in high COVID-surge (high-surge) and three in low COVID-surge (low-surge) regions, and a large national private practice coalition. We sought to assess adaptations, risks of actions, and lessons learned. Methods Percent change of 2020 volume per week was compared to the corresponding 2019 volume calculated for each of the 14 imaging modalities and overall total; outpatient, emergency and inpatient studies, high-surge AMSs, low-surge AMSs, and the practice coalition. Results Steep exam volume drops occurred during week 11, with slow recovery starting week 17. The lowest total AMS volume drop was 40% compared with the same period last year, and the largest was 70%. The greatest decreases were seen with screening mammography and DEXA scans, the smallest decreases were seen with PET/CT, x-ray, and Interventional Radiology. Inpatient volume was least impacted compared with outpatient or emergency imaging. Conclusion Large percentage drops in volume were seen from week 11 through 17, were seen with screening studies, and were larger for the high-surge AMSs than for the low-surge AMSs. The lowest drops in volume were seen with modalities where delays in imaging had greater perceived adverse consequences.