Routine Chronic Disease Screenings and Oncology Biomarker Tests Plummet During COVID-19
On March 19, 2020, Governor Gavin Newsom issued the order to make California the first state in the U.S. to implement a state-wide shelter-in-place order in an effort to stunt the spread of the novel coronavirus (COVID-19). Similar orders soon followed across the country, with an estimated 316 million people in 42 states still being asked to stay home as of April 20, 2020.
The aggressive social distancing measures have helped to “bend the curve” in the spread of COVID-19. Some of the hardest- and earliest-hit regions of the country are now starting to see the number of COVID-19-related deaths and hospitalizations slow.
At the same time, however, the U.S. is also starting to see ripple effects of the pandemic resulting from an overtaxed healthcare system that has spent the last several weeks consumed by COVID-19 cases, while people with non-urgent medical needs were advised to stay home.
In order to provide a more granular look at the impact of COVID-19 on deferred and delayed care for non-COVID-19-related conditions, at Komodo Health we have tracked the two-year trend in screening volume for a range of common preventive screenings and cancer tests that took place in inpatient and outpatient settings. Our findings are reported in a research brief.
Tracking real-world patient data across each state and county in the U.S., we have identified steep drops in routine disease management and preventive screenings, as well as oncology biomarker and monitoring tests.
In the weeks following the first shelter-in-place orders, cervical cytology screening is down more than 68 percent, cholesterol tests are down 67 percent, and hemoglobin A1c tests for diabetes are down nearly 65 percent nationwide. An important test to monitor ovarian cancer is down nearly 34 percent, a breast cancer recurrence test is down 17.4 percent, and BCR-ABL tests used to confirm a chronic myeloid leukemia diagnosis is down nearly 20 percent.
Not surprisingly, the sharpest declines have occurred in COVID-19 “hotspots” such as New York, where HbA1c tests have declined 82.6% over the past few weeks. In Manhattan, HbA1c tests are down more than 90% from average levels prior to COVID-19. In Massachusetts, lipid panels are down 80.5%, and in California, cervical cytology screening is down 76.3%.
The findings are reported in a new Komodo Health research brief that details the impact of the pandemic on these seven lab tests. The findings may have significant implications for future morbidity and mortality if delayed tests and screenings generate a wave of poor outcomes in the months to come.