May 2020: Reduced use of bone age during Covid-19

BoneXpert use dropped to 28% of the normal level in the period 23 March – 19 April. The following four weeks it rose to 45% of the normal level.

BoneXpert is used in more than 150 hospitals world-wide. The number of analyses is counted daily and can be used to monitor the use of bone age in these hospitals. The diagram below shows the weekly use in four selected countries since 6 January 2020. The last data point represents the week ending on 17 May 2020.

Weekly BoneXpert use

From 6 January – 1 March 2020, BoneXpert usage was fairly constant at a level of 610 analyses per week, and this is used as reference period.

A decrease began in the week ending 8 March and reached a minimum in the four weeks 23 March – 19 April 2020, with 170/week, a reduction to 28% of the reference level. In the following four weeks, until 17 May, there were on average 275/week,  which amounts to 45% of the level in the reference period.

The table below gives insight into the variations across the four countries

	BoneXpert analyses in ref. period 6 Jan – 1 March 2020	Relative usage 23 March – 19 April 2020	Relative usage 20 April – 17 May 2020
Denmark	175	25 %	66 %
Sweden	118	60 %	65 %
Italy	166	13 %	34 %
United Kingdom	151	22 %	17 %
Total	610	28 %	45 %

Sweden is an exception. The reduction was down to 60% of the reference level, as most of society was kept open, and it was largely left to the population to act responsibly and only do what was deemed necessary. Apparently, visiting a clinic with your child was regarded important for 60% of the cases, despite a fairly large number of Covid-19 cases. In the following period the activity rose only slightly, to 65%.

In Italy, hospitals were overburdened with Covid-19, and indeed the bone age rate was down at 13% of reference level, but in the following four weeks the usage increased dramatically, as in Denmark.

The UK was also severely affected by Covid-19, and there has been no recovery in the following period ending 17 May 2020.