During the first two months of the pandemic lockdown, Americans dramatically reduced their use of preventive and elective health care, while increasing use of telemedicine—but the switch was not enough to offset reductions in in-person care, according to a new study.

The analysis, one of the first to quantify the cuts in elective medical care experienced in March and April, found that the number of mammograms and colonoscopies—diagnostic procedures that cannot be done via telehealth—dropped by more than 65% during the period. Overall health care utilization declined by 23% in March and by 52% in April.

Smaller cuts in in-person care and lower rates of telemedicine use were observed among patients who reside in lower-income or predominately non-white zip codes. Researchers say the findings are another example of disparities in health care that have worsened during the coronavirus pandemic.

The study, published online by the journal JAMA Network Open, is based on medical records from more than 5 million Americans who have private health insurance.

Most studies about the change in medical care since the beginning of the pandemic shutdown have used information from a single health system or geographic market to observe changes in use of medical services.

Blood sugar tests dropped by more than 50%, vaccines among children under age 2 dropped by 22% and angioplasty procedures dropped by nearly 17%. A small drop was seen in chemotherapy treatments. In addition, musculoskeletal surgery, cataract surgery and MRIs all dropped by 45% or more.

Use of prescription drugs for high cholesterol and diabetes saw small drops, while use of asthma medications increased by 11% over March and April.

During the same period, telemedicine visits skyrocketed, increasing by more than 4,000% in April 2020 as compared to April 2019. But the increase in telemedicine visits replaced only about 40% of the decline in medical office visits.

Read the full article about prevention healthcare during the pandemic by Christopher M. Whaley at RAND Corporation.