The article by Yu and colleagues(
) provides excellent guidance on treatment of osteoporosis patients during the COVID‐19 pandemic. However, it ignores the very important, very preventable burden that osteoporosis has placed on hospitals in this difficult time.In response to the novel coronavirus pandemic, hospitals across the United States ceased elective surgery and most states issued shelter‐in‐place orders. A key goal of abruptly stopping surgery was to rapidly free up hospital beds, conserve personal protective equipment, and redeploy nurses during COVID‐19. Despite a massive drop in admissions, I noticed that osteoporotic fractures continue to be a major burden.Maryland's first confirmed cases of SARS‐CoV‐2 occurred on March 3, 2020, and all elective surgeries were canceled on March 18. Using the electronic medical record, the number of monthly admissions were reviewed for 9 weeks starting Monday, March 2, 2020, and compared with the same calendar period in 2019 at four hospitals in Maryland. Osteoporotic fractures of the appendicular skeleton, including hip fractures, were identified by ICD‐10 code using the validated FREM system,(
) which can discern fragility fractures. The analysis was deemed exempt from IRB review.Although admissions in persons older than 60 years (excluding those related to COVID‐19) declined 40.0% compared with the same time period in the previous year, admissions for fragility fractures declined only 15%. Hip fractures (age >60 years) declined just 10%.During the lockdown period, surgery for fragility fractures became a large percentage of all surgeries. At my hospital, 31% of emergent and urgent surgeries were performed to treat fragility fractures.The burden of osteoporosis‐related fractures remained high during the most inopportune time. When the health care system was marshaling all available resources to care for patients with COVID‐19, hip fractures were a major burden. Although these observations will need to be replicated in other settings and may not be reflective of the nation as a whole, we should not discount the importance of osteoporosis care to reduce fragility fractures and keep elderly patients out of the hospital system during a pandemic.