NewsDesk @bactiman63

The Centers for Disease Control and Prevention (CDC) said today reported cases of sexually transmitted diseases (STDs) in the United States decreased during the early months of the COVID-19 pandemic in 2020, but most resurged by the end of that year.

Neisseria gonorrhoeae/CDC

Ultimately, reported cases of gonorrhea, syphilis, and congenital syphilis surpassed 2019 levels, while chlamydia declined, according to new data published today by the Centers for Disease Control and Prevention (CDC). The data provide the clearest picture yet of COVID-19’s impact on the U.S. STD epidemic.

The newly released 2020 STD Surveillance Report found that at the end of 2020:

  • Reported cases of gonorrhea and primary & secondary (P&S) syphilis were up 10% and 7%, respectively, compared to 2019.
  • Syphilis among newborns (i.e., congenital syphilis) also increased, with reported cases up nearly 15% from 2019, and 235% from 2016. Early data indicate primary and secondary syphilis and congenital syphilis cases continued to increase in 2021 as well.
  • Reported cases of chlamydia declined 13% from 2019.

Chlamydia historically accounts for the largest proportion of reported STDs in the United States. The decline in reported chlamydia cases is likely due to decreased STD screening and underdiagnosis during the pandemic, rather than a reduction in new infections. This also contributed to an overall decrease in the number of reported STDs in 2020 (from 2.5 million reported cases in 2019 to 2.4 million in 2020).

“The COVID-19 pandemic put enormous pressure on an already strained public health infrastructure,” said Jonathan Mermin, M.D., M.P.H., Director of CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention. “There were moments in 2020 when it felt like the world was standing still, but STDs weren’t. The unrelenting momentum of the STD epidemic continued even as STD prevention services were disrupted.”

Several factors likely contributed to the initial decline in reported STD cases during the first part of 2020, including:

  • Reduced frequency of in-person healthcare services as routine visits decreased, resulting in less-frequent STD screening;
  • Diversion of public health staff from STD work to respond to the COVID-19 pandemic;
  • STD test and laboratory supply shortages;
  • Lapses in health insurance coverage due to unemployment; and
  • Telemedicine practices that led to some infections not being captured in national data.

While STDs are increasing across many groups, the 2020 STD data show that some racial and ethnic minority groups, gay and bisexual men, and our nation’s youth continue to experience higher rates of STDs. This trend shows that longstanding factors, such as lack of access to regular medical care, discrimination, and stigma, continue to stand in the way of quality sexual healthcare for everyone who needs it.

“The COVID-19 pandemic increased awareness of a reality we’ve long known about STDs.  Social and economic factors – such as poverty and health insurance status – create barriers, increase health risks, and often result in worse health outcomes for some people,” said Leandro Mena, M.D., M.P.H., Director of CDC’s Division of STD Prevention. “If we are to make lasting progress against STDs in this country, we have to understand the systems that create inequities and work with partners to change them. No one can be left behind.”

The National Coalition of STD Directors (NCSD) released a statement after the news was announced:

After viewing the 2020 STD surveillance data released today by the Centers for Disease Control and Prevention (CDC), the National Coalition of STD Directors (NCSD) – again – is deeply troubled by the amount of ground lost in the fight against STDs. The data shows another sharp uptick in syphilis and gonorrhea cases and detection gaps for chlamydia, all made worse by the pandemic.

Image/CDC

“This affirms once again that America isn’t taking the STD crisis seriously,” said David C. Harvey, executive director of NCSD. “We can only fight this out-of-control epidemic with new funding and the kind of urgency that reflects the enormity of this crisis.”

NCSD has been tracking the impact of the Covid-19 pandemic and calling attention to the negative impact on the fight against STDs. STDs were increasing in the years before the pandemic but Covid-19-related interruptions to STD testing and healthcare access undercut the essential infrastructure states and communities use to fight STDs. In addition, these dualling crises intensified pre-existing health disparities. The data shows people of color, men who have sex with men, and young people continue to be more deeply impacted by the STD crisis, and a dramatic climb in congenital syphilis illustrates the intersection between the STD crisis and the nation’s maternal health disparities.

“When STDs continue to spread this rapidly, we leave a lot of people at risk – especially our most vulnerable people – and the current funding levels aren’t enough to protect them,” adds Harvey. “I cannot imagine seeing a 235% increase in babies born with congenital syphilis over the past five years and not having the federal government put a stop to it.”

NCSD released a statement earlier this month calling out President Biden’s Fiscal Year (FY) 2023 budget for only providing flat funding that fails to address the upward trending STDs. The statement also expressed dismay at the CDC’s failure to advocate for much needed funding. The statement calls on Congress to budget $279 million for STD prevention and $200 million to launch the first-ever dedicated STD clinic pilot program.

“We can absolutely change the trajectory of the STD crisis,” said Harvey, “but we can’t win the fight against STDs unless Congress and the Biden administration recognize the gravity of this epidemic.”