Despite widespread lockdowns and quarantine orders, the first year of the covid-19 pandemic did not stop Americans from spreading sexually transmitted diseases.
This week, the Centers for Disease Control and Prevention released their latest STD figures, showing that 2.4 million cases of the most concerning STDs were reported in 2020. There were record highs for both gonorrhea and syphilis, including cases of life-threatening congenital syphilis in babies. Cases of chlamydia took a slight decline, however.
The CDC’s STD surveillance program primarily keeps track of syphilis, gonorrhea, and chlamydia incidence based on cases that are required to be reported by local doctors and hospitals (HIV, hepatitis B, and hepatitis C cases are tracked as well, but separately). The 2020 numbers were released as part of the CDC’s STD Awareness Week, now in its third year.
The 2.4 million cases reported in 2020 are a slight step down from the over 2.5 million cases reported in 2019, which represented the sixth consecutive year of all time highs. But this drop was only seen for chlamydia, as reported cases declined from 1.8 million in 2019 to 1.6 million in 2020. Cases of gonorrhea rose from 616,392 in 2019 to 677,769 cases in 2020, while cases of syphilis rose from 129,813 in 2019 to 133,945 in 2020—both the highest numbers seen in the U.S. since modern tracking began.
The CDC notes that healthcare visits for STD screening sharply declined during the early months of the pandemic in March and April 2020, which calls the drop in chlamydia cases into question. While these STDS are treatable with antibiotics, people often don’t experience symptoms, so routine screening is essential to preventing the serious complications that accompany them. Left untreated, chlamydia and gonorrhea can permanently damage the reproductive system, causing infertility, while syphilis can become latent for years before reemerging to cause severe organ damage and even dementia. All three infections can also be dangerous to carry while pregnant, especially syphilis.
The incidence of congenital syphilis in particular has surged in recent years, with more than 2,100 cases in 2020. During pregnancy or delivery, syphilis can pass between mother and child and become a life-threatening infection. In 2020, at least 149 congenital syphilis-related stillbirths and infant deaths were reported. Nearly half of these cases could have been caught with timely prenatal care and screening, the CDC says. And the situation isn’t looking any better lately, with early data showing that syphilis cases continued to rise in 2021.
Gonorrhea is another looming disaster as the rate of antibiotic resistant infections continues to climb. The CDC estimates that about half of all infections in 2020 were resistant to at least one antibiotic. Late in 2020, the CDC changed its treatment guidelines for gonorrhea, recommending that simple cases be treated with a single shot of the antibiotic ceftriaxone, which still shows effectiveness against nearly all infections, for now at least.
It’s likely that the pandemic will continue to complicate efforts to prevent, track, and treat these infections. But even before covid-19 was around, the U.S. had been losing ground against STDs. And it’s going to take a lot to reduce these numbers, the CDC warns.
“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, director of STD Prevention at the CDC, in her announcement of the 2020 data. “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.”