Q: I know there were fewer cases of influenza this past flu season. Did rates of other infectious diseases also fall during the pandemic?
A: The news is encouraging for COVID-19 cases, which have continued to decrease nationally and locally. The seven-day moving average in Hamilton County is now as low as it was May of last year. Mitigation and vaccination efforts are contributing to these reassuring trends.
As the burden of COVID-19 disease nationally decreases, attention can now return to other infectious diseases sidelined early in the pandemic. Before the pandemic, for example, the U.S. was experiencing an all-time high for sexually transmitted diseases, with more than 2.5 million cases of chlamydia, gonorrhea and syphilis. Reallocation of resources during the pandemic disrupted many sexual health clinics, and care was affected.
A recent review assessing data from the Centers for Disease Control and Prevention found that cases of sexually transmitted infections that initially decreased - probably because of decreased testing - have increased compared to the same time before the pandemic. An increase of both gonorrhea and syphilis, compared to 2019, occurred after the second COVID-19 surge. The disruption of services may have led to infected persons missing a diagnosis, not getting the appropriate treatment and possibly infecting others. As clinics reopen, identifying infected people will be important for treatment, reducing transmission and preventing long-term consequences of untreated disease.
Similar trends in other infectious diseases around the world are also of concern. In a study published in The Lancet, researchers used a model to assess probable outcomes of high-burden infectious diseases during the COVID pandemic compared to no pandemic and found that HIV could increase by 10%, tuberculosis by 20% and malaria by 36%. The authors suggest that the increase in cases would likely be due to an interruption of therapy, as well as timely diagnosis and treatment of new cases. This study concluded that additional deaths could be of the same order of magnitude as the direct impact from COVID-19.
Other infectious diseases actually decreased as a result of the pandemic. In a study published in the journal Pediatrics, researchers looked at several common childhood infections, including acute otitis media, bronchiolitis, common cold, croup and influenza and found a significant decrease (many were absent) at the beginning of the pandemic. These results are attributed to masking and social distancing, which likely decreased the transmission of viruses that cause these common pediatric illnesses.
However, as children return to school and mask mandates are relaxed, these diseases are likely to return. Additionally, some vaccine-preventable diseases like the measles can make a comeback with low rates of childhood vaccinations during the pandemic. The Hamilton County Health Department encourages parents to get their children's childhood vaccinations up-to-date and has openings at our Third Street clinic as well as the Pediatric Clinic at Sequoyah.
Fernando Urrego, M.D., is the interim health officer at the Chattanooga-Hamilton County Health Department and a member of the Chattanooga-Hamilton County Medical Society.