Health

Covid Chaos has triggered another public health crisis: STDs

Now that Covid cases are declining sharply, public health experts are calling for new investments, including more money for STDs testing and treatment to reverse growth. But rising public health spending has stalled in Congress, and Obamacare opponents are asking a federal judge to repeal part of a law that requires free preventative care that can prevent STDs.

Sexual health experts and government officials warn that without federal action, millions of Americans could face severe, even fatal, consequences if the infections remain unexplored and untreated, the burden of the disease being disproportionately borne by low-income Americans, young people and people of color. .

“Unfortunately, every sign indicates that the numbers are deteriorating and that they will not improve until we take new approaches and invest in STDs and public health programs,” said David Harvey, chief executive of the National Coalition. STD Directors. “We have a lot of work to do to get back to where we were before the pandemic.”

For the past two years, a pandemic has plagued sexual health clinics across the country Close their doors Or reduce their hours and service. Government disease investigators who have spent years in contact with STDs have been transferred to Covid’s work, and many have left the public health field altogether. Federal agencies saw it Common deficit Tampons, glass vials and other test equipment. Millions of people lost their jobs and with them health insurance. The rise of addiction and mental health problems has led to more risky behaviors such as sex trafficking in drugs, the search for anonymous sex, and skipping routine health care.

“People can not live in fear for two years. “People are still having sex,” said Barbara Van der Paul, a professor at the University of Alabama at Birmingham who sits on the board of the American Association of Sexually Transmitted Diseases. “But when life goes on and services are not available, the population has a higher chance of getting infected.”

The growing STD crisis that emerges in the shadow of Covid-19 costs the American health care system billions of dollars each year and is largely preventable. But the pervasive prevalence of STDs, which affects one in five Americans, will only increase, and local health departments stretching to the pandemic are inadequately equipped to build effective defenses.

While Congress has included $ 2.5 million in funding in the budget bill to fight STDs, much greater efforts to modernize the country’s public health system are going nowhere. Democrats Social spending packageThe House, which passed the bill in November, has raised $ 7 billion over five years to support public health infrastructure, but the bill is unlikely to pass in the Senate.

“This is not a lot of money in terms of what is needed to seriously delay the problem,” Harvey said of the small delay in STDs. “We expect Biden and Congress to step up next year.

A more immediate concern for lawyers is the latest lawsuit against Obamacare, filed by Texas individuals and business owners and backed by Trump administration alumni, that threatens the provisions of the Decade of Health Reform Act, which requires health insurance plans to be repealed. Testing, HIV prevention medications, HPV vaccines and other preventative care services.

District Court Judge Reed O’Connor, who is considering the case in the coming weeks, has extensive experience in making decisions against available care law, leading both parties to the lawsuit to speculate that there is a real chance that Obamacare provisions could prevail. To be even more erosive.

Due to the exacerbation of the prevalence of STDs in the country due to the pandemic, officials warn that the lawsuit could hamper efforts to limit the transmission of syphilis, gonorrhea, chlamydia and HIV, leaving preventive services and treatments potentially inaccessible to many people in the country and overcrowding. Health clinics with patients who are now relying on their insurance.

“Anything that prevents people from accessing preventive services is antagonistic to public health,” Jonathan Mermin, director of the CDC’s National Center for HIV, Viral Hepatitis, STDs and Tuberculosis Prevention, told POLITICO. “One ounce of prevention costs a pound of cure.”

Texans argue that they should not pay for services they do not need and that they have religious resistance to, and that they should have the right to refuse this coverage to their employees as well.

“This coverage promotes and encourages homosexual behavior, drug use and sexual activity outside of marriage between one man and one woman,” they argued in a recent court appearance. “The government can not show that forcing private insurance companies to provide PrEP drugs, HPV vaccine and STDs, and drug screening and behavioral counseling, is such an important policy that it can overcome resistance to religious freedom.

Depending on how the case unfolds, health insurance plans may also be allowed to discontinue STDs and other coverage beyond HIV services, from vaccines to colonoscopy.

“If they win, all preventive services must be back on track,” said Roger Severino, a former head of the HHS civil rights office in the Trump administration who now works at the Center for Ethics and Public Policy. “Congress must act quickly.”

According to the latest federal data, nearly 68 million people have STDs. Almost half of these people are between 15 and 24 years old. Blacks and LGBTQ people also have it Disproportionately high rates Chlamydia, gonorrhea and syphilis – inequality that federal officials say is caused by differences in access to health care, not behavior.

Some of the innovations caused by the pandemic have helped, though access to them may end when a Covid-19 emergency occurs. For example, more people living far from the provider can use teleconferencing for the first time to diagnose and manage multiple STDs, and more cities and states have started sending people mail. Free test kit at home For HIV and common STDs.

But experts such as Van der Paul say the progress of these tools has not changed the massive disruption of routine screening caused by Covid. While people who suffer from STD symptoms are still seeking testing and treatment, many others are more likely to walk with an asymptomatic infection that can spread to others. For example, most women who have gonorrhea do not suffer from it Any symptomsWhile chlamydia is asymptomatic in half of men and 80 percent of women.

While federal data for 2021 is not yet available, reports from state and local health departments are vague.

New York officials said in February that the number of gonorrhea cases in the state increased by 23 percent and the incidence of syphilis in women by 17 percent in the first half of 2021 compared to the first half of 2019, and officials say that The real number is likely to be higher Due to testing failure during a pandemic.

Efforts to reduce the incidence of HIV – the nation One success story In recent years, as for STDs, Covid has also slowed down.

The CDC estimates that approximately 1.2 million people in the United States are at risk for HIV infection and will benefit from taking PrEP pills to help prevent infection. The agency announced a goal in 2019 to get 50 percent of those at risk by 2030 to take pills. By that time the country seemed to be on the road and about 22 percent of this population was taking medication. Then came the pandemic.

“Continuing this momentum has been more difficult under Covid,” Mermin said, noting that usage has grown by less than full percentage by 2020, following much greater gains in recent years.

The weakening of the country’s PrEP campaign is also bad for other STDs, as prescription drugs require patients to undergo routine testing. This January, following a major push by advocacy groups, the Biden administration told insurance plans they had to cover screening and doctor visits related to the use of PrEP in addition to the medication itself.

Given A sharp reduction in condom use Over the past decade and a half, public health experts say the drug is now more needed than ever to prevent people from getting HIV, even though some research has shown that people who take the pills have higher STDs because they are less likely to get HIV. they are. Will likely take other precautions.

And if the latest lawsuit against the Affordable Care Act is successful, insurance companies can offer more comprehensive plans that either do not cover STDs, PrEP or other sexual health services, or charge patients to co-pay for them.

As in other areas of healthcare, even a nominal fee can lead to a drastic reduction in people in testing and treatment.

“I think we sometimes forget how hard it was to be poor,” the CDC mermaid said. “When people have to make very difficult decisions about whether to take care of their own health or family needs, small obstacles can become big.

Covid Chaos has triggered another public health crisis: STDs

Source link Covid Chaos has triggered another public health crisis: STDs

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