Measuring the Impact of the COVID-19 Pandemic on Sexually Transmitted Diseases Public Health Surveillance and Program Operations in the State of California.

BACKGROUND: As public health personnel and resources are redirected to COVID-19, sexually transmitted diseases (STD) programs have been unable to sustain pre-COVID-19 activities. METHODS: We used California (CA) surveillance data to describe trends in case reporting for gonorrhea, chlamydia, and syphilis of any stage in the pre- versus post-COVID-19 eras (January-June 2019 and January-June 2020). We also analyzed data from an electronic survey administered by the CA STD Control Branch to local health jurisdictions in April, June, and September of 2020, assessing the impact of COVID-19 on STD programs. RESULTS: There were sharp declines in cases of all reportable bacterial STDs occurring in conjunction with the March 19, 2020 CA stay-at-home order, most of which did not return to baseline by July. Comparing January-June 2020 to January-June of 2019, there were decreases in reported cases of chlamydia (31%), late syphilis (19%), primary/secondary syphilis (15%), early nonprimary nonsecondary syphilis (14%), and gonorrhea (13%). The largest percentage declines in STD case reporting were among Hispanic, Asian/Pacific Islander, and Black persons. Seventy-eight percent of local health jurisdiction respondents indicated that half or more of their workforce had been redeployed to COVID-19 by September 2020. CONCLUSIONS: During the COVID-19 era, STD case reporting and programmatic functions have diminished throughout CA. Because this may contribute to decreases or delays in STD diagnosis and treatment-with resultant increases in STD transmission-providers and public health officials should prepare for potential increases in STD-related morbidity in the months and years to come.

California Gonorrhea Surveillance System: Methodologic Aspects and Key Results of a Sample-Based System.

OBJECTIVES: This article describes findings from the California Gonorrhea Surveillance System (CGSS), developed in response to the need for detailed risk behavior data and clinical data required to control increasing gonorrhea (GC) infections in California. METHODS: CGSS is a sample-based surveillance system implemented throughout California in 2007. In 34 of 61 local health jurisdictions (LHJs), 10% of GC cases are sampled for interview; in the other 27 LHJs, all cases are followed. A standardized case investigation record collects case-reported risk data and provider-reported clinical data, and is electronically prepopulated with available contact data. Exclusion criteria include age younger than 14 years, a GC diagnosis within the previous 30 days, and provider request that patient not be contacted. Analyses are weighted to account for sample design. RESULTS: In 2007, 31,192 cases of GC were reported in California. Of these, 5,388 were sampled for follow-up and 2,715 were interviewed, for a response rate of 54.2%. Of those interviewed, 49.6% were female, 28.8% were heterosexual males, and 21.6% were men who have sex with men (MSM). CGSS collects a wide range of behavioral and clinical data for targeted programmatic action. Findings from the 2007 CGSS included data on the following areas: incarceration (highest among heterosexual males [22.4%]); methamphetamine use (high overall [12.2%] and lower among African Americans [4.6%]); co-infection with human immunodeficiency virus (high among MSM [31.9%] and very low among heterosexual males and females [<0.5%]); and improper antibiotic use (8.3% overall; 25.6% among patients attending urgent care clinics). CONCLUSION: CGSS, an innovative sample-based surveillance system, is effective and flexible. The system provides actionable data on an ongoing basis.