covid-19 distancing isn't stopping the spread of stis

despite public health calls to avoid getting close to anyone from outside our household or bubble, some parts of the world are seeing a jump in sexually transmitted infections.diagnoses of gonorrhea, secondary syphilis and mycoplasma genitalium have increased in parts of milan, italy, according to research presented at the european academy of dermatology and venereology (eadv) congress in late october. the research was originally published in a letter to the sexually transmitted infections journal in august.research into two public health regions of milan, italy, looked at confirmed diagnoses of common stis between march 15, 2020 to april 14, 2020 amid lockdown measures, and then compared it to data from the same time in 2019.milan is the capital of the lombardy region which was hit hard by the pandemic in the spring. despite “unprecedented social isolation measures” and a drop in clinic attendance by about 37 per cent, year-over-year, the number of some acute bacterial infections, including secondary syphilis and gonorrhea, increased.

“it was assumed that the lockdown would reduce the opportunity for sexual encounters and stis. however, i was surprised by the number of new acute infections diagnosed in this short period of time,” says marco cusini, one of the letter writers and a doctor with la fondazione irccs ca’ granda ospedale maggiore di milano policlinico.“gonhorrhea and syphillis are typically more prevelant in people in their 30s, so infection may have increased because the concentration of covid-19 morbidity and mortality in the elderly made the younger, more active, cohort feel protected and so less risk averse.”though the number of cases and regions studied isn’t particularly large, similar trends have been seen in other parts of the world, including canada.while infections dropped in the spring in montreal, public health reports showed a major surge in diagnoses in the summer. the montreal gazette reports that in april, montreal saw 389 cases of chlamydia, syphilis and gonorrhea — a record low, and a steep drop compared with 1,189 in april 2019.in may, stis inched upwards to 442 (compared to 1,229 the year before) and in june, the numbers ticked up to 739 reported stis (1,060 the years before). while the number of infections may be smaller than 2019, the change between may and june still shows a month-to-month increase of 67 per cent.dr. karl weiss, president of the association des médecins microbiologistes-infectiologues du québec, told the gazette in july: “the number of sexually transmitted diseases that we’re seeing right now is skyrocketing. it’s quite striking. it’s a marker that tells you definitely that the confinement rules, especially among the younger population, are not being followed.”new brunswick has been in “outbreak mode” for gonorrhea since 2019, and covid-19 didn’t appear to put a stop to infections. ctv news reported there were above-average increase in cases in most regions in the province during the first quarter of 2020.in the u.s., many public health clinics have slowed or stopped screenings for stis as health officials have focused their efforts of stopping the spread of the coronavirus.the national association of county and city health officials (naccho) noted in april that many of the local health departments they surveyed were concerned that hiv, sti and viral hepatitis cases would increase as people were unable to get tested or were afraid to go out amid the pandemic.several local health departments shared concerns that “people are continuing to have intercourse and passing along stis” or that “people will be reusing needles.” another health department suggested there may be “an increase in drug use possibly related to the stress” of covid-19.adriane casalotti, chief of government and public affairs at naccho, told the verge: “when the dust settles on coronavirus, we’re going to find out about all the public health issues that we haven’t been able to pay attention to, and how big of a problem they’ve gotten as they’ve kind of been under the radar.”public health officials have been fairly open about sexual health during the pandemic, suggesting ways to stay safe for people who aren’t living with an intimate partner. in september, chief public health officer of canada dr. theresa tam suggested wearing a mask if you have sex with someone who isn’t part of your household. in october, public health officials in the city of ottawa put out a detailed list of ways to engage in safe sex, such as keeping things virtual.don’t miss the latest on covid-19, reopening and life. subscribe to healthing’s daily newsletter covid life.