Using information and anecdotes from the Clinic COVID-19 calls organized by NCSD between March and July 2020, NCSD can describe the impact of the pandemic on a variety of sexual health services, including how sexual health clinics have adapted to the pandemic and adopted new practices, and what can be expected moving forward.
Clinics that remained open limited or ended walk-in services, limited the number of appointments, saw patients only for essential services, asked patients to postpone elective services, and required a telehealth screening call prior to a visit. Best practices that have evolved during the pandemic include limiting routine screening, instituting appointment only policies for visits at clinics, advising patients with symptoms of COVID-19 to avoid coming in, and prioritizing higher risk patients with symptoms for treatment.
Sexual Health Clinics & COVID-19 Testing
Sexual health clinics can play a crucial role in slowing and halting the COVID-19 pandemic by using their specialized resources and infrastructure such as disease intervention specialists (DIS). The stimulus bills passed by Congress and the bills currently being considered present significant opportunities for sexual health clinics to bolster their DIS and clinic staff, increase lab capacity, expand services, and strengthen infrastructure. While these measures can help with the ongoing pandemic, they can also be retooled to provide sexual health services in the future.
At Home Self-Collection Testing
At home self-collection testing (AHSC) has emerged as a viable alternative to in-person STD testing. Millions of people are confined at home and traveling to get tested at clinics poses many hazards. Supporting STD screening by relying on AHSC presents many opportunities although there are challenges such as higher costs, accuracy issues, and regulatory barriers. Sexual health clinics around the country have established or expanded AHSC services.
Sexual health clinics around the country have implemented telehealth programs to conduct STD screening, diagnosis, and treatment by prescribing oral medications. Many clinics have made a telehealth screening call a requirement before asking patients with symptoms to come in for testing. Screening calls allow for medical history taking and for a reduction in person-to-person contact and reduces the duration of medical visits. HRSA has encouraged telehealth and described it as a critical mode of healthcare delivery.
The availability of various medications used to treat STDs can change rapidly under current circumstances. Due to rumors or incorrect media reports that certain medications can treat or prevent COVID-19, many medications can suddenly and unexpectedly become unavailable due to hoarding by patients and clinics. Medications such as azithromycin were or continue to be in short supply despite their unproven effectiveness in treating or preventing COVID-19.