Mitigating 2023 health concerns

Mitigating 2023 health concerns
Rate of new early syphilis diagnoses per 100,000 people (2011-2021). Photo/Virginia Department of Health

By Olivia Anderson |

With a new year comes new year’s resolutions, new routines and new … health concerns?

The COVID-19 pandemic has taken center stage for much of the past few years, and various other serious issues have flown under the radar as an unintended result. In 2023, health professionals are working to spread the word about issues like sexually transmitted infections and hypertension in order to raise awareness and slow the uptick in cases.

The Times spoke with several medical experts to learn more about these issues and steps community members can take to mitigate and treat them.

During the early stages of the pandemic, many people opted for virtual rather than in-person primary care visits, and therefore did not test as often for STIs. This term includes any sort of sexually transmitted infection, some of which turn into diseases, which are then called sexually transmitted diseases.

According to Natalie Talis, population health manager with the Alexandria Health Department, the lack of testing caused case numbers to balloon significantly over the past few years. And now that people are getting tested more frequently, Talis said the numbers surrounding STIs have been “concerning” for AHD, particularly syphilis.

“Things were a little quiet during COVID, but it wasn’t because [syphilis] wasn’t in our community. And so what we’ve seen, now that people are going to get tested again … is a very big jump [in cases].”

In fact, the rate of new early syphilis diagnoses is about 41 per 100,000 people in the city – nearly double the number in 2017, which was 20.9 per 100,000 people.

While Alexandria is higher than Virginia as a whole in terms of cases, Talis said that STI cases – including gonorrhea, chlamydia and HIV – are on the rise overall in the United States.

Alexandria’s level of syphilis infections is not only concerning compared to 2017, but also when examined against Virginia as a whole. Alexandria’s rate of new early syphilis diagnoses in 2021 was approximately 2.5 times higher than Virginia’s statewide rate.

As a precautionary measure, Talis said residents should treat STI testing as part of their regular healthcare.

“When you’re going to the doctor’s office, just as you would get maybe your cholesterol tested, to make sure you’re also getting tested for this … and that if your doctor is not asking you about it, you should be able to ask your doctor about it,” Talis said.

She also advocated for more community-wide education and understanding about readily available resources for testing and treatment. For example, there is a teen wellness center at Alexandria City High School that provides free and confidential STI testing and treatment for any Alexandrian between ages 12 and 19.

Nationwide, about half of the STI infections occur in people between the ages of 15 and 24, Talis said, but AHD emphasizes thinking about “the whole life cycle.”

“We have to talk to everyone. This is something that affects a lot of people, and you can get an infection if you’re sexually active at any age,” Talis said. “… Really, the bottom line is that we want people to talk, test and treat.”

Tackling the issue starts with open and honest conversations, Talis said, noting that part of consent in sexual health is knowing whether someone has an infection, what their testing status is and what method of contraception they’ll be using.

STIs caused by bacteria are treatable, especially if caught early on and antibiotics are administered. There are also treatment options for those whose infections have gone viral to manage symptoms and lead healthy lives.

But it’s not just STIs that have gone under the radar in recent months. Dr. Vivek Sinha, chief medical officer of Belleview Medical Partners in Old Town, said that while he has certainly seen an uptick in the common infections, he’s also noticed that hypertension and diabetes are often underdiagnosed.

“A lot of times we’re diagnosing people with high blood pressure when they’ve had high blood pressure for a while. Same thing with diabetes, because a lot of that has to do with routine screening,” Sinha said.

During the pandemic, many patients did not make routine preventative doctors’ visits as frequently and were therefore underdiagnosed or not diagnosed at all. In addition to hypertension and diabetes, Sinha said that high cholesterol, colon cancer and breast cancer often went overlooked as a result.

Although the COVID-19 pandemic presented a host of challenges, Sinha noted that one silver lining was the sharp rise in mental health awareness.

“The advent of therapy and psychiatry and psychology – we all saw how important it was. It was always important, but now [it] was at the forefront of just how important,” Sinha said.

The need for mental health services has increased, Sinha said, which is exemplified by the wait times to get into see therapists and psychiatrists.

“Getting in to see a specialist is challenging, especially now because so many people are seeing therapists,” Sinha said. “So, I think it’s a double-edged sword. I think it was always there. I think the need increased during COVID, but the flip side is that it was just more on peoples’ minds and it was shown how important mental health [is].”

Now that the world has begun spinning again and doctors’ offices have opened back up, Sinha recommended scheduling regular preventative screenings and routine visits as often as possible in order to catch any potential problems early on. He also emphasized finding a primary care doctor, who can point patients in the right direction based on their age, genetics, family history and other risk factors.

“Everybody needs an advocate in their corner when it comes to health care, and the primary care provider, whomever that is, is perfectly poised to know a lot about the patient and be an advocate for them,” Sinha said. “… Having a really good care provider and following up with your preventative visits is by far the most important thing.”