HCV Screening and Identification Decrease During COVID-19 Pandemic

Proactive efforts throughout the pandemic must be made to ensure this gap in primary and preventative care can be filled.

Lockdowns and restrictions to healthcare access due to the coronavirus disease 2019 (COVID-19) pandemic have led to a decrease in testing for and identification in Hepatitis C Virus (HCV), according to a new study.

These findings indicate that telemedicine currently poses a barrier to HCV clinical care.

A team led by Heather Sperring, MS, of Boston Medical Center (BMC), assessed the impact of responses to the pandemic on HCV testing in hospital and ambulatory settings.

Since the start of the pandemic, hospital centers, such as BMC, have taken measures to preserve resources in the event of surges—such as decreasing ambulatory in-person visits. As such, preventative care like HCV testing was been largerly impacted.

The Study: Trends in HCV Screening

Using BMC records, Sperring and colleagues collected unique HCV patients tests for a span of 3.5 months prior to and following March 16th, 2020. 

Data included both hospital-wise HCV antibody tests and results and confirmatory HCV RNA tests and results for those who intitially tested positive.

They then categorized tests as either “Emergency Department/Inpatient” or “Ambulatory” as well as according to time period in relation to mid-March.

Thus, results indicated that hospital-wide total HCV testing decreased by 49.6%, and new HCV+ patient identification decreased by 42.1%.

Mean daily tests decreased by 22.9 tests per day (95% CI; 17.9-28.0, P < .001), and mean daily new HCV+ identification by 0.36 (95% CI; 0.20-0.53, P < .001).

Within ambulatory clinics, testing decreased by 71.9%. New HCV+ patient identification saw a 63.3% decrease.

Further, mean daily tests decreased by 22.1 tests per daily (95% C; 17.5-26.7, P < .001), and mean daily HCV+ identification decreased by 1.40 (95%; CI; 1.03-1.76, P < .001).

Perspectives and Conclusions

“The significant decrease in HCV screening reported here demonstrates the consequential tradeoffs that occur between workplace safety and preventive patient care services, as a result of health system responses during this pandemic,” Sperring and colleagues wrote.

Beyond HCV, screening and identification of other chronic illness are similarly being impacted by the pandemic.

The team indicated that proactive healthcare models must be considered in favor of reactive ones. Implementing such interventions may help reduce health risks, decrease avoidable emergency room visits, and minimize the burden of chronic disease-related complications.

“Healthcare providers utilizing telehealth visits should also use them as an opportunity for greater patient education and emphasize the importance of preventive care,” they wrote.

They suggested that facilities should develop more streamlined processes for rapid tests and vaccination visits that can supplement telehealth appointments.

“The long-term impacts of these gaps in primary and preventive healthcare could be detrimental, and deliberate efforts to counteract this impact must be made,” the team concluded. “Preventive care gaps due to COVID-19 must be identified and targeted.”

The study, “Impact of the 2020 COVID-19 Pandemic on Ambulatory Hepatitis C Testing,” was published online in Journal of Primary Care & Community Health.