COVID Helping Tuberculosis Comeback

"This report confirms our fears that the disruption of essential health services due to the pandemic could start to unravel years of progres against tuberculosis."

"This is alarming news that must serve as a global wake-up call to the urgent need for investments and innovation to close the gaps in diagnosis, treatment and care for the millions of people affected by this ancient but preventable and treatable disease."

Dr.Tedros Adhanom Ghebreyesus, Director General, World Health Organization

 

"In 2020, the COVID-19 pandemic pushed 100 million people into poverty."

"Nearly 20 percent of global tuberculosis incidence is attributable to under-nutrition."

"Without global vaccination, health-care systems in low- and middle-income countries will collapse."

"[Countries in southern Africa] are experiencing massive COVID-19 surges on top of already high tuberculosis and HIV co-infection burdens."

Article, New England Journal of Medicine 

"Once COVID came, we totally lost track of the TB stuff."

"Housing is the biggest issue we face. There are multiple families per house. People are sleeping on couches."

Eric Lawlor, mayor, Pangnirtung, Nunavut, Canada

With most private clinics closed, patients with H.I.V., TB and malaria have few places to go for the kind of medical care offered at this Doctors Without Borders clinic in Nairobi.   Credit...Brian Inganga/Associated Press

In Canada, tuberculosis affects Inuit -- the majority of the Nunavut population -- disproportionately. Both TB and COVID are being spread in the territory by a housing crisis, since both diseases spread readily through person-to-person contact. Some 80 percent of Nunavut residents were given at least one dose of the COVID vaccine, and residents generally follow public health guidelines. 

There is a rising realization globally that tuberculosis is increasingly leading to rising deaths for the first time in a decade and a half, attributable to the presence of COVID. In November, the World Health Organization raised the alarm by citing approximately 1.5 million tuberculosis deaths worldwide in 2020.

Tuberculosis remains the leading cause of death from infectious disease, though it's thought of by most people as an illness of the long-gone past. During the AIDS crisis in the 1980s, cases of TB were seen on a rise when  AIDS patients with compromised immune systems were unable to fight off the infection. North American TB cases began decreasing in the mid-90s, but in many parts of Africa, Asia and Latin America it remains common.

 

Dr. Giorgio Franyuti said many patients with TB at a makeshift hospital in Mexico City were being misdiagnosed with Covid-19.  Credit...Meghan Dhaliwal for The New York Times

Six countries of the world: India, Indonesia, China, Nigeria, Pakistan and South Africa, see sixty percent of worldwide tuberculosis cases. TB is a disease, like COVID, that primarily affects the lungs and like COVID it is transmitted by tiny droplets int he air. Unlike COVID, there is no vaccine for tuberculosis, and what makes it deadly is the antibiotic-resistance of many strains of TB.

What has brought about its resurgence is the medical attention having been shifted wholesale toward treating people with COVID; as a result fewer TB patients were being treated, diagnosed and prevented from dying pf tuberculosis because of a lack of access to medical care. According to the article published in the New England Journal, vaccine inequity represents a large portion of the problem.

Poverty and malnutrition help spread tuberculosis; so that countries with high levels of poverty and malnutrition are also those countries with limited access to the COVID vaccine, as a result of which greater numbers of COVID cases translate to more TB deaths.

 

A patient with tuberculosis waits to be seen by a doctor at the Sizwe Tropical Diseases Hospital in Johannesburg, South Africa. Annual deaths from the infectious disease are on the rise after years of progress.   Michele Spatari /AFP via Getty Images