21. COVID-19 and its impact on TB

Coronavirus disease, or COVID-19, typically affects the lungs and people affected by it may show symptoms similar to TB, such as cough and fever. The lung damage and compromised immunity caused by TB may render these patients more vulnerable to getting severely ill with COVID-19. The COVID-19 outbreak has placed unprecedented demands on our health system. Our health workforce is stretched by a plethora of activities related to managing the pandemic, and in doing so, there is substantial risk of compromising on the essential health services which communities expect from the health system. Continuing to provide essential health services, while managing the COVID-19 related activities, is important to maintain the trust of the community in the health system to deliver essential health services and to minimize any potential increase in morbidity and mortality from other health conditions.

Pandemics like the ongoing COVID-19 could, potentially, derail all progress made by the NTP on ending TB through disruptions to diagnosis, treatment and other interventions like supply chains of medicines and medical supplies. A recent modelling exercise¹¹ to understand the potential impact of short-term lockdowns on TB incidence and mortality over the next 5 years estimates that, due to the COVID-19 pandemic, an additional up to 12% excess cases and up to 19% additional deaths may take place between 2020 2025 in high-burden countries. It is clear now that the pandemic may result in severe disruptions in NTP service delivery and patient care (and care seeking behaviour), with profound consequences on the ongoing efforts to reach the END TB targets.

Hence, the focus should be on building and sustaining strong health systems. Resilient health systems are critical to help respond to unprecedent emergencies like the COVID-19. When these situations arise, the health systems should be in readiness to take immediate steps to ensure health worker protection, communication to affected communities, maintenance of essential services, supply chain coordination, early replenishment of stocks, disinfection of assets, and safe & efficient waste management. Additional activities include pandemic preparedness assessment, laboratory testing, sample transportation, use of surveillance infrastructure, infection control in health facilities, and information and advocacy campaigns.

¹¹http://www.stoptb.org/assets/documents/news/Modeling%20Report_1%20May%202020_FINAL.pdf?fbclid=IwAR1I4py4vDnzh-DTxErv4abXNF1NC4Dv-6iRbByE0GJSIsOe1_Lzycg2Svg