How One Pandemic Worsened Another

Traces of Mycobacterium tuberculosis, commonly known as tuberculosis (TB), have been detected as far back as 2,500 years ago in ancient Egypt. As such, it is an age-old affliction that threatened humans for countless years. In fact, before COVID-19, TB was thought to be the deadliest infectious killer, infecting over 10.6 million and killing over 1.6 million individuals in 2021 alone. Prior to COVID-19, this long-standing TB pandemic was seeing declines in deaths. But with the emergence of the new pandemic, this old pandemic worsened too, and TB deaths began rising again. A paper published in 2021 predicts that the number of deaths will increase by 5% to 15% over the coming five years, and the WHO believes that COVID-19 has set back progress against TB by numerous years.

About a quarter of the world’s population has a TB infection, so many people who have been infected by the TB bacteria are not yet ill with the disease and may never develop symptoms. In higher-income regions with clean water ventilated homes, and abundant food, the infection remains latent. The sickness mostly infects people with weak immune systems. People with HIV, diabetes, and poverty-related conditions like malnutrition are the most vulnerable, with undernutrition increasing risk by 300%. Smoking and drinking alcohol also increases TB risk, with 1.37 million new TB cases in 2021 being attributed solely to these two factors. Just eight countries, almost exclusively less developed countries, including China, India, Indonesia, and Nigeria, account for two-thirds of worldwide symptomatic cases.

The emergence of the COVID-19 pandemic resulted in a downpour of problems for anti-TB efforts, particularly in less developed countries (where TB is more prevalent) that have less advanced healthcare systems. Though it was believed that stay-at-home restrictions and mandatory mask laws might help slow down the spread of the disease (because, like COVID-19, TB is spread through airborne particles emitted through coughing, sneezing, and speaking), the overall effect of these COVID-19 restrictions have been negative.

As poor families were forced to stay put in very small, badly ventilated homes, the bacterium spread more rapidly. On top of this, economic disruption and the widespread loss of low-income jobs meant that poverty and hunger rose, exponentially decreasing access to preventative treatment. Diagnoses also fell, because of a fear of breaking lockdown regulations while trying to see a doctor. Of those who were clinically diagnosed, many struggled to attain treatment. Health systems were jammed with COVID-19 patients, leaving little room for other equally life-threatening illnesses. TB patients in specific suffered more since medical resources linked to respiratory diseases were diverted to tackle the new pandemic. Worldwide spending on TB, which was already less than half the global target, fell further, from $6bn in 2019 to $5.4bn in 2021.

However, while the COVID-19 pandemic has harmed many TB patients, some officials argue that the worldwide response to this most recent pandemic could teach us about how to tackle old pandemics as well. Huge quantities of money and effort were poured into developing and assessing COVID-19 treatments. Convenient diagnostic tests were invented, refined, mass-produced, and shipped worldwide within just a few months. Vaccine production was tremendous, with vaccines and revised boosters being formulated and supplied across the world within the pandemic’s first year. The new pandemic has changed patient behavior as well. More patients feel the need to visit healthcare professionals when they develop symptoms like a cough or a fever rather than waiting for it to pass because they have realized it may be a sign of more serious illnesses like COVID-19 or TB. Thus, enabling increased detection and treatment measures to be prescribed to control deaths from such pathogens.

So, if the world takes the lessons learned from the COVID-19 pandemic and equally dedicates medical-related human and financial capital to anti-TB efforts, this pandemic, too, can be tackled.

Sources:

How One Pandemic Made Another One Worse

Tuberculosis

Global tuberculosis cases increase for the first time in 20 years