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Millions at risk of tuberculosis amid COVID-19 lockdowns, warns study

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File, 2014 - a doctor examines a tuberculosis patient in a government TB hospital in Allahabad, India
File, 2014 - a doctor examines a tuberculosis patient in a government TB hospital in Allahabad, India   -   Copyright  AP Photo/Rajesh Kumar Singh
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One health crisis may be hiding another.

The lockdowns and disruptions caused by the COVID-19 pandemic could lead to millions more cases of tuberculosis (TB) going undetected and untreated, new research warns.

Up to 6.3 million additional people could contract TB by 2025, and 1.4 million more people could die as cases go undiagnosed and untreated due to lockdown restrictions.

The findings, released by the Stop TB Partnership, would set back the global fight against TB by five to eight years.

TB is a highly contagious respiratory disease that’s been around for centuries. Like COVID-19, it attacks the lungs and causes similar symptoms, such as cough, fever and difficulty breathing.

You might think that the drastic confinement measures taken across the world to contain the spread of COVID-19 could have also helped reduce transmission of this more ancient plague.

But in fact, lockdowns are proving disruptive, as they’re diverting attention and resources to the new coronavirus and leaving many TB sufferers under the radar, says Stop TB Partnership Executive Director Lucica Ditiu.

"It’s a sort of perfect storm (…) people with TB are basically left without being diagnosed and treated," she told Euronews in a live interview.

On the one hand, the disease mainly affects vulnerable or marginalised people living in poverty. Lockdowns only make it harder for them to access health care services, she explained.

On the other hand, many hospital units that provided services around TB are now being turned into COVID-19 units, and people have very few places left to go to for TB diagnosis and treatment.

"Most of our colleagues dealing with TB are lung disease specialists, or in infectious diseases, and they are also front-liners as doctors, as nurses, as lab technicians in the COVID fight," Ditiu said.

The World Health Organization has urged governments to ensure continuity of TB services throughout the pandemic, noting that people already sick with TB are also expected to be more at risk of complications if they get infected with COVID-19 as well.

The new study was commissioned by the Stop TB Partnership in collaboration with the Imperial College, Avenir Health and Johns Hopkins University, and was supported by USAID.

The modelling focused on three high burden countries – India, Kenya, and Ukraine – and extrapolated estimates from those countries to create global estimates of the impact of COVID-19 on TB.

'Not our problem'

Despite being both preventable and curable, TB kills around 1.5 million people each year, more than any other infectious disease.

There is currently no effective TB vaccine for adults, only one for children, and drugmakers have found little incentive to invest in the field, despite an alarming rise in antibiotic-resistant forms of the disease. When Johnson & Johnson’s new TB drug was put on the market in 2012, it was the first one to be approved in 40 years.

To date, TB simply hasn’t swept across the world – rich and poor countries alike – in the same way that COVID-19 has. TB overwhelmingly affects poor people in poor countries: over 95 per cent of cases and deaths from the disease happen in developing nations, according to the WHO.

"They are not perceived in most of the Western world as our problem: It’s their problem," Ditiu said.

She suggested the coronavirus pandemic may finally get people to realise that airborne diseases including TB "know no borders" and should be seen as a threat to the whole world.

"Coronavirus is much more contagious than TB, and we need to be mindful about that. However, TB is killing around 4,000 people a day. It’s not a joke."