An alarming report from the Stop TB Partnership predicts that 1.4 million more people could die of tuberculosis, and an additional 6.3 million people could be infected, by 2025 due to the impact of the COVID-19 pandemic. Commissioned by the Stop TB Partnership and with modeling carried out by Imperial College London, Avenir Health, and Johns Hopkins University, the report warns that rates of detection have plummeted and treatment has been delayed because of lockdowns in place in many countries with high rates of TB infection. While the global pandemic poses a serious threat to the fight against TB, the report underscores the importance of a rapid and intense restoration of TB prevention, diagnosis, and treatment as lockdowns are lifted. A strong response with intensive community engagement, heightened awareness, and ramped-up active case finding could prevent close to half a million new infections each month.
The World Health Organization has declared TB the world’s “top infectious killer,” with 10 million people infected and 1.5 million deaths annually. TB is an airborne infectious disease which is highly contagious, meaning that an individual with an undiagnosed case can spread the infection easily to many other people. But both the infection and resulting disease are curable with antibiotics, and effective mitigation strategies rely on extensive contact tracing and widespread treatment availability, both of which have been curtailed by the pandemic.
Stop TB Partnership’s research looked at India, Kenya, and Ukraine, all identified as “high burden countries” for their rates of TB infection, and modeled what both a 2-month lockdown with a 2-month restoration period and 3-month lockdown with a 10-month restoration period would mean for TB treatment worldwide. In addition to the decrease in detection and treatment, the analysis warns of an excess of 420,400 TB cases for every month of restoration, because of the surge in undetected and unreported cases during lockdown. Stringent lockdowns exacerbate this by eliminating the chance to diagnose and treat these new cases. In response, Stop TB Partnership is calling on governments to keep diagnostic, treatment, and prevention services in place for the duration of the pandemic. The alternative, Stop TB Partnership’s executive director Lucica Ditiu warns, is to erase half a decade’s progress in combating the infection and risk millions dying.
While this report underscores the threat COVID-19 poses to TB treatment, it highlights what measures can counteract these risks, calling for more intensive diagnosis and contact tracing and intensive community engagement using digital technology and other tools. A coordinated global response, using all resources and tools available for the treatment of TB, is needed to prevent this massive surge in cases and deaths.