Three lessons the Covid-19 pandemic has taught us

Tuberculosis (TB) is a treatable disease, but the death toll is increasing For the first time in 10 years, Even though the case is down. why? Because the coronavirus threw a spanner while working.

World Health Organization (WHO) Report In 2020, the number of deaths from tuberculosis reached the level last seen in 2017, despite the number of cases. 1.3 million decrease Between 2019 and 2020. This is what they say The world is unlikely to reach that goal Reduce tuberculosis infection by 20% or end tuberculosis death By 2030..

The situation is a secondary pandemic damage that we have not prepared, urgently fighting new illnesses, diverted from countries implementing strict blockades and public medical programs with established medical resources. As a result, many people have no access to TB testing and treatment.

For this reason, WHO predicts we will meet more people He was diagnosed with tuberculosis and died the following year. And low- and middle-income countries are not only suffering from the highest disease burden, but are probably the hardest hit due to the unequal economic consequences of a pandemic.

World Bank estimates that pandemic has pushed up Over 97 million people are in extreme poverty —That is, they live below R28 a day — more than expected before Covid.The economies of poor countries It takes time to bounce The World Bank says it has raised it to a precovid level rather than developed countries. This is because wealthy states are expected to recover their losses sooner.

But the news isn’t all bad — Covid’s pandemic has also taught us valuable lessons.

Here are three things we can take from dealing with Covid to tackle tuberculosis.

1. Use effective means for other airway disorders

The bacteria that cause tuberculosis and Covid-19 are different, but they can also control the spread of the infection. This is because both tuberculosis and Covid-19 affect the respiratory system, the airways and lungs. Both spread simply Crowded setting when people cough or sneeze..

According to public health statistics, respiratory tract infections such as influenza and pneumonia decreased dramatically during the first year of the pandemic.For example, in a US lab Influenza cases are reduced to 1/100 The period from September 2020 to May 2021 (the month normally considered the influenza season in the Northern Hemisphere) is higher than the four-year average prior to Covid.

And in South Africa, the National Institute for Infectious Diseases reported There are few cases of respiratory syncytial virus (RSV) infection, The main cause of bronchiolitis (inflammation of the small airways) and pneumonia in children under 1 year of age in the 2020 season. A similar pattern Other countries..

Scientists believe these trends are due to non-pharmaceutical interventions (NPIs) such as wearing face masks, washing hands, and increasing social distance to help control the spread of the disease. Moreover, Studying from KoreaAlthough no strict blockades were implemented in the early days of the pandemic, countries with high mask wear have shown that the spread of respiratory infections can be significantly stopped by NPI.

Quite cheap interventions and the powerful effects of having people change their behavior may be good news for the fight against tuberculosis, but that doesn’t mean we can sit and relax. Covid (and our response to it) did not wipe out respiratory illness, as the prediction of RSV infection in South African children shows. In the short term it only weakened the case. For illnesses, such as tuberculosis, that show symptoms weeks or months after someone is infected, a small number can give false relief. It is wise to take advantage of the short rest that Covid has brought us to prepare for a reoccurrence of the case. They are..

2. Stop wearing the stigma of the mask

If tuberculosis is diagnosed, the patient Wear the mask until you take the medicine long enough to prevent them from getting infected anymore.. This is to prevent the mask from releasing the bacteria that cause tuberculosis into the air.

The advice has been around for years, but people were hesitant to accept it. because, Look better Previously reportedPrior to the Covid pandemic, wearing a mask was considered an indication that someone had tuberculosis.Such a stigma meant that people resisted Get tested or treated for tuberculosisWhich in turn hampered efforts to control the disease.

Covid changed that. We have been accustomed to seeing people wearing face masks for the past two years. Instead of masks being a symbol of illness, they are now a sign of solidarity to combat threats common to many.

This is good news for reducing the spread of tuberculosis in an affordable way.research Published in American Journal of Respiratory Care and Critical Medicine In 2012, wearing a face mask was shown to reduce the prevalence of multidrug-resistant (MDR) TB by up to 56%. MDRTB Is a type of disease for which commonly used tuberculosis drugs do not work, it is difficult to treat and it is expensive.

In South Africa Disproportionately high numbers Of cases of multidrug-resistant tuberculosis. Therefore, simple and cheap interventions, such as wearing masks, can be a real benefit in countries with poorly funded public health systems. And Covid showed that it is possible for most people to accept behavioral changes fairly quickly.

3. Tests, tests, tests — and traces

Covid’s pandemic shows how important testing is. A positive test means that people can be isolated during infection and limit the number of people who can spread the SARS-CoV-2 virus. Similarly, contact tracing was seen as a way to contain the spread of the virus, at least in the early stages of the pandemic. This is because it is possible to alert people who may have been unknowingly infected with Covid from active contact at an early stage.

Similarly, early detection of tuberculosis can be very helpful in controlling the disease. Due to the long incubation period of tuberculosis (the time between infection and the onset of symptoms), many people who are unaware that they are infected can be exposed to the bacteria.In addition, tuberculosis Opportunistic infectionIn other words, it is a disease that mainly affects people with weak immunity. Therefore, tuberculosis may be hidden in the body in a healthy state, but weakened immunity can cause tuberculosis to recur or develop into a serious condition.

People infected with HIV are particularly vulnerable to the development of tuberculosis... In fact, WHO estimates that about one-third of people infected with HIV in 2017 developed tuberculosis worldwide. About 70% of HIV / TB co-infected people live in sub-Saharan Africa. Therefore, it makes a lot of sense to test them together. Good results have been achieved by running HIV / TB combination services at 41 treatment centers in five states in Nigeria. And in Uganda “One stop shop” For maternal health / HIV / TB services, the number of cases detected and treated increased.

Existing piggy backing Facilities and expertise in dealing with one illness can be of great help in dealing with another... For example, in a South African system previously developed to monitor viral load (viral load in the body) of HIV patients, know-how already existed, so the institute expedited PCR testing (the gold standard for Covid testing). I was able to carry it out. Established.

Muluken Melese is a Senior Technical Advisor to TB, HIV, and Aids with Management Sciences for Health, a non-profit global health organization, and doctors and public health with over 30 years of clinical, project management, and research experience. I’m an expert.

Andre Zagorski is a Senior Principal Technical Advisor at Management Sciences for Health with over 25 years of experience managing tuberculosis, infectious diseases and essential medicines projects worldwide in Europe, Asia and Africa.

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