While stay-in-place and physical distancing measures to control the spread of COVID-19 are projected to also slow the spread of other illnesses, lockdowns prompted by that pandemic will delay TB diagnoses and treatment efforts by much greater proportions, leading to rising rates of tuberculosis illness and deaths, an analysis released today shows.
Focusing on impacts of COVID-related shutdowns in Kenya, India and Ukraine, three of the countries hardest hit by the tuberculosis pandemic, the findings, based on modeling, reflect stalled efforts that will be felt globally, allowing undetected disease to contribute to increased tuberculosis illness and treatment resistance worldwide, taking lives and derailing strategies to control the disease within the next decade.
TB transmissions would drop by about 10% in each of the three countries during COVID-19 prompted lockdowns, analysts found. At the same time delays in seeking care would increase by 50% in India and Kenya and by to 30% in Ukraine, while the chances of being diagnosed correctly with the disease during a visit to a health provider would drop by 70% in India and Kenya, and be halved in Ukraine. With overwhelmed healthcare staff unable to monitor and support the long and arduous treatment required to treat tuberculosis that responds to the most effective and efficient treatments, completion of first-line treatment is projected to drop by almost a third in India and Kenya, and by half in Ukraine. Completion of the longer and more toxic treatment for tuberculosis that is resistant to first-line treatments is projected to drop to about a quarter of those starting treatment.
Globally, in a scenario of lockdowns lasting two months and succeeded by recovery of health services in another two months, the world would see a little more than a 3% rise in people sick with tuberculosis between 2020 and 2025, an increase of more than 1.8 million people requiring treatment for the disease. Deaths would increase by 4% — with the loss of 342,500 more lives. With a three-month lockdown and recovery of health services taking 10 months, the rise in illnesses would be 10% with more than 6.3 million additional people sick with TB, and deaths would rise by 16% — with more than 1.3 million lives lost over the next four years.
The modeling study, carried out by the Stop TB Partnership, with USAID, Johns Hopkins University, Avenir Health and the Imperial College of London, comes as resources and efforts already were falling far short of meeting targets set to end tuberculosis as a global public health threat in the next 10 years.