Tuberculosis in times of COVID-19

Abstract

The COVID-19 pandemic has caused widespread disruptions to tuberculosis (TB) care and service delivery in 2020, setting back progress in the fight against TB by several years. As newer COVID-19 variants continue to devastate many low and middle-income countries in 2021, the extent of this setback is likely to increase. Despite these challenges, the TB community can draw on the comprehensive approaches used to manage COVID-19 to help restore progress and mitigate the impact of COVID-19 on TB. Our team developed the ‘Swiss Cheese Model for Ending TB’ to illustrate that it is only through multisectoral collaborations that address the personal, societal and health system layers of care that we will end TB. In this paper, we examine how COVID-19 has impacted the different layers of TB care presented in the model and explore how we can leverage some of the lessons and outcomes of the COVID-19 pandemic to strengthen the global TB response.

Integrated Tuberculosis and COVID-19 Activities in Karachi and Tuberculosis Case Notifications

“…The collaborative efforts by the PTP Sindh and private sector partners facilitated this reduced loss in case notification. Our findings support calls for an integrated comprehensive approach to care delivery for TB and COVID-19 [6,7].…”

“…The situation has been further exacerbated with unequitable distribution and access to health services and vaccines. The rapid increase in COVID-19 cases has led to TB services being severely impacted due to the cancellation of essential health services in high burden TB countries [5][6][7]. The pivoting of health services infrastructure and workforce towards COVID-19 has not helped either [5,8].…”

World TB Day 2022: Revamping and Reshaping Global TB Control Programs by Advancing Lessons learnt from the COVID-19 pandemic

“…The COVID-19 pandemic has reversed a decade of progress made to control the TB pandemic. (Alene et al 2020;Wu et al,2020;John Hopkins Report, 2022;Zimmer et al, 2021;Pai M, et al, 2022). World TB Day presents an opportunity to highlight that TB is the second most important cause of death from an infectious disease worldwide, and it requires equal attention as COVID-19, if not more.…”

“…Similar messages, and other lessons learnt and recommendations for future pandemic preparedness have also been coming through from other independent political and scientific expert groups and committees from their assessments of the underlying determinants of the COVID-19 pandemic (OECD, 20221;IPPR, 2021;John Hopkins IAE, 2022). Thus these lessons learnt from several COVID-19 innovations in the health systems delivery during lockdowns, and the rapid development and rollout of diagnostics and vaccines highlight the need to stimulate ambitious political and scientific actions for revamping global TB control efforts whilst COVID-19 is brought under control (Ntoumi F et al, 2022a;2022b;Chakaya et al, 2022-IJID;Pai et al, 2022;Zimmer AJ et al, 2021;Ruhwald M et al, 2021Ruhwald M et al, , 2022Hopewell PC et al, 2020;Chapman H et al, 2021;Sahu S et al, 2021: Keene C et al, 2020. This should also include use of Artificial Intelligence (AI) for improved TB screening at all points of care and rapid data communication (Codlin et al, 2021: Malik et al, 2021.…”

“…Before the advent of the COVID-19 pandemic the 2018 United Nations High Level Meeting on TB (UNGA-HLM 2018) had brought renewed hope and increased prospects of muchneeded global advocacy efforts, political commitment with increased funding required to control TB and achieve the WHO and Stop TB Partnership 'End TB targets' for 2030. To get back UNGA-HLM TB control targets back on track, several activities for enhancing TB case finding utilizing latest available TB diagnostics and treatment regimens(TAG Report, 2021) should be taken forward immediately by national governments in high TB burden countries by aligning TB and COVID-19 services(Ntoumi F, 2022b;Zimmer AJ et al, 2021;2022; USAID & STOP TB 2021;Hopewell et al, 2021;Pai et al, 2022;Ruhwald et al, 2021;2022).…”