Mar 24, 2021

Double trouble with TB and COVID-19: Lessons learned

Op-ed by Shu-Hua Wang, MD, GOHi director of research and implementation science and associate professor of internal medicine, and Getnet Yimer, MD, GOH LLC. eastern Africa regional director.

To date, the unprecedented COVID-19 pandemic has totaled more than 124,124,997 cases with 2,734,045 deaths worldwide. Globally, tuberculosis (TB) remains a major public health concern and a leading cause of infectious disease death. The World Health Organization (WHO) reported more than 10 million cases of active TB disease accounting for 1.4 million deaths in 2019. Preliminary reports indicate that TB case reports decreased globally by 21% in 2020. On this World TB Day, we must examine the impact that emerging diseases like COVID-19 have on TB mitigation.

The decrease in case count is due to multiple factors including diversion of TB personnel to COVID-19 mitigations efforts, interruptions in TB programmatic care and management, delay in care delivery and delay in patients seeking medical care.  

There are similarities between TB and COVID-19, such as being primarily a pulmonary disease that presents with symptoms such as cough, fever, shortness of breath, as well as being able to be mitigated by public health efforts such as wearing face masks, social distancing and hand washing.

Other similarities include increase morbidity and mortality, adverse effect in individuals with co-morbidities, elderly and immunocompromised. Disparities in racial and economic inequalities has also been identified.

If we are to meet the United Nations Sustainable Development Goals (SDGs) of ending the TB epidemic by 2030, major public and private changes are necessary including rapid test diagnostic development and scale-up, rapid vaccine development and implementation effort, and increase of laboratory and personnel capacity. These efforts are needed for COVID-19, TB and in preparation for other emerging infectious disease in the future.

The Ohio State University Global One Health initiative (GOHi) has been working on different TB projects in Ethiopia, Guatemala, China and locally in Columbus, Ohio.

In Ethiopia, GOHi has been involved in several COVID-19 activities including strengthening the surveillance system through training and deployment of officers, conducting a multistage, nationwide assessment of non-pharmaceutical interventions, sero-surveillance of COVID-19 prevalence, supporting the prioritization of COVID-19 research topics and laboratory capacity.

The world is at a pivotal point. GOHi's efforts must continue in the future and support is needed.