With millions of cases of TB going undetected and untreated during the lockdown period, there is a high risk involved. Chander Shekhar Sibal, Senior Vice President, Head of Medical Division, Fujifilm India, shares his insights on why it is critical that TB services are not disrupted during the COVID-19 response
The coronavirus has not only caused a global financial crisis, but an unprecedented global health emergency worldwide. The spread of the disease has forced countries to adopt the lockdown approach affecting the economy and businesses across all sectors. The healthcare industry has been the maximum affected due to the surge in demand for care of COVID-19 patients.
As proven by doctors, individuals suffering from any pre-existing health conditions are prone to be affected by the coronavirus disease seriously. With the COVID-19 spreading to almost all corners of the world, the Stop TB Partnership has released results of the latest modelling study that demonstrates the impact the virus will have on tuberculosis (TB). According to the World Health Organization (WHO), TB is the world’s biggest killer among infectious diseases, claiming more than 4,000 lives each day. With the ongoing pandemic, there is a significant risk that prevention and treatment programmes for the existing conditions will be disrupted. Therefore, it is essential to plan and monitor the procurement and supply of TB medicines and diagnostics that are not disturbed and available to the affected individuals.
While the lockdown period is being lifted in phases, in the coming times, we expect these prolonged disruptions due to lockdown to cause severe limitations on diagnostic, treatment and prevention services, thus leading to an expected increase in the annual number of TB cases and deaths over the next five years due to the lack of non-testing/treatment of TB patients, delay in the production and availability of TB medicines, test-kits and consumables. This impact is likely to eliminate and cause a loss of at least five years of progress towards TB elimination. With millions of cases of TB going undetected and untreated during the lockdown period, there is a high risk involved. Therefore, it is imperative to take essential and additional measures in order to avoid larger explosion of the COVID-19 infection, especially to staff members at the hospitals and medical centres, as healthcare facilities, including those that diagnose and care for TB and other infectious diseases, are bound to receive patients with COVID-19, many of whom may be undiagnosed.
To ensure continuity of services, we must take full measures for people who need both preventive and curative treatment for TB. It is critical that TB services are not disrupted during the COVID-19 response; hence, public health authorities at central level as well as state levels must take proactive steps, plan and ensure that procurement and supply of TB medicines, diagnosis and treatment remain uninterrupted. The networks of TB laboratories that our country has established in recent years are one of the important assets that should be leveraged in response to COVID-19.
Accurate diagnostic tests are essential for both TB and COVID-19 patients. While the tests for the two conditions are different, these are made available to individuals with respiratory symptoms, which may be similar to both the diseases. The specialists for patients with pulmonary complications of COVID-19 are respiratory physicians, pulmonology staff of all grades, TB specialists and health workers at the primary healthcare level. In order to diagnose it early and offer timely treatments, we should aim to establish TB laboratory networks in India with the support of WHO and private healthcare partners.
In line with the Government of India’s initiative to eliminate tuberculosis from the country by 2025, we are providing access to efficient healthcare for the masses at a lower cost by working together with the Ayushman Bharat initiative. With the Pradhan Mantri Surakshit Matritva Abhiyan, we even aim to provide assured, comprehensive and quality ante-natal care by creating 1,50,000 Health & Wellness Centers (HWCs) equipped with IBD/IVD, ECG and X-ray machines for basic screening. All measures are being taken to ensure continuity of services for people who need preventive and curative treatment for TB. With early detection and effective treatment, we feel it may reduce morbidity and mortality from both COVID-19 and most forms of TB.
The priority for all governments during these difficult times is to focus on ensuring continuity of essential health services, including national programmes to end diseases like HIV, TB and malaria. For the sustainable development of society, we are also extending our contribution to various organisations and hospitals such as Moolchand Medcity, Delhi; Chengalpattu Medical College and Kilpauk Medical College, Tamil Nadu; Gadag Institute of Medical Sciences, Karnataka, along with various NGOs to curb the spread of these diseases.