By Christopher Sirota
Key Takeaway: A non-for-profit group that combats various diseases worldwide, has released a report highlighting how the COVID-19 pandemic has impacted their efforts to address tuberculosis, HIV, and malaria. Additionally, some researchers are concerned about how COVID-19 could activate so-called "latent tuberculosis."
When a global pandemic strikes, attention naturally falls to that specific disease. But other diseases do not suddenly stop occurring and can be exacerbated by a pandemic. For example, we previously posted that other diseases may be going undiagnosed posing a risk not just to individuals but also to those around them because many people may be deferring or avoiding medical treatment and screenings during the pandemic. We also noted that one study conducted in Europe found that mortality rates for non-coronavirus illnesses had reportedly increased, with fatalities related to pneumonia, other respiratory diseases, and sepsis reportedly on the rise.
Now, Reuters reports on the latest findings regarding the impacts of the pandemic on preventing the spread of other diseases. Per Reuters, efforts by the not-for-profit Global Fund, which is, per their website, "a partnership designed to accelerate the end of AIDS, tuberculosis and malaria as epidemics," have been hampered by the pandemic.
The above diseases are reportedly linked to thousands, and sometimes millions, of deaths annually. According to the World Health Organization (WHO):
- Tuberculosis: caused about 1.4 million deaths in 2019.
- HIV: caused about 680,000 deaths in 2020.
- Malaria: caused about 409,000 deaths in 2019.
Reuters explains that the pandemic disruption caused the number of people treated by Global Fund programs for drug-resistant TB to drop by 19 percent in 2020 compared to 2019. Services for HIV also declined by about 11 percent.
Regarding malaria, per the Global Fund's press release, preventive measures such as mosquito net distribution actually increased by 17 percent in 2020, however "suspected cases of malaria tested fell by 4.3% and progress against the disease stalled." (Full Global Fund report available here.)
Of interest, a related preprint abstract published by MedRxIV in May 2020, states that researchers predicted an average 25 percent decrease in TB detection in 2020 which would likely result in an increase in deaths by 13 percent compared to 2019, totaling about 1.66 million victims - equivalent to the global level of TB-related mortality in 2015.
Latent TB and COVID-19
Notably, although TB risk is reportedly lower in higher income countries, one researcher from San Diego State University expressed concern in 2020 for the possibility of COVID-19 activating the bacterium (Mycobacterium tuberculosis) in patients with the asymptomatic stage of TB, so-called "latent tuberculosis." The university article elaborated on the global extent of the concern as follows:
Latent TB is present in populations everywhere, including the U.S. While there is a high incidence of active TB in India, China, Indonesia, the Philippines, Pakistan, Bangladesh, Nigeria and South Africa, what is less well-known is that nearly 9,000 TB cases were reported in the U.S in 2019 and up to 13 million people are estimated to have the latent form of the disease in the U.S. alone, per the U.S. Centers for Disease Control and Prevention (CDC). [2020 CDC stats here]
In fact, in January 2021, the National Institutes of Health (NIH) published a paper describing perhaps the first case of latent TB likely activated by COVID-19. The study explains the researchers' concerns, noting that:
This case appears to confirm the concerns that the CD4+ T-cell depletion associated with COVID-19 may promote the development of active tuberculosis from latent infection much like HIV does. If this effect is widespread it may have a significant impact on the worldwide TB burden. We suggest vigilance to ensure patients are diagnosed early and meticulous contact tracing is undertaken to treat those with latent tuberculosis.
Per the NIH paper, researchers estimate about one third of the global population has latent TB.