COVID and TB

Does COVID have any effect on TB?

There are two ways in which COVID might have an effect on TB.

There could be a direct effect. This is what happens when someone with TB then becomes infected with the virus that causes COVID.

There might also be an indirect effect. This could be the result of people working on TB being changed over to doing work on COVID or in other ways there being a disruption of TB services.

The direct effect that COVID might have on someone who already has TB

By April 2021 data emerging from India and South Africa showed that people coinfected with TB and COVID-19 have 3 times higher mortality than people infected with TB alone.1Stop TB Partnership

There is more about TB & COVID in India.

The indirect effect that COVID might have on TB services

The World Health Organisation has emphasized that:

TB services must not be disrupted during the COVID 19 response 2Updated WHO Information Note https://www.who.int/news-room/detail/12-05-2020-updated-who-information-note-ensuring-continuity-of-tb-services-during-the-covid-19-pandemic

But by 2021, one year after the start of the COVID-19 pandemic, nine of the countries with the most TB cases, representing 60% of the global TB burden, have seen a drastic decline in diagnosis and treatment of TB. This decline ranged from 16% to 41%. The drop brought the overall number of people diagnosed and treated for TB in these countries to 2008 levels, a setback of 12 years.

Twelve years of impressive gains in the fight against TB, including reducing the number of people who were missing from TB care, have been tragically reversed by another virulent respiratory infection.312 Months of COVID-19 Eliminated 12 Years of Progress in the Global Fight Against Tuberculosis, Stop TB Partnership

There will inevitably be some disruption of TB services as a result of country wide or even district wide "lockdowns" due to COVID-19.  Stringent COVID-19 responses may only last for a few months but they are likely to have a lasting impact on TB in high burden settings. Some people will not be diagnosed with TB whilst others may not have TB treatment. Disruption of treatment could result in more cases of drug resistant TB.4Liz Ford, Millions predicted to develop tuberculosis as result of COVID-19 lockdown, 2020, Guardian, https://www.theguardian.com/global-development/2020/may/06/millions-develop-tuberculosis-tb-covid-19-lockdown

Impact of COVID-19 on TB deaths © WHO

Impact of COVID-19 on TB deaths © WHO

 

A study looking at this in 2020 suggested that a 3 month lock down and a protracted 10 month restoration of TB services could result globally in an additional 6.3 million cases of TB between 2020 and 2025 and an additional 1.4 million deaths from TB.5The Potential Impact of the COVID-19 Response on Tuberculosis in High Burden Countries: A Modelling Analysis, Stop TB Partnership, 2020, http://www.stoptb.org/covid19.asp

Does the TB vaccine, BCG, protect people against infection with Covid-19?

At the moment there is no clear evidence that the TB BCG vaccine protects people against infection with the COVID-19 virus. The recent impact of COVID in India, where many people have had the BCG vaccine, supports the need for a specific COVID vaccine. By early 2021 several such vaccines have now been developed although there are some issues about the availability of supplies.

What research studies are ongoing?

The World Health Organisation (WHO) is keeping lists of the studies and publications that are taking place in this area.6Compendium of TB/COVID-19 Studies, WHO, 2021, https://www.who.int/teams/global-tuberculosis-programme/covid-19/compendium

Is COVID-19 the name of the virus or the disease?

Viruses and the diseases they cause will often have different names. For example HIV is the virus that causes the disease AIDS. But this doesn't happen with all diseases. For example, the disease TB is caused by TB bacteria.

COVID-19 is the name of the disease. The disease is also sometimes just known as coronavirus disease.

The official name of the virus is "severe acute respiratory syndrome coronavirus 2".  This is because the virus is genetically related to the coronavirus responsible for the SARS outbreak of 2003.  The World Health Organisation (WHO) generally refers to the virus as either "the virus responsible for COVID-19" or "the COVID-19 virus".7Naming the coronavirus disease (COVID-19) and the virus that causes it, WHO, 2020, https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it

How do you diagnose COVID-19 in high burden TB countries?

There is now a test for the coranavirus that causes COVID-19 which is available for use on the Genexpert system. The Genexpert sytem is widely available in low and middle income countries where it is already used for diagnosing TB.8Stop TB Partnership, 2020, http://www.stoptb.org/news/stories/2020/ns20_020.html

The Truenat system which is widely used in India can also now be used to test for COVID-19.9https://www.thehindu.com/news/national/kerala/truenat-results-can-be-the-final-word/article31872536.ece

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This page was last updated in May 2021.
Author Annabel Kanabus

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