TB & COVID-19 warning

AMID the increasing number of COVID-19 infections locally, people living with tuberculosis (TB) — a disease caused by bacteria that usually attack the lungs — have to be even more mindful of their health.

Ahead of World TB Day which will be recognised on Wednesday, March 24, Dr Terry Baker, senior medical officer at National Chest Hospital in St Andrew, is warning that it could be a dual burden and double attack on the lungs if TB patients contract the novel coronavirus.

“COVID-19 truly respects no one,” she told the Jamaica Observer in an interview on Friday. “So, persons with TB should definitely be mindful, just as anybody else. Not because we are not seeing the [TB] numbers here, but for someone with tuberculosis who already has underlying lung disease, getting COVID-19 may very well make it worse.

“The thing with COVID and TB is that COVID is caused by a virus while tuberculosis is caused by bacteria — most of which have seemingly a predilection primarily for the lungs,” Dr Baker told Your Health Your Wealth.

She further compared both diseases.

“While the onset of symptoms for COVID-19 can definitely be more acute and much more dramatic in its presentation once the person has been exposed, for tuberculosis it’s often a more indolent, prolonged, sometimes even chronic type of picture onset that we’re seeing,” she said. “Both primarily affect the lungs. Tuberculosis can affect other organs, and we see this in the more chronic cases. The symptoms are so vague that it may be a challenge to diagnose.”

Similar to that of the novel coronavirus, TB spreads through the air when a person with the disease coughs, sneezes or talks. Additionally, both diseases have similar symptoms such as fever, cough, and difficulty breathing.

“While it is that we are focused on COVID-19 we have to ensure that we are still mindful that there is TB out there and to recognise the difference in the clinical picture, even though both have predilections for the lungs,” Dr Baker urged. “And, while it is that the health care staff may be stretched to managing patients with COVID-19, [for] our patients who are currently undergoing treatment for tuberculosis we need to ensure that they are accessing medical care, accessing their medication, which would put them at a lower risk in the event that they are exposed to COVID-19.”

She insisted that the health system needs to be organised and empowered to ensure that individuals with other chronic diseases and illnesses can still access care.

“It may not be the same as it were prior to the pandemic, but they should not be forgotten,” Dr Baker insisted.

Last year the organisation leading the response to the novel corona virus pandemic — World Health Organization (WHO) — also advised that TB treatment must continue.

“While experience on COVID-19 infection in TB patients remains limited, it is anticipated that people ill with both TB and COVID-19 may have poorer treatment outcomes, especially if TB treatment is interrupted. TB patients should take precautions, as advised by health authorities, to be protected from COVID-19 and continue their TB treatment as prescribed,” WHO said then.

In the meantime, the Pan American Health Organization (PAHO) has also echoed Dr Baker’s call ahead of World TB Day.

“As the world comes together to tackle the COVID-19 pandemic, it is important to ensure that essential services and operations for dealing with long-standing health problems continue to protect the lives of people with TB and other diseases or health conditions. Health services, including national programmes to combat TB, need to be actively engaged in ensuring an effective and rapid response to COVID-19,” the organisation said.

Painting a picture of the current TB and COVID-19 situation locally, Dr Baker told Your Health Your Wealth that of the COVID-19 cases registered across the country since the first confirmed case last year March, TB patients are not prominent among those infected.

According to statistics released by the Ministry of Health and Wellness yesterday, Jamaica has recorded 34,665 cases of COVID-19 since March 2020 of which 17,958 cases are still active, and 524 people have died.

“Right now the patients that we’re seeing coming in with COVID primarily are those with previous heart disease, uncontrolled hypertension, uncontrolled diabetes, and those who are significantly overweight. Those are some of the risk factors that we are seeing. Not that these are the only persons, but certainly these are some of the risk factors,” the senior medical officer for National Chest Hospital said.

She added: “We are not really seeing, in patients with active TB, a lot of COVID. Our number of tuberculosis disease is lower; our number of patients with tuberculosis disease is lower compared to COVID. We average about 100 patients roughly; we have anywhere between 80 to 120 new cases of tuberculosis per year.”

Dr Baker had reported last year that Jamaica, which had a TB death rate of 0.3 cases per 100,000 people in 2019, has experienced a decline in TB cases since 2015. At the time, she had said the cases averaged between 120 and 150 annually.

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