Lockdowns unleashing a worse epidemic: TB

by Jarius Bondoc (The Philippine Star), 6 Aug 2021

Lockdowns aim to contain the deadly COVID-19 pandemic. But they unintentionally unleash a worse killer, tuberculosis.

Region-, province- and city-wide lockdowns disrupt livelihoods. Earnings lessened, people are forced to subsist hand-to-mouth. They go hungry and undernourished. Mental anguish and cooped up stress drive them to smoke and drink. With mobility restricted they are unable to seek medical care and buy medicines. TB-related diseases like diabetes go unattended; numerous kidney dialysis centers have, in fact, shut down.

TB thrives in those conditions. Nearly 600,000 Filipinos fell ill to TB in 2019, the World Health Organization reported. Five main causes were undernourishment, smoking, alcohol use disorder, diabetes and human immunodeficiency virus.

TB killed 22,000 Filipinos in 2017, the world’s fourth worst fatality rate. In 2019 the deaths rose to 28,000, WHO said. That makes TB more lethal than COVID-19, which has killed 28,000 in 18 months, February 2020 to date.

Also in 2019, the Philippines had 554 TB cases per 100,000 population, the worst incidence in Asia. About 21,000 contracted drug-resistant TB. Too, 11,000 HIV sufferers fell ill with TB.

The stats can only have worsened in 2020 to the present. But data-recording is all messed up, precisely due to COVID-19. Since March 2020, when the first lockdowns were imposed, TB consultations, testing and treatment dropped, according to the Department of Health. By the end of 2020, only 268,816 new and relapse TB cases were notified to DOH. It was a 35-percent decrease in reporting from 2019 figures.

Case notification is the first step in the government’s anti-TB program. Identified patients are then treated to stem the epidemic.

One can only imagine how many TB cases are left unattended out there.

TB is caused by Mycobacterium tuberculosis. A patient transmits the bacteria from cough, sneeze, spit and talking. Droplets are inhaled during close contact. At first the exposed person’s natural defense system will fight the bacteria. But once the immune system weakens, the bacteria attack the lungs and other organs.

TB is curable. Treatment is free in public health facilities nationwide.

But the 2016 National TB Prevalence Survey found out that only 19 percent of people with TB symptoms sought treatment and care. The rest ignored the condition or self-medicated. “These behaviors likely prevail today as mobility restrictions continue with COVID-19,” the DOH said.

Amid the pandemic, DOH and its partners are doubling efforts to get TB care back on track, it said. At least 100,000 TB deaths are expected in the five years to 2025.

Symptoms of TB are: persistent cough that lasts more than three weeks, usually with phlegm and blood; weight loss; night sweats; high temperature; tiredness and fatigue; loss of appetite and swellings in the neck.

Those experiencing symptoms or diagnosed with TB are encouraged to consult barangay health centers or nearest government clinics for free treatment. The DOH also is addressing public stigma and discrimination.