Analysis

COVID-19 and Tuberculosis (pulmonary) are similar on specific grounds yet strikingly different in response and awareness. Rather than comparing them, this blog looks to explore the best practices and learnings from the COVID-19 response that could be transferred to the Tuberculosis (TB) response and vice versa, in order to complement national and global responses. Cross-learning and timely interventions have the potential to save more lives by building up our defenses against prospective global health threats.

Tuberculosis is a communicable disease that has been around for centuries. It is mainly a respiratory disease but can affect other parts of the body such as the brain, kidneys and spine. The most effective approach to prevent active tuberculosis transmission is a combination of active tracing, taking medication to reduce bacterial load, social distancing and maintaining ventilation in close quarters, maintaining cough etiquette, and avoiding public places until 2 weeks with medication or three consecutive negative AFB sputum tests.

Worldwide, TB is one of the top 10 causes of death and the leading cause from a single infectious agent, claiming more than 4000 lives each day.

Does this remind you of a rapidly spreading pandemic that has us self-quarantined at home?

Shocking, isn’t it?

Table 1: What the similarities and differences between COVID-19 and Pulmonary TB mean for you

Analyzing factors that are common to both illnesses can help bridge the gaps and deepen our understanding of best practices. As such, the considerable overlap between TB and COVID-19 in terms of prevention, case detection, contact tracing, and non-pharmaceutical interventions presents a unique opportunity to devise strategies that can help tackle both diseases using a cross-functional approach.

Through this blog, we will examine the two principles of infection control-triaging and care cascade.

1. Triaging

Patient triage is the process of rapidly determining the best treatment for patients based on their specific needs and anticipated outcome of care. WHO recommends triaging of people with TB signs and symptoms or with TB disease, to reduce M. tuberculosis transmission to health workers or other persons in settings with a high risk of transmission. Even though guidelines for triaging have been developed for TB, implementation is low and uptake minimal mainly due to a lack of consistency in investment and political commitment. COVID-19 has seen a tremendous push for compulsory triaging processes at healthcare facilities.

Here are a few factors that have helped successful triaging practices with COVID-19:

● Consistent political will: The objective of breaking the chain of transmission was aligned with political agendas, ensuring that the communication of the urgency for infection control through triaging was consistent across all verticals. The joint efforts of the central and state governments working together have shown exponential results, especially in terms of access and adherence to Standard Operating Procedures (SOPs).

● Task sharing with private facilities: Joining forces with the private sector helped relieve much of the burden state-owned hospitals had been facing in their lone war against the virus, thereby equipping both parties with the resources needed to care for the burgeoning coronavirus cases. The number of beds dedicated to COVID patients in any private facility was under the sole discretion of the state. Depending on the severity of the spread, it was anywhere between 20% to 50% of all beds.