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INDIANAPOLIS — As we continue to face the continued impacts that the COVID-19 pandemic had, one element that the Centers for Disease Control and Prevention (CDC) is focusing on is another deadly respiratory disease.

On World Tuberculosis Day, the CDC released its Morbidity and Mortality Weekly Report (MMWR). In this report, the CDC reported tuberculosis (TB) disease diagnoses fell 20% in 2020 and remained 13% lower in 2021. This is compared to a 1% to 2% decline each year before 2020.

While at first glance the data is encouraging, the CDC said the drastic decrease in diagnoses may be linked to factors associated with the COVID-19 pandemic. While this may include a true reduction in the disease, delayed or missed diagnoses may have factored into the decline. For example:

  • Efforts to prevent COVID-19, such as wearing masks and staying six feet away from others, may also reduce the spread of TB.
  • Widespread disruptions to healthcare during the COVID-19 pandemic may have delayed TB diagnoses.
  • Similarities in symptoms between COVID-19 and TB disease may have led to missed TB diagnoses.

“Delayed or missed tuberculosis disease diagnoses are threatening the health of people with TB
disease and the communities where they live. A delayed or missed TB diagnosis leads to TB
disease progression and can result in hospitalization or death – and the risk of transmitting TB to
others. The nation must ensure that healthcare providers understand how to diagnose and
distinguish TB disease from potential cases of COVID-19.”

Philip LoBue, MD, FACP, FCCP, Director of CDC’s Division of Tuberculosis Elimination

Marc Destito, vice president and head of global health for QIAGEN, said disruptions to healthcare and funding have had a negative impact on the fight against TB. This is something that has happened historically.

“Anytime there’s a disruption to health services health-seeking behavior that often causes a rise in TB,” said Marc. “I think we’re only beginning to see sort of the tip of the iceberg right now.”

The CDC says the COVID-19 pandemic has strained public health services including TB prevention and control services. With funding being reallocated to fight COVID-19, Marc says TB services took a hit.

“There’s been so much funding, both public health funding, global health funding that has been reallocated to fight COVID that that has really put a dent in what we’ve seen in terms of spending for TB,” said Marc. “So it’s a resource constraint issue. If you’re taking money away from one pot, which is TB screening, TB prevention, TB treatment, and putting that to something else, then, of course, TB cases are going to increase.”

The CDC data supports this, showing a 9.4% increase in cases in 2021 compared to 2020. The CDC says delayed or missed TB diagnoses because of disruptions in health care access or assumptions that patients with respiratory symptoms had COVID-19 might contribute to the observed changes.

CDC

Marc says there are separate tests for COVID-19 and TB. However, there has been talk in the community about the need for bidirectional testing. This way, if someone needs to get tested for COVID-19, they would also get tested for TB.

“Testing has become such a critical component, and I think one maybe silver lining to the pandemic is the fact that it seems we’re becoming as a society more accustomed to testing and testing is being made easier and more available, and I think that has to remain as well for TB,” said Marc.

The CDC recently renewed its efforts to fight TB. They launched the Think. Test. Treat TB campaign to help ease awareness and recognize the importance of TB prevention. The CDC says starting a conversation with your doctor is the first step to protecting your family, friends and community from TB.