WHO urges health care providers to maintain TB services during COVID-19 pandemic
In a new resource, released in advance of World Tuberculosis Day (24 March), the World Health Organization (WHO) has outlined the key considerations for tuberculosis (TB) care services in light of the COVID-19 pandemic.
Tuberculosis is one of the world’s oldest diseases, and continues to be the leading infectious disease killer. A total of 1.5 million people died from TB in 2018, which included 251,000 people living with HIV.
Both COVID-19 and TB primarily affect the lungs and the presented symptoms are also common: a cough, fever, weakness and difficulty breathing. The diseases are also spread in similar ways, although TB typically has a much longer incubation period and more gradual onset of symptoms.
There is currently very limited information available about the impact of COVID-19 on people at risk of and living with tuberculosis. In a small-scale observational study from Shenyang, China, researchers reported an increased susceptibility of SARS-CoV-2 – the virus that causes COVID-19 disease – and increased COVID-19 severity among patients with active or latent TB. However, this requires validation in a larger study.
The WHO also acknowledges the increased risk of severe illness among people with both TB and COVID-19 – particularly if TB patients have their treatment interrupted. To ensure continuity of care for people affected by TB, it has issued an information note to assist healthcare providers in maintaining TB services during the pandemic.
Among the WHO’s recommendations are measures to limit the transmission of TB and COVID-19. It highlights that similar protection measures for infection prevention and control can be applied to both diseases, in line with WHO Guidelines. Alongside this, preventative treatment for TB needs to be maintained as much as possible.
To reduce opportunities for COVID-19 infection, the WHO strongly recommends prioritising patient-centred outpatient and community-based care over hospital care for TB patients. In line with this, TB medicines should be made available for patients to take home in order to reduce the number of visits to treatment centres.
Appropriate planning and monitoring are crucial to maintain the supply of treatment and ensure diagnostics services continue to operate – with tests for both TB and COVID-19 offered to those with respiratory symptoms.
In addition, the WHO also identifies opportunities where TB services can be leveraged in the response to the pandemic. This includes drawing on the expertise of health care workers for pulmonary complications of COVID-19, and efforts made in prevention and control, contact tracing, household and community-based care and surveillance and monitoring systems.
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