Abstract
SUMMARYEarly in the COVID-19 pandemic, models predicted hundreds of thousands of additional TB deaths as a result of health service disruption. To date, empirical evidence on the effects of COVID-19 on TB outcomes has been limited. Here we summarise the evidence available at a country level, identifying broad mechanisms by which COVID-19 may modify TB burden and mitigation efforts. From the data, it is clear that there have been substantial disruptions to TB health services and an increase in vulnerability to TB. Evidence for changes in Mycobacterium tuberculosis transmission is limited, and it remains unclear how the resources required and available for the TB response have changed. To advocate for additional funding to mitigate the impact of COVID-19 on the global TB burden, and to efficiently allocate resources for the TB response, requires a significant improvement in the TB data available.
Highlights
Given concerns for maintaining TB care and prevention services during the COVID-19 pandemic,[1] mathematical modelers have attempted to estimate the potential impact of program disruptions on TB incidence and mortality.[2,3,4,5] Despite the use of different methods and assumptions about the future of the pandemic, as well as modelling a variety of settings including India, China, South Africa, Kenya, Ukraine and Brazil, these analyses reached broadly similar conclusions
We identify where country-specific data and evidence can be found to quantify the impact of COVID-19 on TB outcomes, and the costs of any mitigation
Services appear to have recovered somewhat, the potential for COVID-19-related lung damage to lead to widespread vulnerability to TB is still unknown, as are the impacts of changes in other vulnerabilities such as diabetes and malnutrition
Summary
Given concerns for maintaining TB care and prevention services during the COVID-19 pandemic,[1] mathematical modelers have attempted to estimate the potential impact of program disruptions on TB incidence and mortality.[2,3,4,5] Despite the use of different methods and assumptions about the future of the pandemic, as well as modelling a variety of settings including India, China, South Africa, Kenya, Ukraine and Brazil, these analyses reached broadly similar conclusions. We identify where country-specific data and evidence can be found to quantify the impact of COVID-19 on TB outcomes, and the costs of any mitigation.
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