The Union Ministry of Health and Family Welfare on Saturday said there is not enough evidence to link the increase in TB cases to COVID-19 though Tuberculosis (TB) screening for all COVID-19 positive patients and COVID-19 screening for all diagnosed TB patients has been recommended.
The ministry issued the clarification following reports of sudden rise in TB cases noticed among patients who were infected with COVID-19 recently, leaving the doctors worried on receiving around a dozen similar cases every day.
States/UTs have been asked for convergence in efforts for better surveillance and case finding of TB and COVID-19, as early as August 2020, the ministry pointed out.
Apart from this, the ministry stated that multiple advisories and guidance have also been issued by MoHFW to reiterate the need for bi-directional screening of TB-COVID and TB-ILI/SARI. The States/ UTs have been implementing the same.
Due to the impact of COVID-19 related restrictions, case notifications for TB had decreased by about 25 per cent in 2020. But special efforts are being made to mitigate this impact through intensified case finding in OPD settings as well as through active case finding campaigns in the community by all states, the ministry said.
Moreover, there is not enough evidence currently to suggest that there has been an increase in TB cases due to COVID-19 or due to increased case finding efforts, the ministry said.
The dual morbidity of TB and COVID-19 can be further highlighted through the facts that both the diseases are known to be infectious and primarily attack the lungs, presenting similar symptoms of cough, fever and difficulty in breathing, though TB has a longer incubation period and a slower onset of disease, ministry added.
The ministry further explained that TB bacilli can be present in humans in a dormant state and has the potential to start multiplying when the individual’s immunity is compromised for any reason. The same is applicable in post COVID scenario, when an individual may develop decreased immunity due the virus itself or due to the treatment, especially immune-suppressants like steroids.
SARS-CoV-2 infection can make an individual more susceptible to developing active TB disease, as TB is an opportunistic infection like black fungus, the ministry added.
