Modeling the impact of COVID-19 on future tuberculosis burden

Abstract

Background The ongoing COVID-19 pandemic has greatly disrupted our everyday life, forcing the adoption of non-pharmaceutical interventions in many countries and putting public health services and healthcare systems worldwide under stress. These circumstances are leading to unintended effects such as the increase in the burden of other diseases. Methods Here, using a data-driven epidemiological model for tuberculosis (TB) spreading, we describe the expected rise in TB incidence and mortality if COVID-associated changes in TB notification are sustained and attributable entirely to disrupted diagnosis and treatment adherence. Results Our calculations show that the reduction in diagnosis of new TB cases due to the COVID-19 pandemic could result in 228k (CI 187–276) excess deaths in India, 111k (CI 93–134) in Indonesia, 27k (CI 21–33) in Pakistan, and 12k (CI 9–18) in Kenya. Conclusions We show that it is possible to reverse these excess deaths by increasing the pre-covid diagnosis capabilities from 15 to 50% for 2 to 4 years. This would prevent almost all TB-related excess mortality that could be caused by the COVID-19 pandemic if no additional preventative measures are introduced. Our work therefore provides guidelines for mitigating the impact of COVID-19 on tuberculosis epidemic in the years to come.

Digital cities and the spread of COVID-19: Characterizing the impact of non-pharmaceutical interventions in five cities in Spain

“…The quick spread of a deadly infection among a population represents a threat to public health systems, which requires immediate action and extra resources in order to mitigate and eventually control the impact of the associated disease on the population. However, interventions need to be carefully evaluated, as our society is a complex interdependent system in which mitigating the effects of one disease might result in non-desirable side effects such as the reduction of the services provided to both prevent and treat other diseases (22)(23)(24). To avoid these effects, scientists and policy-makers need computational resources that allow for a fast assessment of the possible outcome of interventions whenever pharmaceutical interventions, such as vaccination campaigns, are not possible.…”

Flaws and uncertainties in pandemic global excess death calculations

“…Focused efforts should estimate excess deaths from various non-COVID-19 causes during 2020-2023 and beyond, for example, from disruption of healthcare services regarding acute cardiovascular disease, 52 chronic diseases such as cancer, 53 reversal in progress on infectious diseases such as malaria 54 or tuberculosis, 55 hunger/ starvation, 56 mental health deterioration, 57 drug overdose epidemics 49 and diverse worsening circumstances. 58 The The proportion of deaths in residents of long-term facilities among reported COVID-19 deaths in 2020-2021 is estimated at 34% for the United States and 22% for Germany, 32 while it is likely to be negligible in India where long-term care facilities are very rare.…”

“…Focused efforts should estimate excess deaths from various non‐COVID‐19 causes during 2020–2023 and beyond, for example, from disruption of healthcare services regarding acute cardiovascular disease, 52 chronic diseases such as cancer, 53 reversal in progress on infectious diseases such as malaria 54 or tuberculosis, 55 hunger/starvation, 56 mental health deterioration, 57 drug overdose epidemics 49 and diverse worsening circumstances 58 . The quality of relevant data varies across countries and extrapolations require great caution.…”

Decline in prevalence of tuberculosis following an intensive case-finding campaign and the COVID-19 pandemic in an urban Ugandan community

“…There is potential, however, to restore or even accelerate pre-pandemic declines in TB incidence, prevalence, and mortality, by undertaking interventions to find and treat more people with TB. Intensive case-finding efforts were shown to reduce the community prevalence of TB in certain pre-COVID clinical trials [10,11], and models estimate that case-finding can also overcome adverse effects of the COVID pandemic on TB burden [6,12]. Thus, it is possible that, in the context of ambitious TB case finding, TB prevalence could fall substantially from pre-pandemic levels.…”