New Delhi: Omicron driven  pandemic has impacted other health services in the country of which tuberculosis (TB) is the most significant.With similar clinical symptoms, TB and Covid-19 present a deadly mix for India’s health system. 

TB, though curable, remains India’s severest health crisis  which kills an estimated 4,80,000 Indians every year and around 1,400 every day with delays in diagnosis, treatment, access and possibly increased suffering, mental health issues for those affected, said Dr Naresh Purohit, Advisor for National Tuberculosis Elimination Programme.

 Not only has the ongoing pandemic affected testing and tracking of TB patients, even routine vaccinations against TB have been disrupted, said the noted Infectious Disease Epidemiologist Dr Purohit.

He said that TB is  India’s largest infectious disease problem.Twenty seven per cent of the world’s TB burden is in India.

According to recent WHO report titled "Global Tuberculosis Report 2021’, India accounted for 41 per cent of the global dip in reporting TB cases during the Covid pandemic. 

“The countries that contributed most to the global drop between 2019 and 2020 were India (41 per cent), Indonesia (14 per cent), the Philippines (12 per cent) and China (8 per cent); these and 12 other countries accounted for 93 per cent of the total global drop of 1.3 million."   said the report.

The report further said for India, the TB case fatality ratio (estimated mortality/estimated incidence) went up to 20 per cent in 2020 from 17 per cent in 2019.

 Principal Investigator for National Integrated Disease Surveillance Programme Dr Purohit averred that COVID-19 has affected the TB control effort in a devastating way that needs to be addressed and its effect may last for years to come.

Over the past 18 months, the COVID-19 pandemic has disrupted health services not only in the country but globally and has negatively impacted on gains being made in global TB control efforts to achieve elimination of TB targets.

Renowned Disaster Respiratory Health Expert Dr Purohit stated that the drug- sensitive and drug-resistant tuberculosis patients are unable to access medicines during the omicron pandemic putting the treatment in jeopardy and likely increasing in transmission. 

He added, there have been reports of nonavailability of drugs in both the public and private sectors. Also, access to new drugs such as Bedaquiline and Delamanid is bound to reduce during this time leading to increased challenges for the treatment of multi-drug- resistant TB.

He said that the worst affected are drug-resistant TB patients who are on regimens containing injections that have to be administered by health workers who are either unavailable or not easy to reach due to staff shortage caused by omicron crisis. 

He stated that persistently high TB mortality can be reduced by earlier diagnosis and treatment. For as many as 3 million estimated TB cases all over the world there is no notification, 3 million victims of TB are suffering without receiving professional care, and this raises serious concern about optimal clinical and public health management. This is mainly attributed to incomplete compliance of private providers in some countries, while economic barriers to primary care access might determine underdiagnosed TB in low-income countries.

He urged the need for a robust integrated effort from policy makers, from state and national government and from non-governmental organizations to reduce the burden of TB by urgently maintaining continuity of essential services, accelerating surveillance of vulnerable populations and asymptomatic contacts to identify high-risk groups and performing high-quality molecular epidemiologic research.