'Don't forget tuberculosis patients during coronavirus pandemic'

A group of India’s leading doctors and experts has written to the National Tuberculosis Elimination Programme (NTEP), requesting them to issue India specific guidance on tuberculosis (TB) and related challenges with the rising Covid-19 crisis in India.

The letter requests the NTEP to issue guidance for medical personnel and communities to ensure that essential services and operations for TB remain unaffected and patients, their families and health workers remain protected.

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The letter also urges the NTEP for detailed guidelines on avoiding stock outs, addressing needs of public and private sector patients among others and recommendations for doctors, health workers and communities on clinical practice and good public health actions, specific to the Indian context.

This, they stress, will help deal with not just TB but also TB & Covid-19 cases together. “In our focus on the Covid-19 pandemic let’s not lose sight of the fact that tuberculosis kills 1,000 Indians every day, a far higher number than the coronavirus will,” says Zarir F. Udwadia, one of India’s leading pulmonologists and a signatory to the letter.

The other key areas, wherein guidelines are requested, include people-centred delivery of TB diagnosis, treatment and care services in tandem with the Covid-19 response, prevention during treatment, so the primary caregivers and patients can stay safe, stigma reduction and economic and mental health support.

Another key area is advance planning for future procurement and supply of medicines and equipment to ensure continuity of services.

Recognizing the possibility of Covid-19 impacting TB patients, the experts have also asked the NTEP to issue guidelines on simultaneous testing for TB and Covid-19, and vice versa, since the symptoms for both diseases seem to be very similar.

The letter has also requested guidelines be made for survivors/patients who have lung damage already, both, precautionary and remedial, should they get infected.

“Building up local community based cadres to give support to TB patients nearer their homes would have served us well in this epidemic. It's never too late to start,” says Nerges Mistry, a leading expert, Foundation of Medical Research director, and a signatory to the letter.

The letter also urges the programme to issue guidelines for people living with comorbidities such as HIV and previously existing mental health issues, to help cope with the Covid-19 crisis more comprehensively.

“We need a renewed evidence based strategic push on TB services while factoring Covid-19 into this response otherwise we will lose the gains made in TB,” says Chapal Mehra, convener, Survivors Against Tuberculosis (SATB).

The group has offered their support to the NTEP towards the process of formulating these guidelines..