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Fact check: Post comparing responses to tuberculosis and COVID-19 pandemics lacks key information

A social media post comparing responses to the novel coronavirus and Tuberculosis (TB) pandemics implies that measures to combat COVID-19, such as lockdowns and face coverings, are examples of scaremongering by the media, as they have not been implemented to combat TB – a disease that kills 1.5 million people each year. But this comparison is misleading and fails to consider why responses to TB have differed around the world.

Reuters Fact Check. REUTERS/Axel Schmidt

The post reads: “10 Million People contracted Tuberculosis last year. 1.5 Million People DIED. Did you even know? Were you scared for your life? Did we wear masks, close the economy, cancel schools, and ruin small businesses? No. Why? Because the media didn’t tell you to be AFRAID!” (here).

The post presents accurate statistics about the prevalence of TB, which stands as the leading infectious cause of death worldwide (here).

However, it does not consider the differences between the transmission and geographical distribution of COVID-19 and TB, and how these differences influence what measures are used to tackle the diseases.

In terms of transmission, tuberculosis is caused by mycobacterium tuberculosis. It most often affects the lungs, and like COVID-19 can spread from person to person through the air (here).

There are two TB related conditions – latent TB infection and TB disease (here). When exposed to TB, a person can either develop TB disease with symptoms such as a cough, fever or weight loss, or become infected but not have any symptoms (latent TB infections). Those with latent TB infections can go on to develop TB disease at a later point.

Dr Tom Wingfield, Senior Clinical Lecturer and Honorary Consultant Physician at Liverpool School of Tropical Medicine, points to this ‘dormant’ form of tuberculosis as a feature that makes it distinct from COVID-19.

“TB infection / disease normally occurs over a long time period and perhaps longer person-to-person exposure, whereas COVID-19 can transmit from short periods of exposure and develops symptoms usually within about five days,” he explained to Reuters via email.

“Indeed, COVID-19 doesn’t have a ‘latent infection’ phase like TB”, he added, with the caveat that TB can sometimes be transmitted from minimal exposure, “so this is not a water-tight rule”.

On top of this, the post on social media does not consider that differences in the geographical distribution of the two diseases influences where preventative measures are enforced.

For instance, it would be unlikely that a widescale lockdown for tuberculosis would be implemented in the United States. In 2019, the country provisionally recorded 8,920 cases of TB, out of 10 million globally (here).

That compares with more 5 million confirmed cases of COVID-19 in the U.S. so far, with more than 168,000 deaths (here).

Furthermore, unlike COVID-19, which threatened to overwhelm healthcare systems if widespread lockdowns were not implemented, there does not seem to be evidence that this would have happened because of TB.

Globally, there are areas of the world where TB remains a threat. In 2018, eight countries including India, China and Indonesia accounted for two thirds of new TB cases (here).

In areas where tuberculosis is prevalent, Wingfield said that measures like mask-wearing and social distancing can be used to help reduce the spread of the disease.

There is also a vaccination that reduces the likelihood of children contracting severe TB symptoms, although it doesn't protect adults (tinyurl.com/y6drzzka).

In some cases, workplaces or schools can be temporarily shut down while dealing with an outbreak, but Wingfield explained that “this is more likely to happen in high-income settings that have the resources to do this as opposed to low-income settings where TB is more prevalent.”

One issue with lockdown measures that are implemented nationally, Wingfield notes, is the concern that they will cause people to lose income and have reduced funds to buy nutritional food.

Undernutrition increases the risk of TB, and according to the World Health Organization (WHO) causes around one quarter of all new TB cases globally (here).

Ultimately though, the post points to a lack of global awareness about TB which Wingfield alleged is due to the majority of TB cases being among poorer people living in low- and middle-income countries.

“Often, such communities have limited agency or advocacy to raise the disease up the national and international policy agenda,” he said.

“If, like COVID-19, TB affected people in such numbers in high-income settings then it is highly likely people would be more aware and, to be frank, more would be done to address it”.

VERDICT

Misleading. Although the post presents accurate statistics about the prevalence of TB, it does not examine the key differences in transmission and geographical distribution between TB and COVID-19.

This article was produced by the Reuters Fact Check team. Read more about our fact-checking work (here).    

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