Tuberculosis has been one of the most damaging infectious diseases of India for several decades. COVID-19  has been the most  feared disease In India for over a year now.

From the beginning of 2020 to March  2021 , a period of about 15 months, about 150 thousand or 1.5 lakh deaths were caused by COVID-19 in India. The normal number of tuberculosis deaths  in 15 months would be 550 thousand (5.5 lakh). This is based on WHO figure of 4.4 lakh TB deaths in a year in India, which while higher than the government estimate is accepted more widely than the government estimate with a more limited base.

In other words, counting from the beginning of 2020 around which time COVID deaths started being recorded in world, the number of COVID 19 deaths has been approximately 330 per day In India while during the same period the number of tuberculosis deaths has been around 1230 per day.

While both are known to be highly infectious diseases, it is not clear why there has been much less fear and much less concern associated with tuberculosis compared to COVID-19.

Here it may be noted that while a significant number of COVID patients do not exhibit very painful symptoms or recover quickly, most of those who suffer from TB disease experience much more painful conditions.

Most victims of TB are in the prime of their productive years, although all age-groups including children are affected.

While the comparison of  fatality rate  involves more complications, nevertheless there is enough evidence that overall there are more chances for fatality rate to be higher for tuberculosis.

In addition we must contend with the fact , as confirmed  by the WHO, that about 40 per cent of the population in India is infected with the TB bacteria ( the vast majority have latent TB rather than the TB disease). People infected with TB bacteria have a 5 to 10 % lifetime risk of falling ill with TB disease.

In addition while so much hope has been reposed in the COVID-19 vaccines, it may be noted that vaccine for TB (BCG ) has existed for almost a hundred years.

While the entire health system has been increasingly devoted to COVID-19 during the last 15 months or so, the treatment of TB,  not known to be particularly good even earlier, has deteriorated compared to earlier times. Continuity in  longer-term treatment of  TB is very important, but during this phase this has been disrupted in the case of a significant number of TB patients. While earlier also there were several problems relating to diagnosis and treatment of TB , during this phase of  around 15 months or so the situation has become  much worse.

It is also important to note that while the death toll of around 1000 TB  patients per day has continued for several years this never attracted front page headlines for long periods ( or even for one day) in newspapers and TV channels , as has happened in the case of COVID-19.

It will be useful to understand the very different responses of the government, the health system , the mass media and other important sections to these two important diseases, tuberculosis and COVID-19.

Bharat Dogra is a journalist and author. His recent books include Protecting Earth For Children and Planet in Peril.


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