Tuberculosis patients with no food and medicines one of the biggest casualties of lockdown and pandemic

A son sold the dry straw of the thatched roof of their house in a village in Banda so that his father, suffering from tuberculosis (TB), could get treatment, but lost the battle as his father died of the dreaded disease in Attara block of Banda district of Bundelkhand recently.

A patient with symptoms of COVID-19 was brought to Ram Manohar Lohia Hospital in Lucknow last week. He was a TB patient with badly damaged lungs. He died within 24 hours of his admission in hospital.

These are not solitary cases. TB has started taking its toll during lockdown and unlock periods across the country with TB and HIV patients becoming the prime target.

Manohar and Rajkumar, two TB patients who died on Sunday, belonged to Kuchbandiyas caste – untouchables – who lived in Kherwa village in Banda. The villagers detest interacting with the Kuchbandiyas even in normal circumstance; the fear of COVID-19 has further excluded this community from the rest of the society.

Ramesh, son of Raj Kumar, said that they did not have anything to eat. “My father was eating food once a day. He was suffering from TB. I sold the straw of our thatched roof so that I could get medicine for my father, but this did not help,” he said.

Local NGO Vidya Dham Samiti (VDS) had even lodged a complaint with CM’s Jan Sunvai portal demanding food grain for the dalits of the village. But nothing happened.

“Today morning my father died,” Ramesh said.

TB patient need nutritious food but during the lockdown, the supply chain snapped and the volunteers working with the TB patients did not information about the health of the patients.

“Go to any village of Bundelkhand and you will find TB patients. They are dying because one, they are not getting food and two, they are missing out on the medicines they are supposed to take regularly,” said Raja Bhaiya of VDS. “Doctors are talking about COVID-19 but what about TB patients? Almost every day, 4-5 people are dying of TB in villages,” he said.

Incidentally, the government does not have records of how many people have died of TB from March 25 onwards. “We are compiling the numbers,” a senior official said, requesting anonymity.

Dr Surya Kant Tripathi, head of the Department of Respiratory Medicine at King George’s Medical University, said that any person with compromised lungs is vulnerable to COVID-19. People having TB need to take more precautions during this period.

Dr Tripathi said that the TB was the leading killer and an estimated 4.35 lakh people died every year because of this disease. “So on an average, over 1,000 people die every day of TB,” he said.

Incidentally, the government pays Rs 500 as sustenance allowance to TB patients, but officials have no information as to in how many cases this has stopped.

Exports believe that during lockdown, the number of COVID-19 cases must have gone up because the TB patients are living with their family and this increases chances of them getting infected with the disease.

Over 28 million cases of tuberculosis were live pre-COVID-19 across India.

Dr Gargi Maitra, Associate Consultant, Pulmonology, Fortis Memorial Research Institute, Gurugram says that non-adherence and poor compliance to tuberculosis treatment are in fact two major obstacles in preventing the spread of this infection and its cure. Poor adherence to treatment not only causes medical complications for the patients in the form of disease relapse, treatment failure and emergence of drug resistant tuberculosis, but also exposes the surrounding community to risk of various medical, psychological and economic challenges which further become hurdles in the path of tuberculosis management.

In India, once a patient is diagnosed with TB, they are notified as being part of India’s National Tuberculosis Elimination Program. Protocol mandates that community health workers follow up on notified patients, making sure that they consume their medicines and show up for scheduled appointments at the tuberculosis unit for health check-ups and to collect medicines.

But the lockdown has resulted in a significant disruption of this system: patients have been unable to travel to the clinics for their appointments.

“We have asked the TB health workers not to compromise and test any person for both TB and COVID-19. The primary symptoms of both the diseases are the same. In TB the cough is accompanied with sputum while in case of COVID-19, it is dry cough. Otherwise, both kind of patients have fever. In case of COVID-19, the infected person will develop pain in the body which he cannot conceal,” Dr Suryakant said.