It is hard to know what to make of calls to South Africans to stop using public transport, mostly minibus taxis, because airline passengers are getting sick and spreading a new virus around the world.
I don’t know that the Covid-19 alarmists are wrong that the coronavirus will start spreading like wildfire in South Africa soon. But I do know that TB will take some beating as the number one danger facing the hundreds of thousands of South Africans who use public transport every day.
There is no doubt that the country’s un-serviced and often slum-like informal settlements and jam-packed townships are frequently incubators for disease. We know and acknowledge, too, the high burden of HIV/Aids, and other immune-supressing conditions. It seems likely, although we don’t yet know for sure, that these conditions will add significantly to difficulty containing any Covid-19 outbreaks. What we do know for sure is that these are the conditions in which TB thrives. We know it because it is happening all around us.
That is not to say we should not do everything in our power to prevent the struggling masses (as well as the rest of us) from facing an additional health threat. It does, however, beg the question about the lack of alarm about tuberculosis, a far greater, older, ever-present and totally treatable disease, which is, at current rates, hundreds of times more likely to be contracted by taxi passengers in South Africa.
As always, context is helpful. And here is some from Professor Harry Hausler, Cape Town-based family physician, HIV clinician and public health specialist:
“Of the world’s population (7.7 billion), about 1.8 billion (23%) is infected with TB, of whom about 180 million will get sick with TB during their lifetime.
Of those who are sick with TB (10 million), an estimated 1.4 million (14%) die of TB every year despite effective treatment being available.
The latest Covid-19 stats (14 March 2020: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200314-sitrep-54-covid-19.pdf?sfvrsn=dcd46351_2) show 142,539 people infected, of whom 5,393 (3.8%) have died. “
Professor Hausler, who has 28 years’ experience in implementing and evaluating interventions to fight infectious diseases and improve health, wellness and happiness, adds: “It would be a terrible shame if the global attention on this new flu was not somehow leveraged to strengthen infection prevention and control measures, household TB contact-tracing, rapid diagnosis/linkage to care/ treatment and TB preventive therapy.
“Our global health impact would be so much greater by preventing and treating TB than by diagnosing and quarantining Covid-19!”
And therein lies the rub. We are no Covid-19 deniers here at Call Off The Search but, as always, we seek a little extra calm, context and compassion.
Here in Cape Town, treatable communicable diseases stalk the communities around us all the time. When they ask for help they are not worried about the stock market, house prices or their pension savings. They want to keep their children alive. Let’s widen the circle of concern about this disease.
Please take 5 minutes to complete this survey about Covid-19/coronavirus in South Africa. This survey is being run by All-Told, which compiles the respected annual Brand Atlas report about SA. All-Told wants to track how the virus is impacting lives in towns and the countryside, suburbs and settlements. If you complete the survey you will be sent free links to the findings. Click Here
Read Whither Covid-19? An interview with SA’s chief virus hunter, by Mark Heywood