After COVID-19, more tuberculosis cases will surface in Nunavut: expert

‘There are going to be more cases of TB,’ says Dr. Gonzalo Alvarez

This is a close-up of the bacteria that causes tuberculosis, a disease that affects Nunavut residents at a much higher rate than other Canadians. (Photo courtesy of the Centers for Disease Control/Dr. George Kubic)

By Jane George

Updated Thursday, March 25 at 11:15 a.m.

Nunavut is likely to face a wave of new tuberculosis cases after COVID-19 is brought under control with vaccinations, says an Ottawa researcher.

Dr. Gonzalo Alvarez is a tuberculosis researcher and respirologist at Ottawa Hospital. He led Nunavut’s former TAIMA TB (End TB) campaign, from 2012 to 2015.

TAIMA TB was designed to get more Nunavummiut tested and treated for the infectious disease, which occurs at a rate roughly 50 times higher in Nunavut than in the rest of Canada.

In 2020, 16 Nunavut communities had cases of either active or latent TB, the Health Department said. It said that the numbers of cases are not yet available.

Alvarez said international studies which looked at 84 countries have found TB services have been diminished by COVID-19. As a result, about 21 per cent fewer people received TB care around the world.

“If you’re in a pandemic and you feel sick, maybe you’re not going to a clinic. With a communicable disease like TB that’s terrible,” he said.

“People will stay home and get sicker, and because of TB’s similar transmittable capacity as COVID-19, there are going to be more cases of TB.”

In 2018, the federal government committed $27.5 million over five years to eliminating the disease in Inuit Nunangat by 2030.

The COVID-19 pandemic has caused setbacks in that work. In Nunavut, it’s led to the cancellation of meetings and trainings on mitigating the disease.

In October, then-health minister George Hickes said community-wide screening clinics, such as what took place in 2019 in three communities: Qikiqtarjuaq, Whale Cove and Kinngait, were no longer happening.

Health Department spokesperson Chris Puglia told Nunatsiaq News this week that some TB projects and programs have been put on hold, but “essential” TB services have continued.

TB screening, surveillance and treatment has been continued to maintain status quo with modifications,” he stated in an email.

Clinic access and program delivery has been “modified to observe pandemic restrictions especially in communities impacted by COVID-19,” said Puglia.

Alvarez said he isn’t surprised that Arviat saw an outbreak of COVID-19.

Just last year, Arviat childcare centre staff and children were exposed to TB in the community.

The same vulnerabilities for TB, such as poor health determinants, food insecurity, overcrowded housing, poor nutrition and smoking, “are paralleled with what we’re seeing with COVID-19,” he said.

In a seven-year research study, Alvarez looked at those vulnerabilities in Iqaluit.

“The transmission of TB in Iqaluit was deeper and more than we could have expected, and if you parallel that, it speaks to the vulnerability of communities in Nunavut to COVID-19.”

The Health Department said the social determinants of health continue to be “the biggest barrier to combatting TB in the territory.”

These will “continue to be present post COVID-19,” the Health Department said.

Alvarez would like to see more attention put to developing a vaccine for TB that works for adults.

Presently, the Bacille Calmette-Guérin vaccine, which is administered at one month of age to all Nunavut babies, is ineffective for adults.

Alvarez said the priority given to developing and rolling out vaccines for COVID-19 in one year amazes him. “If we can we do it for COVID, why can’t we turn our attention to TB?”

Correction: A previous version of this article contained inaccurate information. The Nunavut Health Department continues to provide screening, testing and surveillance for tuberculosis in all communities, with modifications required for safety during the pandemic. 

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(3) Comments:

  1. Posted by Ian on

    Go away, and all the other normal things that kill us here,isn’t NTI looking after this one .

    • Posted by Donald on

      I didn’t know NTI has taken over the responsibilities of the Governments, health departments.
      Does this mean NTI will receive the hundreds/thousands of million annually that the GN gets?
      Better question is; what is the GN doing about this?

  2. Posted by Iqaluit Mom on

    While I acknowledge Dr. Alvarez’ expertise, has any consideration been given to the increased sanitation/hygiene practices that have been put in place due to the pandemic? It would be interesting to see if this factors at all into transmission. The previous study had shown that lack of housing was a big contributor to TB spread.

    While Nunavut has managed to remain mostly Covid free, the comment that people are staying home and getting sicker has no scientific basis. The poor housing conditions were present before Covid and will likely remain after. The international studies looking at TB spread and monitoring during Covid may not apply given that Nunavut has managed to keep Covid under control. Dr. Alvarez could have phrased this better, as it is very close to fear mongering in an time where fear about illness is more rampant than ever before.

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