Reflections on TB in the Age of Coronavirus

Chest x-ray of a patient with tuberculosis 

showing a lesion in the upper-right lung 

Zephyr / Science Photo Library

 

 

One of the positive aspects of the Covid-19 pandemic is that it has obliged people to consider all things virological, including how tiny parasitic agents evolve and cross from one species to another, infecting and exploiting host cells, etc.

 

One of the negative aspects - and this, ironically, as a consequence of knowing too much thanks to a 24-hour news media that is obsessed with the coronavirus - is that almost the entire world seems to have gone mad and is gripped by fear. 

 

In the past, when people knew much less about viruses and disease in general, they may have been concerned about catching something nasty and falling mortally ill, but there was no mass hysteria and the population didn't isolate themselves indoors, or walk around outside wearing masks and obsessively squirting hand gel.  

 

In 1920, for example, when the average life expectancy for a man in the UK was under fifty and for a woman fifty-four - and when we were only just emerging from the post-War flu pandemic that affected a quarter of the population, killing 228,000 British citizens - infectious diseases were the leading cause of death in young and middle-aged people. 

 

Polio, diptheria, measles, and mumps may now have been largely eradicated in the UK thanks to programmes of immunisation, but they were very serious illnesses a century ago. As was tuberculosis; a bacterial disease that was "by far the biggest and most consistent killer in Western Europe throughout the nineteenth and the first half of the twentieth centuries" [1]. 

 

 

II. 

 

According to David Ellis, in the year that D. H. Lawrence died, 1930, there were 50,000 registered deaths from TB in Great Britain; a figure higher than the present number of deaths associated with Covid-19, but also a figure that showed a significant decline from earlier years thanks to improved living conditions and better palliative care.   

Like the coranvirus, TB "is chiefly spread by droplets of sputum when the infected person coughs in the presence of others, with repeated close contact an important factor" [2]. But citizens in 1930 weren't ordered by their government to socially distance and obey the rule of six. Apparently, they accepted that disease and dying were a normal part of life and, whilst naturally wishing to remain healthy and avoid infection, they understood that risk can never be eliminated entirely.

 

Oh, and before anybody mistakenly says that consumption is old news in the Age of Coronavirus, it's worth remembering that one quarter of the world's population is thought to have a latent infection with TB and that in 2018 there were more than 10 million active cases, resulting in 1.5 million fatalities. 

 

TB thus remains the deadliest of all infectious diseases afflicting mankind and if we in the West don't seem to care about this, it's probably because the majority of the cases are in Asia and Africa (I think we all know that if Covid-19 had politely respected borders and stayed in China it would have received very little media attention).   

 

 

Notes

[1] David Ellis, Death and the Author, (Oxford University Press, 2008), p. 10.

 

[2] Ibid., p. 14.