Safety measures to stop the spread of the coronavirus (COVID-19), put in place by Chinese authorities beginning in January 2020, have threatened the ability of patients with tuberculosis and multidrug-resistant tuberculosis (TB/MDR-TB) in this region to receive and adhere to treatment. Staff and partners of the Control and Prevention of Tuberculosis (CAP-TB) project, funded by the U.S. Agency for International Development (USAID) and implemented by FHI 360, have been working on the front lines to ensure that tuberculosis patients are able to continue their treatment without disruption.
CAP-TB’s emergency response has focused on ensuring uninterrupted treatment access for MDR-TB patients across all its project areas. Access has been particularly in jeopardy in Hubei Province, at the center of the coronavirus emergency, with more than 60,000 reported cases of COVID-19 and entire cities on lockdown.
Patients and close contacts are often quarantined, roads and highway are closed, and public transportation and mail delivery services are suspended. As a result, many patients are unable to travel to their designated hospitals for scheduled TB clinical monitoring visits and drug refills, and they may not be able to access pharmaceuticals through mail delivery.
Local health authorities designated Jin Yin Tan Hospital, an MDR-TB care facility in Wuhan supported by CAP-TB, as an emergency center for coronavirus critical care patients. This has had a major impact on MDR-TB patients from Wuhan and surrounding areas. As local health authorities focused on the battle against the coronavirus, CAP-TB and their facility- and community-based partners have stepped in to:
- Monitor the status of MDR-TB patients, using the MDR-TB Clinical Management Platform designed by FHI 360 to identify and triage patients who are running out of drug supplies
- Help develop and implement simplified emergency hospital workflows to ensure that patients who cannot travel to their designated TB hospital have timely access to locally available ambulatory care
- Collaborate with peer volunteers, using CAP-TB’s 57 Zone social media model to connect with TB patients in the community, provide ongoing psychosocial support and assist with patient care and delivery of anti-TB drugs; CAP-TB supports the peer volunteers to gather information from patients and make appointments with local TB care teams, which then can launch emergency outreach services, such as delivering medications and collecting blood samples
Additionally, CAP-TB facilitated the distribution of emergency drug supplies from two neighboring CAP-TB sites, and FHI 360’s headquarters and Asia-Pacific Regional Office arranged shipments of n95 and surgical masks, which went to support the work of peer volunteers and health care providers at TB hospitals affected by the outbreak. Since the pandemic began, masks have become almost impossible to source inside China. Ms. Jia, the head nurse of the MDR-TB ward at Jin Yin Tan Hospital, explained that the donation “means a lot more than just a few masks.”
With the technical support of CAP-TB and supported by 57 Zone peer volunteers, the Hubei Center for Disease Control and Prevention (CDC) has mobilized locally accessible resources. Since the lockdown began, peer volunteers like Guo Guo — an MDR-TB survivor based in Jing Men City — have been working overtime to facilitate peer support groups, transmit information to doctors and coordinate between the local CDCs and TB hospitals.
This support has been critical to ensure smooth transportation and timely delivery of drugs from the hospitals to the patients and to relieve some of the burden on overworked health care providers. “I really hated myself when I had to send the list of more priority MDR-TB patients to the doctors,” Guo Guo said. “They have been overwhelmed by caring for coronavirus patients. … A little more I do, a bit more detailed and considerate I can be, the more time the doctors can spare for themselves and coronavirus patients.”
With the COVID-19 pandemic continuing worldwide, CAP-TB and FHI 360 staff will continue serving their patient communities while working under extraordinarily difficult circumstances.
