While data are preliminary, Wolf says the rate of tuberculosis increased in Saskatchewan for the first time in years in 2020,
Isa Wolf’s job was easier when she had one infectious disease to worry about.
The manager of Saskatchewan’s Tuberculosis (TB) Prevention and Control Program says the COVID-19 pandemic may have made the stubborn sickness even trickier to find and diagnose.
While data are preliminary, Wolf said the rate of tuberculosis in the province increased to roughly 100 in 2020, from 64 in 2019 — the first increase in years.
“In Saskatchewan right now, we have anecdotal evidence that COVID-19 is impacting our gains on tuberculosis prevention, but we don’t have anything measurable quite yet,” she said.
While some in Canada may think tuberculosis is a thing of the past, it persists in places where socioeconomic factors like poverty and crowded housing help it spread and where it may evade detection because of stigma and limited access to health care.
Indigenous Services Canada’s regional medical health officer, Dr. Ibrahim Khan, said there is a long history of TB disproportionately affecting Indigenous people. In the 1950s and ’60s, many Indigenous TB patients were forcibly confined to sanatoriums, a historical trauma that continues.
“Historically, TB has been always the disease of poor people, wherever there are health inequities,” Khan said. “And in Saskatchewan First Nations, unfortunately, that has been the case.”
TB usually first affects the lungs, where its symptoms might be confused with a flu or cold — cough, malaise and sweating at night.
“Some people have noted that tuberculosis is the great mimicker. It can mimic other conditions,” Wolf said.
Tuberculosis can be prevented and cured, and the sooner the better, Khan and Wolf said. If it spreads from the lungs to other parts of the body, it can take longer to cure and leave lasting impairment. Northern First Nations are disproportionately affected, but TB is not limited to any ethnicity or geography, Khan said.
Khan said ISC staff saw some of the “most advanced” cases of TB in 2020. In a normal year, ISC hires between 60 and 70 workers to provide TB treatment across the province. In 2020, much of that work was diverted to testing, tracing and containment of COVID-19. He said the uptick in TB cases is alarming because access to testing was likely impeded by the pandemic.
“We still don’t know the true impact of the pandemic on these communicable diseases,” Khan said, noting similar worrying trends have been spotted in HIV, hepatitis C and syphilis — all of which, like TB, disproportionately affect people in poverty.