7 ms·

The Long Road to End Tuberculosis

108 points by tintinnabula 2y ago

sampo 2y ago
> TB remains the deadliest infectious disease on Earth, killing about 1.2 million people every year. I would guess, in 2024 Covid killed more than 1.2 million people. I guess many people are assuming that Covid was a temporary disturbance, and will attenuate in the coming years. But what if it doesn't but will keep at about the current levels from year to year for a long time.
- mauricioc 2y ago
  The WHO [0] reports 60 thousand Covid deaths this year so far, and around 250 thousand deaths in 2023. [0] https://data.who.int/dashboards/covid19/deaths https://data.who.int/dashboards/covid19/deaths
  - sampo 2y ago
    US CDC has about 40k deaths for 2024 so far [1] for United States, and 76k for the year 2023 [2]. Maybe the WHO dashboard is left unmaintained, or maybe many countries have stopped reporting Covid deaths to WHO. [1] https://covid.cdc.gov/covid-data-tracker/#trends_totaldeaths_select_00 https://covid.cdc.gov/covid-data-tracker/#trends_totaldeaths... [2] https://jamanetwork.com/journals/jama/article-abstract/2823584 https://jamanetwork.com/journals/jama/article-abstract/28235...
    - dgfitz 2y ago
      Or it’s accurate.
      - tightbookkeeper 2y ago
        How is the cause of death determined for 250k people? EDIT: I got curious and looked up the CDC guidelines https://www.cdc.gov/nchs/data/nvss/vsrg/vsrg03-508.pdf https://www.cdc.gov/nchs/data/nvss/vsrg/vsrg03-508.pdf > based on sound medical judgment drawn from clinical training and experience, as well as knowledge of current disease states and local trends > the disease or injury which initiated the train of morbid events leading directly to death It goes on to suggest that if Covid was present they strongly recommend including it. And even if you did not diagnose Covid it can be a good assumption to make.
        robertlagrant 2y ago
        There were upper and lower bound stats that accounted for many discrepancies. The high numbers were "death with covid", which means the covid might not've done it, and the low numbers were "death by covid" where we were (fairly) sure Covid did it due to lack of other factors, but missed things where Covid tipped someone over the edge.
        tightbookkeeper 2y ago
        That sounds right. Based on my reading the CDC numbers are basically death with Covid test or symptoms, with the exception of an obvious distinct cause. Which honestly I can’t think of a better way for mass data collection.
- thenerdhead 2y ago
  This isn’t even considering the latest being found about Covid either for long term illness/disability, virus on tumors making certain cancers grow faster, and sudden stroke/cardiac events. We are heavily undercounting until we can definitively link it. That requires families to consent to an autopsy and for biomarkers to be finalized and used to confirm. Researchers are pretty close to that nowadays though with micro clots, viral rna persistence assays, and even pathology studies which are all showing results this year and will be for years to come.
- Yeul 2y ago
  The difference is that TB kills young people. Old people have to die from something it's irrelevant what eventually knocks them out. But with TB it was laying waste to people who were supposed to be in their prime. That's why it was so insidious.
  - giraffe_lady 2y ago
    Covid turns young people into disabled people. Then we can say "well they had preexisting conditions, it's irrelevant what eventually knocks them out."
    - tightbookkeeper 2y ago
      Based on the percentage of young people who got Covid (very high) and were disabled (very few), this doesn’t seem significant.
      - aredox 2y ago
        The difference with TB being that COVID infects 95% of the population several times per year, turning those low relative rates into higher and higher absolute numbers... "Death by a thousand cuts"
        tightbookkeeper 2y ago
        Can you estimate those absolute numbers for us?
        giraffe_lady 2y ago
        Can you? You were the first to bring in a concrete claim about them, that they are "very small."
        tightbookkeeper 2y ago
        I’m not the one claiming Covid is as impactful or dangerous as TB, a very unusual claim. Please make your case.
- ywvcbk 2y ago
  > I would guess, in 2024 Covid killed more than 1.2 million people Why? Seems extremely speculative.
- tzs 2y ago
  COVID-19 appears to act similarly to the other coronaviruses that are endemic in humans. There are two key properties. 1. You don't develop an immunity to infection by them, but you do become less likely to be made severely ill from subsequent infections. 2. The severity of illness from the first infection is generally less if you are very young. With the others it is thought that they probably did cause deadly pandemics when they first crossed over to humans, but did not cause much harm to babies or very young children, and so by the next generation they were no longer a big deal. Nowadays we don't even bother to have a name for infection by them. We just lump them in with around 200 other viruses and call what happens when we get sickened by any of them a "common cold". Pretty much everybody alive now was exposed to those viruses as a baby, got mildly ill and got that first infection out of the way, and then it is just a routine common cold to them when they get older. I don't think it is yet known if COVID-19 will fully follow that path of those others. It still does cause severe illness far more often than the common cold viruses even in people who have been infected multiple times. We probably won't know for sure until we see what happens over several years with people who were very young during the pandemic or were born after it. For people older than that is is probably going to be something that is more like a severe flu, where we'll have a vaccine each year for the strains expected to be most common that year, and while the vaccine won't stop you from getting sick it will greatly increase you chances of not getting severely sick. We are already seeing that. COVID-19 fell from the 4th highest cause of death in the US in 2022 to the 10th highest in 2023, with 76000 deaths. Compare to 246000 deaths in 2022 and 462000 in 2021.
sharpshadow 2y ago
It’s relieving that at least other branches of vaccine development are not under the information regime as with COVID. “However, environmental bacteria complicate the picture. If present before vaccination, memory immune cells primed to destroy the environmental relatives might cross-react with and neutralize the BCG strain before it has a chance to set up an immune response against itself and M. tuberculosis.” Nobody cared if one already had covid before administering the vaccine and since the vaccine came late many have had a previous infection already. The new mRNA vaccine utilities the body to produce the actual pathogen and with already existing immunity from a previous infection one’s immune system starts to attack the mRNA modified cells and pathogen product.
- thenerdhead 2y ago
  Previous COVID infection enhances immunity, creating what we call hybrid immunity. This happens because current vaccines mainly target the spike protein, while natural infection exposes the immune system to other parts of the virus. New vaccines in development aim to include multiple proteins and improved delivery methods, which could lead to longer-lasting immunity. For now, hybrid immunity (infection plus vaccination) offers broader protection, while vaccines safely boost antibody levels without the risks of infection.
  - sharpshadow 2y ago
    An infection exposes the immune system to the whole virus while the mRNA vaccine triggers the synthesis of the viral spike protein which would be a specific part of the virus. It can be called hybrid since it is a combination of a original and novel technique but the underlying immune system still deals with the invaders the same way and creates immunity against them. Naturally an infection would be temporary but with the mRNA technique it's a constant stream of spikes which the immune system attacks to the source. One of the issues here are the byproducts from the immune activity, especially dangerous if the mRNA dosen't stay around the injection area. Hybrid immunity without looking at the cons is not the full picture and seeing some counterpoints about vaccines was refreshing.
    - 2y ago
ch1kkenm4ss4 2y ago
[flagged]
amluto 2y ago
A mystery not mentioned in the article: why is TB so unusual in places like the US? The US does almost nothing to control TB. We don’t vaccinate. We don’t routinely test (except in special cases, but those cover very little of the population). We don’t treat latent cases unless they somehow get noticed. And yet the incidence of symptomatic TB is low, and there’s no sign of TB developing resistance to whatever the US is accidentally doing right.
- alexey-salmin 2y ago
  Less public transport perhaps? I remember studies showing strong correlation even though causation can be questionable (less protected member of society in the first place). And anecdotally the only person I know with TB never had known cases neither at home nor at work, which basically leaves the public transportation (which he was using 2-4 times a day at the time) as the most likely source. Another idea could be "better climate" but it's not obvious when I look on the world map of TB incidence.
  - deleted 2y ago
    [deleted]
- noodlesUK 2y ago
  TB is almost the archetypal disease of poverty. Living on top of each other, especially in childhood & adolescence, combined with other environmental and health factors explains almost all of it. If you’re malnourished and your immune system is in bad shape, you’re at risk. If you have HIV, you’re at risk and so on.
  - dyauspitr 2y ago
    That’s still not an explanation. Kids in the US spend a lot of time with other kids at daycare and school. It’s a transmittable bacterial disease. Why aren’t people in the US getting it more? Are you saying you have to be mal/undernourished to get it?
    - 2y ago
senadir 2y ago
This lecture from John Green is a great full summary on the history of TB https://www.youtube.com/watch?v=7D-gxaie6UI https://www.youtube.com/watch?v=7D-gxaie6UI He's also publishing a book about it https://www.penguinrandomhouse.com/books/312472/everything-is-tuberculosis-by-john-green/ https://www.penguinrandomhouse.com/books/312472/everything-i... Recently, John Green lobbied to get certain pharma companies to lower the price of tests and vaccines https://www.scientificamerican.com/article/how-advocates-pushed-big-pharma-to-cut-tuberculosis-drug-prices/ https://www.scientificamerican.com/article/how-advocates-pus... Tuberculosis is not a medical problem, it's an inequality and access problem. Tuberculosis is fully solved in advanced countries yet less developed countries still suffer from it. Pakistan has 260 death per 100k capita, the US has 2.6. The highest 5 countries have at least 600 per 100k capita.
BWStearns 2y ago
Oh hey, I had TB. It sucked. I had to be proper quarantined for 3 months, felt like shit for a whole year and a half, and nearly died because I didn't realize I had any symptoms. I thought I was just tired and depressed all the time because I hated my job, and then one day I collapsed from what I thought was a heart attack. I was/am otherwise healthy and must have just drawn the short straw (or it was a very long dwelling infection from a trip abroad years earlier). I really wish we vaccinated for it like Europe. I'd have taken the little scar on my arm for reducing the already small chance of dealing with that shit.
- kylehotchkiss 2y ago
  BCG doesn't really do much beyond childhood, and even then, just reduces the impact of the disease if you do get it.
  - arthur2e5 2y ago
    There's some work in looking at alternative ways of administering the BCG vaccine (iv injection, inhalation). The IV numbers are pretty promising -- if the monkey numbers hold. I hope that someone, somewhere pushes it into human trials soon. There's also the nebulous but very nice-sounding "non-specific effect" with it. Who knows.
    - kylehotchkiss 2y ago
      Interesting, it was my understanding that you don’t actually gain immunity to TB after an infection (as the treatment itself eliminates the bacteria; not your body, mycobacteria stay alive within microphages) so curious what about alternative injection approaches works
  - BWStearns 2y ago
    I would have accepted reduced impact.
    - kylehotchkiss 2y ago
kylehotchkiss 2y ago
I almost lost a former partner to this disease. Totally changed my life. One of my first projects at my development consulting job was a site build for an org working on vaccine candidates, which a decade later, unfortunately haven't crossed the finish line. So with a fairly personal connection with the disease, and the nonzero chance I could one day develop it myself, I have a personal interest in seeing progress in the space. I saw an IAVI update the other day stating TB research is currently only funded to the tune of 1 billion a year when they need 6. 10.5 million infections a year reported. Remember the countries where the disease have the biggest impact have limited diagnostic abilities outside of cities and politically, these countries are very quick to pretend the problem is solved when the reality is that TB started speeding up again in the covid days because the care programs for patients then was put on pause. If you wanna change the world and aren't just out for VC cash, go design a mobile X-Ray unit to take into villages, work on an AI model to diagnose from imagery, and work on figuring out how to speed up the testing because a MGIT machine needing power 24/7 is not the type of equipment you can always get in the places the disease impacts. Figure out how to get those little mycobacteria suckers to divide quicker in agar (my limited biology education tells me mess up the mycoic acid synthesis without killing it?) and then get people a positive result in 3 days instead of 3 weeks. Remember: the very good blood test (quantiferon gold) is banned in the largest country in the world because it comes back positive for the 1/3 of the population latently infected.
- selimthegrim 2y ago
  So this New Yorker article is wrong? https://www.newyorker.com/news/news-desk/how-banning-a-tb-test-will-save-lives-in-india https://www.newyorker.com/news/news-desk/how-banning-a-tb-te...
  - kylehotchkiss 2y ago
    IMO the mistake was using the test in isolation without considering other criteria. Let’s say you have somebody in a village who travels to visit a clinic. Chest xray positive so sputum samples taken. They don’t convert for 3 weeks, but contact is lost with patient. Maybe in this scenario the blood test adds the additional factor needed to start treatment sooner. There’s a lot of other diseases there a blood test can diagnose immediately, and I don’t blame health workers for the confusion, quantiferon is a unique test, but a countrywide education campaign could have worked to keep it as part of the diagnostic tools.
jmspring 2y ago
Elections have consequences, I just hope the incoming administration isn't actually going to roll things back on vaccines, etc. Otherwise, we may end up with upticks of diseases previously mostly eradicated (at least here in the US).
- dopylitty 2y ago
  I wouldn’t be surprised if states like Idaho and Florida that don’t have functioning public health departments start having TB outbreaks to go with their measles outbreaks once the CDC is decimated and can’t provide a backstop anymore.
- deleted 2y ago
  [deleted]
- SoftTalker 2y ago
  I see no evidence that Trump is anti-vaccine. He promoted the development and apporval of the first COVID vaccines. He called them "wonderful" or whatever similar words he likes to use.
  - jmspring 2y ago
    If he appoints RFK jr as head of anything health - he is antivax. Maybe he doesn’t get appointed.
deleted 2y ago
[deleted]
CatWChainsaw 2y ago
It would help if greed would stop being an obstacle.

108 points by tintinnabula 2y ago

> TB remains the deadliest infectious disease on Earth, killing about 1.2 million people every year. I would guess, in 2024 Covid killed more than 1.2 million people. I guess many people are assuming that Covid was a temporary disturbance, and will attenuate in the coming years. But what if it doesn't but will keep at about the current levels from year to year for a long time.

mauricioc 2y ago
The WHO [0] reports 60 thousand Covid deaths this year so far, and around 250 thousand deaths in 2023. [0] https://data.who.int/dashboards/covid19/deaths https://data.who.int/dashboards/covid19/deaths
- sampo 2y ago
  US CDC has about 40k deaths for 2024 so far [1] for United States, and 76k for the year 2023 [2]. Maybe the WHO dashboard is left unmaintained, or maybe many countries have stopped reporting Covid deaths to WHO. [1] https://covid.cdc.gov/covid-data-tracker/#trends_totaldeaths_select_00 https://covid.cdc.gov/covid-data-tracker/#trends_totaldeaths... [2] https://jamanetwork.com/journals/jama/article-abstract/2823584 https://jamanetwork.com/journals/jama/article-abstract/28235...
  - dgfitz 2y ago
    Or it’s accurate.
    - tightbookkeeper 2y ago
      How is the cause of death determined for 250k people? EDIT: I got curious and looked up the CDC guidelines https://www.cdc.gov/nchs/data/nvss/vsrg/vsrg03-508.pdf https://www.cdc.gov/nchs/data/nvss/vsrg/vsrg03-508.pdf > based on sound medical judgment drawn from clinical training and experience, as well as knowledge of current disease states and local trends > the disease or injury which initiated the train of morbid events leading directly to death It goes on to suggest that if Covid was present they strongly recommend including it. And even if you did not diagnose Covid it can be a good assumption to make.
      - robertlagrant 2y ago
        There were upper and lower bound stats that accounted for many discrepancies. The high numbers were "death with covid", which means the covid might not've done it, and the low numbers were "death by covid" where we were (fairly) sure Covid did it due to lack of other factors, but missed things where Covid tipped someone over the edge.
        tightbookkeeper 2y ago
        That sounds right. Based on my reading the CDC numbers are basically death with Covid test or symptoms, with the exception of an obvious distinct cause. Which honestly I can’t think of a better way for mass data collection.
thenerdhead 2y ago
This isn’t even considering the latest being found about Covid either for long term illness/disability, virus on tumors making certain cancers grow faster, and sudden stroke/cardiac events. We are heavily undercounting until we can definitively link it. That requires families to consent to an autopsy and for biomarkers to be finalized and used to confirm. Researchers are pretty close to that nowadays though with micro clots, viral rna persistence assays, and even pathology studies which are all showing results this year and will be for years to come.
Yeul 2y ago
The difference is that TB kills young people. Old people have to die from something it's irrelevant what eventually knocks them out. But with TB it was laying waste to people who were supposed to be in their prime. That's why it was so insidious.
- giraffe_lady 2y ago
  Covid turns young people into disabled people. Then we can say "well they had preexisting conditions, it's irrelevant what eventually knocks them out."
  - tightbookkeeper 2y ago
    Based on the percentage of young people who got Covid (very high) and were disabled (very few), this doesn’t seem significant.
    - aredox 2y ago
      The difference with TB being that COVID infects 95% of the population several times per year, turning those low relative rates into higher and higher absolute numbers... "Death by a thousand cuts"
      - tightbookkeeper 2y ago
        Can you estimate those absolute numbers for us?
        giraffe_lady 2y ago
        Can you? You were the first to bring in a concrete claim about them, that they are "very small."
        tightbookkeeper 2y ago
        I’m not the one claiming Covid is as impactful or dangerous as TB, a very unusual claim. Please make your case.
ywvcbk 2y ago
> I would guess, in 2024 Covid killed more than 1.2 million people Why? Seems extremely speculative.
tzs 2y ago
COVID-19 appears to act similarly to the other coronaviruses that are endemic in humans. There are two key properties. 1. You don't develop an immunity to infection by them, but you do become less likely to be made severely ill from subsequent infections. 2. The severity of illness from the first infection is generally less if you are very young. With the others it is thought that they probably did cause deadly pandemics when they first crossed over to humans, but did not cause much harm to babies or very young children, and so by the next generation they were no longer a big deal. Nowadays we don't even bother to have a name for infection by them. We just lump them in with around 200 other viruses and call what happens when we get sickened by any of them a "common cold". Pretty much everybody alive now was exposed to those viruses as a baby, got mildly ill and got that first infection out of the way, and then it is just a routine common cold to them when they get older. I don't think it is yet known if COVID-19 will fully follow that path of those others. It still does cause severe illness far more often than the common cold viruses even in people who have been infected multiple times. We probably won't know for sure until we see what happens over several years with people who were very young during the pandemic or were born after it. For people older than that is is probably going to be something that is more like a severe flu, where we'll have a vaccine each year for the strains expected to be most common that year, and while the vaccine won't stop you from getting sick it will greatly increase you chances of not getting severely sick. We are already seeing that. COVID-19 fell from the 4th highest cause of death in the US in 2022 to the 10th highest in 2023, with 76000 deaths. Compare to 246000 deaths in 2022 and 462000 in 2021.

sharpshadow 2y ago

It’s relieving that at least other branches of vaccine development are not under the information regime as with COVID. “However, environmental bacteria complicate the picture. If present before vaccination, memory immune cells primed to destroy the environmental relatives might cross-react with and neutralize the BCG strain before it has a chance to set up an immune response against itself and M. tuberculosis.” Nobody cared if one already had covid before administering the vaccine and since the vaccine came late many have had a previous infection already. The new mRNA vaccine utilities the body to produce the actual pathogen and with already existing immunity from a previous infection one’s immune system starts to attack the mRNA modified cells and pathogen product.

thenerdhead 2y ago
Previous COVID infection enhances immunity, creating what we call hybrid immunity. This happens because current vaccines mainly target the spike protein, while natural infection exposes the immune system to other parts of the virus. New vaccines in development aim to include multiple proteins and improved delivery methods, which could lead to longer-lasting immunity. For now, hybrid immunity (infection plus vaccination) offers broader protection, while vaccines safely boost antibody levels without the risks of infection.
- sharpshadow 2y ago
  An infection exposes the immune system to the whole virus while the mRNA vaccine triggers the synthesis of the viral spike protein which would be a specific part of the virus. It can be called hybrid since it is a combination of a original and novel technique but the underlying immune system still deals with the invaders the same way and creates immunity against them. Naturally an infection would be temporary but with the mRNA technique it's a constant stream of spikes which the immune system attacks to the source. One of the issues here are the byproducts from the immune activity, especially dangerous if the mRNA dosen't stay around the injection area. Hybrid immunity without looking at the cons is not the full picture and seeing some counterpoints about vaccines was refreshing.
  - 2y ago

ch1kkenm4ss4 2y ago

[flagged]

amluto 2y ago

A mystery not mentioned in the article: why is TB so unusual in places like the US? The US does almost nothing to control TB. We don’t vaccinate. We don’t routinely test (except in special cases, but those cover very little of the population). We don’t treat latent cases unless they somehow get noticed. And yet the incidence of symptomatic TB is low, and there’s no sign of TB developing resistance to whatever the US is accidentally doing right.

alexey-salmin 2y ago
Less public transport perhaps? I remember studies showing strong correlation even though causation can be questionable (less protected member of society in the first place). And anecdotally the only person I know with TB never had known cases neither at home nor at work, which basically leaves the public transportation (which he was using 2-4 times a day at the time) as the most likely source. Another idea could be "better climate" but it's not obvious when I look on the world map of TB incidence.
- deleted 2y ago
  [deleted]
noodlesUK 2y ago
TB is almost the archetypal disease of poverty. Living on top of each other, especially in childhood & adolescence, combined with other environmental and health factors explains almost all of it. If you’re malnourished and your immune system is in bad shape, you’re at risk. If you have HIV, you’re at risk and so on.
- dyauspitr 2y ago
  That’s still not an explanation. Kids in the US spend a lot of time with other kids at daycare and school. It’s a transmittable bacterial disease. Why aren’t people in the US getting it more? Are you saying you have to be mal/undernourished to get it?
  - 2y ago

senadir 2y ago

This lecture from John Green is a great full summary on the history of TB https://www.youtube.com/watch?v=7D-gxaie6UI https://www.youtube.com/watch?v=7D-gxaie6UI He's also publishing a book about it https://www.penguinrandomhouse.com/books/312472/everything-is-tuberculosis-by-john-green/ https://www.penguinrandomhouse.com/books/312472/everything-i... Recently, John Green lobbied to get certain pharma companies to lower the price of tests and vaccines https://www.scientificamerican.com/article/how-advocates-pushed-big-pharma-to-cut-tuberculosis-drug-prices/ https://www.scientificamerican.com/article/how-advocates-pus... Tuberculosis is not a medical problem, it's an inequality and access problem. Tuberculosis is fully solved in advanced countries yet less developed countries still suffer from it. Pakistan has 260 death per 100k capita, the US has 2.6. The highest 5 countries have at least 600 per 100k capita.

BWStearns 2y ago

Oh hey, I had TB. It sucked. I had to be proper quarantined for 3 months, felt like shit for a whole year and a half, and nearly died because I didn't realize I had any symptoms. I thought I was just tired and depressed all the time because I hated my job, and then one day I collapsed from what I thought was a heart attack. I was/am otherwise healthy and must have just drawn the short straw (or it was a very long dwelling infection from a trip abroad years earlier). I really wish we vaccinated for it like Europe. I'd have taken the little scar on my arm for reducing the already small chance of dealing with that shit.

kylehotchkiss 2y ago
BCG doesn't really do much beyond childhood, and even then, just reduces the impact of the disease if you do get it.
- arthur2e5 2y ago
  There's some work in looking at alternative ways of administering the BCG vaccine (iv injection, inhalation). The IV numbers are pretty promising -- if the monkey numbers hold. I hope that someone, somewhere pushes it into human trials soon. There's also the nebulous but very nice-sounding "non-specific effect" with it. Who knows.
  - kylehotchkiss 2y ago
    Interesting, it was my understanding that you don’t actually gain immunity to TB after an infection (as the treatment itself eliminates the bacteria; not your body, mycobacteria stay alive within microphages) so curious what about alternative injection approaches works
- BWStearns 2y ago
  I would have accepted reduced impact.
  - kylehotchkiss 2y ago

kylehotchkiss 2y ago

I almost lost a former partner to this disease. Totally changed my life. One of my first projects at my development consulting job was a site build for an org working on vaccine candidates, which a decade later, unfortunately haven't crossed the finish line. So with a fairly personal connection with the disease, and the nonzero chance I could one day develop it myself, I have a personal interest in seeing progress in the space. I saw an IAVI update the other day stating TB research is currently only funded to the tune of 1 billion a year when they need 6. 10.5 million infections a year reported. Remember the countries where the disease have the biggest impact have limited diagnostic abilities outside of cities and politically, these countries are very quick to pretend the problem is solved when the reality is that TB started speeding up again in the covid days because the care programs for patients then was put on pause. If you wanna change the world and aren't just out for VC cash, go design a mobile X-Ray unit to take into villages, work on an AI model to diagnose from imagery, and work on figuring out how to speed up the testing because a MGIT machine needing power 24/7 is not the type of equipment you can always get in the places the disease impacts. Figure out how to get those little mycobacteria suckers to divide quicker in agar (my limited biology education tells me mess up the mycoic acid synthesis without killing it?) and then get people a positive result in 3 days instead of 3 weeks. Remember: the very good blood test (quantiferon gold) is banned in the largest country in the world because it comes back positive for the 1/3 of the population latently infected.

selimthegrim 2y ago
So this New Yorker article is wrong? https://www.newyorker.com/news/news-desk/how-banning-a-tb-test-will-save-lives-in-india https://www.newyorker.com/news/news-desk/how-banning-a-tb-te...
- kylehotchkiss 2y ago
  IMO the mistake was using the test in isolation without considering other criteria. Let’s say you have somebody in a village who travels to visit a clinic. Chest xray positive so sputum samples taken. They don’t convert for 3 weeks, but contact is lost with patient. Maybe in this scenario the blood test adds the additional factor needed to start treatment sooner. There’s a lot of other diseases there a blood test can diagnose immediately, and I don’t blame health workers for the confusion, quantiferon is a unique test, but a countrywide education campaign could have worked to keep it as part of the diagnostic tools.

jmspring 2y ago

Elections have consequences, I just hope the incoming administration isn't actually going to roll things back on vaccines, etc. Otherwise, we may end up with upticks of diseases previously mostly eradicated (at least here in the US).

dopylitty 2y ago
I wouldn’t be surprised if states like Idaho and Florida that don’t have functioning public health departments start having TB outbreaks to go with their measles outbreaks once the CDC is decimated and can’t provide a backstop anymore.
deleted 2y ago
[deleted]
SoftTalker 2y ago
I see no evidence that Trump is anti-vaccine. He promoted the development and apporval of the first COVID vaccines. He called them "wonderful" or whatever similar words he likes to use.
- jmspring 2y ago
  If he appoints RFK jr as head of anything health - he is antivax. Maybe he doesn’t get appointed.

deleted 2y ago

[deleted]

CatWChainsaw 2y ago

It would help if greed would stop being an obstacle.