Title: Tuberculosis Cases Surge in New York City Amidst Budget Cuts and Staffing Shortages
Byline: Marc Lallanilla
Published: Oct. 6, 2023, 11:58 a.m. ET
Years of budget cuts and staffing shortages have left the New York City Department of Health ill-equipped to handle a significant rise in tuberculosis (TB) cases, according to a shocking new report. TB, known as the world’s deadliest infectious disease, has seen a 20% increase in active cases in NYC compared to the same time last year. This surge in infections marks 2023 as the worst year for TB in a decade, raising concerns about the disease’s spread.
Elizabeth Lovinger from Treatment Action Group, a NYC public health advocacy group, expressed her concerns, stating, “This is definitely a more dramatic resurgence than we would have probably expected.” Lovinger also emphasized that spikes in TB cases in NYC often serve as a warning sign for the rest of the country.
The rise in cases in NYC can be partially attributed to the impact of the COVID-19 pandemic and vaccine fatigue, which hinder efforts to diagnose and treat TB cases. In addition, the arrival of over 100,000 migrants since spring 2022 has increased the risk of developing active tuberculosis infections. Recent TB cases have also been reported in Olathe, Kansas, and Brockton, Massachusetts, leading to a high-level meeting by the United Nations to discuss strategies for controlling the global spread of the disease.
Despite the alarming data, NYC Health Department spokesperson Patrick Gallahue reassured the public, stating, “This city is a leader in TB care.” However, the report reveals that the city is ill-prepared for a widespread tuberculosis outbreak. Employees from the NYC Department of Health’s Bureau of Tuberculosis Control, speaking anonymously, revealed that long waits of up to a week for testing and treatment are routine at the city’s three TB clinics. This delay in treatment makes the disease harder to treat and increases the likelihood of transmission.
Compounding the issue, one of the four NYC-run TB clinics in Washington Heights, the only TB clinic in Manhattan, was recently closed for renovation. This closure occurred as the clinic was needed to assist in the response to COVID-19. The clinic may be renovated or upgraded in the future, according to Gallahue. In the meantime, he assured the public that efforts were being made to increase screening, diagnosis, and treatment among at-risk individuals.
The problem is further exacerbated by the challenge of finding suitable housing for newly arrived migrants, who are at a higher risk of developing TB due to crowded and poorly-ventilated living conditions. Health experts express concerns that as the weather turns cold and people spend more time indoors, TB and other respiratory illnesses such as the flu, respiratory syncytial virus, and COVID-19 could spread more easily. Vaccine hesitancy and “COVID fatigue” also pose a threat, potentially overwhelming healthcare facilities during the upcoming virus season.
Tuberculosis is a respiratory disease caused by airborne bacteria and can result in serious symptoms such as coughing (including coughing up blood), chest pain, fever, chills, night sweats, and weight loss. Early detection and treatment with drugs can effectively manage the disease, but if left untreated, TB can be deadly, claiming approximately 1.5 million lives annually. Additionally, some strains of the TB bacteria have developed drug resistance, making the disease incurable.
The report highlights extensive problems with TB screening and treatment in NYC, including staffing shortages in various critical positions such as doctors, X-ray technicians, case managers, and public health experts. The remaining staff members are burdened with heavy workloads due to the time-sensitive and lengthy treatment required for TB cases.
These challenges underscore the urgent need for increased funding and support to strengthen the city’s response to TB and prevent further spread of the disease. Without swift action, the impact of TB in NYC could have far-reaching consequences for public health in the region and beyond.