COVID-19 – Silicosis and TB

• What is the coronavirus and what is COVID-19?

  Coronaviruses are a large family of viruses which may cause infections of the airways and the lungs. These infections can range from the common cold that we all know to more severe diseases. The latest coronavirus is a new virus and causes a new illness called coronavirus disease 2019 or COVID-19 for short.

  Most people who become sick with COVID-19 do not get very sick and can recover after several days. However, there are people who become very sick with COVID-19 and they may get severely ill and die from it.  

  Since it is still a new virus and a new disease, new information is becoming available almost every day from across the globe. This helps us to find new ways to respond better to COVID-19. At present, there are limited treatments for COVID-19 available and there is no vaccine to prevent it.

  A major recent apparent breakthrough has found that a common drug Dexamethasone appears to assist COVID-19 sufferers who are seriously ill. Dexamethasone is a steroid that has been used since the 1960s to reduce inflammation in a range of conditions, including inflammatory disorders and certain cancers. It has been listed on the WHO Model List of Essential Medicines since 1977 and is currently off-patent and affordably available in most countries, including South Africa.

  There are research studies in many countries in the world to look for effective treatment options for COVID-19 and to develop vaccines that may be able to prevent COVID-19. These studies are in progress and our countries are contributing to the studies.

  In the meanwhile, it is essential that each and every one of us must try our utmost to prevent ourselves and others from getting infected with COVID-19.

• How is the coronavirus spread?

  The coronavirus is thought to spread in droplets from person-to-person. The droplets are sent into the air when someone infected with the virus talks, coughs or sneezes. If you are within 2 metres of them, you could breathe these droplets into your airways. These droplets can also land on different surfaces where they may be picked up by your hands. If you then touch your face, especially your mouth, nose and eyes you could become infected with COVID-19.

• Who is more vulnerable to COVID-19 or are likely to have a more severe infection?

  Based on what we know at the present time of this new disease, those at higher risk for developing a more severe COVID-19 illness include:

  • People 65 years and older
  • People who have serious heart conditions
  • People who have hypertension not well controlled on treatment
  • People who have diabetes not well controlled on treatment
  • People who have chronic lung conditions
  • People who are immunocompromised such as those who are HIV positive and not on treatment
  • People who are malnourished
• I have been diagnosed with active TB. Am I more at risk of COVID-19?

  There is limited research on this at this stage. But it is foreseen that people who are sick with both TB and COVID-19 may have poorer treatment outcomes, especially if TB treatment is interrupted. It is very important to ensure you have adequate supplies of your TB medication and there is no interruption in your treatment programme. Extra care is needed to protect your health and not put yourself at risk of becoming sick with COVID-19. Please discuss with your health service provider or call a toll-free hotline regarding what steps you can take to best protect yourself from the virus.

• I have been diagnosed with Silicosis. Am I more at risk of COVID-19?

  There is limited research on this at this stage. Experience suggests that people with chronic lung diseases may develop more complications with COVID 19 illness. You need to take extra care of your health and not put yourself at risk of becoming sick with COVID-19. If you have silicosis, you must also be very careful to protect yourself from being at risk of getting TB. You should therefore try your utmost to protect yourself against both COVID-19 and TB. Please discuss with your health service provider or call a toll-free hotline regarding how best to protect yourself or use the tollfree hotlines for the respective countries.

• What are the differences between symptoms of COVID-19 and symptoms of TB?

  It is important to speak to your health service provider about the symptoms you experience or use the toll-free hotlines. Both COVID-19 and TB cause symptoms which, among others, include fever, cough and shortness of breath. The main difference is the speed with which these symptoms develop. COVID-19 symptoms occur quickly over a short period of time which can be within a matter of days. TB symptoms occur more slowly often over a period of weeks or longer. It is important to remember that untreated TB can cause severe weight loss and severe illness.

• Symptoms of silicosis

  Silicosis is usually considered an occupational lung disease caused by workers breathing silica dust in their work environment in the mining, construction and some other industrial sectors. The silica dust causes inflammation and scarring mostly in the upper parts of the lungs. If you have silica dust in your lungs, you tend to get TB more easily. In the early stages of silicosis people are often not very sick but can progress to severe illness over the years. The symptoms of silicosis can develop slowly over a number of years and include cough, shortness of breath, chest pain and weakness, especially if the silicosis is severe. Please do not hesitate to discuss your concerns with your health service provider or one of the toll free hotlines.

• I am feeling very anxious about COVID-19. What can I do?

  Many people are feeling anxious about COVID-19 and you must not hesitate to find ways to share your concerns. It is understandable that you are concerned if you are also affected by TB and/or silicosis. It is important to talk to people you trust to share your concerns especially your health care providers. Please do not hesitate to contact one of the toll-free hotlines provided here.

• What can I do about testing for COVID-19?

  In order to know if you should be tested for COVID-19 in South Africa, and whether you qualify to be tested for COVID-19 please call the Emergency Hotline: 0800 029 999. For countries in Southern Africa please use the same toll-free numbers as listed for your respective countries.

• What can you do to protect yourself from COVID-19?
  

  1. It is essential that everyone supports the efforts of our governments in Southern Africa by complying with government regulations and guidance shared with us via radio, TV, our phones or via the internet
  2. Stay at home if you are sick except to get medical care
  3. If you leave your home, stay 2 metres away from other people at all times
  4. Cover your cough or sneeze with tissues or your flexed elbow. Throw away the tissue in a waste-bin and wash your hands afterwards
  5. Avoid touching your eyes, nose and mouth
  6. Wash your hands frequently with soap and water, for at least 20 seconds.
  7. If soap and water are not available, use an alcohol-based hand sanitiser that contains at least 70% alcohol. Cover all surfaces of your hands with the sanitiser and rub your hands together until they feel dry.
  8. Clean and disinfect surfaces especially those that are frequently touched
  9. Wear a cloth mask with at least 3 layers of material each time you step out of your home. Do not touch the mask while you are wearing it. On returning home, carefully take the mask off without touching the part you have breathed through and wash your hands and the mask thoroughly in water with adequate soap
  10.  Wear a cloth mask inside your home if people living with you have symptoms of COVID-19. They should wear a cloth mask and should be tested as soon as possible. You should observe all the standard steps of keeping the 2-metre distance, wash your hands regularly with soap, clean surfaces in your home regularly and wash your masks as soon as you take them off.
  11. Avoid smoking
  12. If you were diagnosed with TB, strictly adhere to your treatment programme
  13. Try and get the latest flu vaccine and the pneumococcal vaccine

  Please know that the Tshiamiso Trust will update this information sheet from time to time when important new information becomes available.

Useful websites and phone numbers for information about COVID-19

South Africa 
National Department of Health Coronavirus Portal: https://sacoronavirus.co.za/

National Institute for Communicable Diseases (NICD): www.nicd.ac.za.
NICD hotline: 0800 029 999

National Institute for Occupational Health (NIOH): www.nioh.ac.za.
NIOH hotline: 0800 212 175. (This number is for health workers mainly but also for other work-related concerns, particularly occupational health and safety professionals who have questions about COVID-19 and the workplace or any occupational health issue

References

1. National Department of Health. Republic of South Africa. COVID-19 Corona Virus South African Resource Portal.  https://sacoronavirus.co.za/
   WHO; Coronavirus disease (COVID-19) pandemic.
2. WHO Information Note; Tuberculosis and COVID -19. Considerations for TB care. https://www.who.int/docs/default-source/documents/tuberculosis/infonote-tb-covid-19.pdf
3. WHO: Stop TB partnership. https://www.stoptb.org/covid19
4. The Union. COVID-19 and TB: Frequently Asked Questions. Version 2, 22 April 2020.https://theunion.org/our-work/covid-19
5. CDC: What you can do if you are at higher risk of severe illness from COVID-19. https://www.cdc.gov/coronavirus/
6. Coronavirus Disease 2019 (COVID-19) and Mining. https://www.cdc.gov/coronavirus/2019-ncov/community/miners.html?deliveryName=FCP_1_USCDC_10_4-DM30499
7. Handwashing: Clean Hands Save Lives. https://www.cdc.gov/handwashing/campaign.html