Contaminating the Breath: The Syndemic of Tuberculosis and Covid-19 On the Eastern Cape of South Africa

Abstract

The Covid-19 pandemic lays bare our collective vulnerability to communicable diseases. As the world attempts to control its spread, the pandemic has taken up all the spaces of political, societal, and medical discourse. As I write, there are 121 million confirmed cases and 2.68 million deaths worldwide. The world has termed Covid-19 a “pandemic” to enforce global health protocols for countries. However, the term “pandemic” does not take into consideration the interaction of Covid-19 with other diseases and within social spaces. For example, the narrative of Zithulele hospital in South Africa reveals the impact of Covid-19 on tuberculosis care and the care of vulnerable populations. The present state of the world can be described as a ‘synergy of pandemics occurring in time and place, interacting with each other to produce complex sequelae, and sharing common underlying drivers’ (Swinburn et.al., 2019). However, the incessant media reporting that saturates our daily lives continues to overlook these synergies–the closely tied ecologies of Covid-19 and other existing diseases, like tuberculosis. The long-term consequences of synergistic events are likely to deepen inequalities, stretch public health resources, recalibrate healthcare systems, and increase the burden of co-existing diseases. The analysis and response to the Covid-19 pandemic must be approached through the syndemic framework. It broadens the approach of global healthcare through a consideration of interactions that increase a person’s susceptibility to worse health outcomes. The most important consequence of seeing Covid-19 as a syndemic is to underline its social origins and reorient public health and clinical medicine by showing that an integrated approach to understanding disease is far more effective than controlling epidemic disease.