Effect of COVID-19 on Tuberculosis in the U.S.

In the United States, reported tuberculosis (TB) disease diagnoses fell 20% in 2020 and remained 13% lower in 2021 than TB disease diagnoses made prior to the COVID-19 pandemic, according to preliminary CDC data published today.

The new data suggest that the pandemic has had a substantial effect on TB trends in the United States. Before COVID-19, TB disease diagnoses typically declined between 1% and 2% each year. The 2020 and 2021 declines may be related to factors associated with the COVID-19 pandemic, including a true reduction in incidence as well as delayed or missed TB diagnoses. For example:

• Efforts to prevent COVID-19, such as wearing masks and staying six feet away from others, may also reduce the spread of TB.
• Widespread disruptions to healthcare during the COVID-19 pandemic may have delayed TB diagnoses. The COVID-19 pandemic has strained public health services, including TB prevention and control services.
• Similarities in symptoms between COVID-19 and TB disease may have led to missed TB diagnoses. Case reports have revealed some people with TB disease were evaluated for COVID-19 — but not tested for TB — during multiple encounters with healthcare systems. Initial misassumptions might have contributed to missed diagnoses, or delayed diagnoses until more advanced stages of disease.

TB prevention and control activities are essential public health functions for communities throughout the United States. To assist in these efforts, CDC launched the Think. Test. Treat TB campaign to help raise awareness of TB and recognize the importance of TB prevention. Starting a conversation with your doctor is the first step to protecting your family, friends, and community from TB disease.

Please attribute the following quote to Philip LoBue, MD, FACP, FCCP, Director of CDC’s Division of Tuberculosis Elimination
“Delayed or missed tuberculosis disease diagnoses are threatening the health of people with TB disease and the communities where they live. A delayed or missed TB diagnosis leads to TB disease progression and can result in hospitalization or death – and the risk of transmitting TB to others. The nation must ensure that healthcare providers understand how to diagnose and distinguish TB disease from potential cases of COVID-19.”

Additional Resources

CDC Media Fact Sheet: TB in the United States, 2021pdf icon

CDC World TB Day Graphics

CDC World TB Day Resources

CDC Think. Test. Treat TB Campaign

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