On Wednesday, October 4th, it was reported that New York City was grappling with an unprecedented rise in tuberculosis (TB). The city, which has witnessed a roughly 20% increase in active tuberculosis cases from the previous year, is now sounding alarms in the health sector. With approximately 500 confirmed cases so far this year, the city is on track to experience its worst year in a decade, raising eyebrows and concerns among health professionals and policymakers alike.
Elizabeth Lovinger, a health policy director at Treatment Action Group, warns, “When there are particularly high spikes in TB and other infectious diseases in New York City, that tends to be kind of a bellwether for the rest of the country.” This statement echoes the fears of many, as the city’s Bureau of Tuberculosis Control, already impacted by years of budget cuts and widespread vacancies, struggles to manage the spread with its limited capacity.
The situation is further exacerbated by the closure of the department’s center in Washington Heights, one of the four city-run clinics offering no-cost testing and care for tuberculosis. City Health Department spokesperson Patrick Gallahue articulates, “The health of our city is our core mission, and we’ll do whatever we can to ensure that no one goes without care.” However, the reality on the ground, with wait times for appointments and chest X-rays increasing due to understaffing, tells a different story.
The historical context of tuberculosis in New York City, especially the major spike witnessed in the late 1980s, serves as a stark reminder of the potential devastation the disease can wreak. Dr. Jay Varma, an epidemiologist, notes, “It seems paradoxical, but many disease control programs struggle harder during the elimination phase than they do during a surge — because the level of staffing and political commitment declines more rapidly than the case numbers.”
The current budget allocates $14.3 million to tuberculosis control, accounting for 151 personnel across three clinics. However, as one city health employee succinctly puts it, “We’re all just doing triage all the time.” The city, once the epicenter of a nationwide tuberculosis epidemic in the early 1990s, now faces the specter of history repeating itself as the combination of rising tuberculosis cases and a resource-starved bureau harkens back to a darker time.
Symptoms of tuberculosis include persistent cough with phlegm and possibly blood, fatigue, night sweats, loss of appetite, and weight loss.