Will there be a rise in tubercular meningitis due to the COVID 19 pandemic?

It has been noticed since the 1930's that there is a clear seasonal variation in the incidence of tuberculosis. Tuberculosis showed a peak in the summer months and a decline in the winter. This was in contrast to the flu, which showed an increase in the winter and a decline in summer. 

A 28 year time series study from Birmingham beautifully illustrates this pattern. What is more interesting is that this fluctuation is tightly linked to the number of sunshine hours in the previous 2 -3 months. A decrease in the sunshine hours in the previous months meant a rise in the incidence of tuberculosis.https://dx.doi.org/10.1371%2Fjournal.pone.0057752

There is some data to show these fluctuations are more marked in children, in extra pulmonary tuberculosis like tubercular meningitis and in latitudes away from the equator.

Another study from South Africa also showed that a decrease by 100 hours / month of sunshine hours in the preceding 3 months led to a 45% increase in tubercular meningitis.

The overcrowding in winter may lead to increased transmission of infections and the decrease in sunlight exposure is hypothesised to increase disease due to a decline in vitamin D levels.

There is much data to support that vitamin D is crucial in activating macrophage responses to the M tuberculosis bacilli and the synthesis of antimicrobial peptides such as cathelicidin and defensins. 

In the current pandemic people have been virtually housebound for several months. An increase in tubercular meningitis seems imminent.