(COMMENTS reached the max, daily update) If I were North American/West European/Australian, I would take BCG vaccination now against the novel coronavirus pandemic.
I declare that there is no conflict of interest for BCG vaccination but I have a big interest in stopping this pandemic. One of my businesses is an online tourism agency and its sales have dried up!
1) Scientists have started to work on this hypothesis
Immune boost against the coronavirus
2) If you look at the map displaying BCG vaccination policy by country, there seems to be a correlation to the speed of coronavirus spread and its spread among young people.
- The spread speed is fast in Italy and western Europe and the U.S. while the spread speed among Russia, eastern European countries, and Asian countries except Wuhan city is slow.
- In Asian countries, there are few young infected people or almost zero serious cases among young people. However, in western Europe and the U.S., there are cases among young people.*
- In Western Europe, you can compare Italy vs Croatia, Spain vs Portugal**, UK vs Ireland, Sweden vs Norway, ex-West Germany vs ex-East Germany. In the former countries, BCG vaccine is not mandatory while in the latter countries, BCG vaccine is mandatory. Now, you can compare the U.S. and Mexico.
- I live in Tokyo and Brisbane. Though the normal social distance is much longer and less crowded in Brisbane and the government policy is 10 times stricter, the spread speed is faster in Brisbane than in Tokyo.
* (Added on 5 Apr) A reader told me that Ecuador has its BCG program. However, it started in 1977. No strain information.
According to http://www.bcgatlas.org/, the start year for Columbia: 1960, Peru: 1945, Brazil: 1976. Brazil was late to introduce the program but it uses BCG Moreau, which seems to be effective against COVID-19.
(Added on 29 Mar)
A reader told me there is a pre-print article (not yet certified by peer review)
The article has this chart. I believe if we can adjust for the timing of coronavirus spread, the correlation would be even higher.
(Added on 30 Mar)
In the world map above, Canada is in orange and categorized in C: The country never had universal BCG vaccination programs. However, if you look at Canada in http://www.bcgatlas.org/, it seems that Canada had a "routine" BCG vaccination program until 1960s-1970s (Please correct me if I read wrongly). This means people elder 50s mostly vaccinated! This may be the reason why Canada has a low death rate compared with the U.S. And Canada used BCG Tokyo strain.
One more weak fact. In Canada, people elder than the 60s had a BCG vaccine while people younger than 50s had not. Then, look at the age distribution of COVID-19 cases in Canada. Skew to people younger than the 50s?! But infection rate may not vary by age, only hospitalization/ICU/death rate may vary by age. I'm looking for that data and BCG vaccine penetration data by age group for Canada.
* I couldn't find good stats on this. Only anecdotal news stories. Eg. Greta Thunberg got infected by the novel coronavirus. Well, she is Swedish and born in 2003. Sweden stopped BCG vaccination in 1975.
** Among West European countries that had/have universal BCG vaccination program, Spain and Portugal are (one of) the last countries introduced it in 1965. And Spain is (one of ) the first country to stop it in 1981 and Portugal stopped it in 2017. Portuguese elder than 55 may have a low BCG vaccination rate, which may result in a high death rate than the other western Europe, but probably better than Spain.
3) There are several strains of BCG vaccination and Soviet/Japan/Brazil strains may be the most effective against the novel coronavirus.This comment by Tiger Paw sounds most plausible regarding the country differences though the article itself is worthless.
* The comment was deleted for some reason. The initial idea of this section attributes to Tiger Paw. If I hadn't read his comment, I would not know there are multiple types of BCG vaccine.
You can see this table updated on 4 Apr.
A reader did a fantastic analysis regarding ex-West/East Germany. He/she separated ex-West/East within Berlin, and categorized regions by the population. Within Berlin, the deaths/per 0.1M population in ex-East is 0.24 while it in ex-West is 0.76. Three times different!
I obtained a map showing which strains are used in each country though this map maybe not perfectly correct.
High-level impression; BCG Brazil, BCG Russia/Bulgaria, BCG Japan countries may immune to novel coronavirus. Countries that use more than one BCG vaccine strain look immune, too. BCG Brazil, BCG Russia/Bulgaria, BCG Japan are categorized in "I" and this may be the effective strain category.
Then, I looked into how BCG strains are categorized. I found the chart below. BCG Russia/Japan/Moreau(Brazil) are the first generation of the BCG vaccines.
While Iraq uses the Japan strain*, Iran uses different strains. According to http://www.bcgatlas.org/ Iran had used its local (original?) BCG vaccine from 1947 to 1984 and make it compulsory in 1984. This means elderly people in Iran have less BCG vaccinated and for those who had it had a local(original?) BCG vaccine. Please check and compare Iraq and Iran figures. You will be surprised to see how different they are.
BCG Japan(Tokyo) looks working quite well against the novel coronavirus. 1) Japan, Thailand, Taiwan, and Iraq have used BCG Tokyo and all of them have low death rates though they are close to China or Iran. 2) And so far, it is not reported that any Japanese got severely infected or died in Italy or Western Europe. 3) In Japan, there are 1,349 cases reported, and 934 are Japanese and 415 are non-Japanese. Hmm, quite a high ratio of non-Japanese (as of 28 Mar).
(Added on 5 Apr)
Let's do simple math. The New York state has 19 million population and Japanese consists of 0.3%, 52 thousand. As there happened 3,565 deaths by COVID-19 so far, there should be 0.3% = 10 deaths of Japanese. I have never heard of death or even severe conditions of Japanese living in the New York state. If we assume the death by COVID-19 comes equally to any people no matter of BCG vaccination, the possibility of no Japanese death in NY state so far is 0.01%. Even if we assume the number of Japanese to half (26 thousand), the possibility is 0.76%. Death by COVID-19 doesn't come equally at more than 99%.
Also, this calculation dismisses another hypothesis that the virus has evolved into a stronger mutation when arriving in western Europe and the U.S.
(Added on 1 Apr)
I am afraid that I hardly understand the mechanism of BCG vaccines but there seems to be a piece of medical evidence that BCG Tokyo works quite well against COVID-19.
The website, http://www.bcgatlas.org/, seems to have a lot of information about BCG vaccination though this is not perfect, either.
I am afraid that I cannot digest this detailed medical information. Expert explanations will be welcomed.
I live in Tokyo and Brisbane and have been wondering why the spread speed is faster in Australia than Japan.
Tokyo is a very crowded city and it's impossible to keep the social distance. People are packed in a very crowded train twice a day and I expected a high speed of spread but the actual speed is low so far (though it's beginning to explode).
4) Deaths and severe cases skew to people who probably have not BCG vaccinated.
In Japan, all babies since 1951 have BCG vaccination and the coronavirus deaths in Japan are skewed drastically to the elderly born before 1951. 44 out of 45 deaths happen to those older than 70 (as of 26 Mar, https://toyokeizai.net/sp/visual/tko/covid19/).
I found three facts regarding China's BCG vaccine policy.
- China started its BCG vaccination program in 1978 (->42 years old), not universally but partially.
- Penetration varies by province. Among high/middle/low penetration categories, Hubei Province(where Wuhan is) is in the low category. Beijing and Shanghai are in the high category.
- China uses its own local strain produced in China.
5) BCG vaccination has a long history and there seems no little downside to human beings.
(Added on 28 Mar)
(Added on 31 Mar)
6) Lockdown reduces the reproduction rate significantly but lockdown may not be enough for the countries where BCG vaccination has not been mandatory.(Added on 1 Apr)
I checked the Imperial College COVID-19 report as of 30 Mar and read the chart of 13 west European countries. I am afraid that I don't check other than the chart below.
- 12 out of 13 countries already implemented lockdown and have reduced their R1 significantly. Sweden is the only country not implementing lockdown and making the virus to spread fast (R1=3).
- Sadly, lockdown may not be enough to contain COVID-19. All countries except one seem to have their R1>1. This is a very bad sign.
- Hey, look at Norway! Norway seems to be the only country where its R1<1! And look at the first map I cited. Norway is the only one light orange country among these 13 countries; Mandatory BCG vaccine. To be precise, according to http://www.bcgatlas.org/, Norway had its compulsory BCG vaccine program from 1947 to 2009 for 62 years, which is the longest among these 13 countries.
- If a country doesn't have a long history of mandatory BCG vaccination program, lockdown may not be enough to contain COVID-19. Additional measures required. BCG vaccine?
- If a country has a long history of mandatory BCG vaccination program even if it is BCG Denmark strain, a country can contain COVID-19 by the lockdown.
- BCG can reduce the infection rate by half no matter what strain is.
- Lockdown can reduce the infection rate to 40%.
- What BCG strain matter seems to be in the death rate. While weak strains such as BCG Denmark may not so effective to reduce the death rate, strong strains such as BCG Tokyo can reduce the death rate to one-tenth.
Probably the most exhaustive and most accurate estimate of COVID-19's lethality at this time. After correcting for data censoring errors and demographic differences, the overall result is 1.38%. A very important implication is that elaboration of treatment does not appear to have much effect on this figure.
Coincidentally, the result is the same as my deep-learning analysis. From my deep-learning analysis, the death rate (no BCG & Ordinary life) was estimated at 1.38%! And BCG Tokyo reduces it to around 0.1%.
(Added on 5 Apr)
The U.S. and Irish medical and scientific experts have started to work on this. Please check this recording.
- BCG vaccination is safe for adults and healthcare workers.
- The U.S. is expecting the second wave of the pandemic in fall/winter. BCG vaccine can prevent that second pandemic.
- In the U.S., the BCG vaccine supply is limited and in shortage.
- The researchers are BATTLING AGAINST THE CLOCK.
(Added on 4 Apr)
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