(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 am not a medical expert and this is just a hypothesis; taking BCG vaccination may strengthen immune to the novel coronavirus. If I were American/West European/Australian, I would take BCG vaccination now. Six reasons follow.

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!


(Added on 4 Apr)
The comment system does not work on this post anymore. Too many comments? For discussion purposes, I created a new post. Please leave a comment on the post below.


1) Scientists have started to work on this hypothesis


Can a century-old TB vaccine steel the immune system against the new coronavirus?

The Max Planck Institute (the best German science institution with 33 Novel Prize winners that developed BCG vaccine a century ago)
Immune boost against the coronavirus

Some countries, the U.S. and Australia will start a trial to give BCG vaccine to healthcare workers.

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.



A: The country currently has universal BCG vaccination program.*
B: The country used to recommend BCG vaccination for everyone, but currently does not.
The year the country stopped it; Spain 1981, Germany 1998, UK and France 2005-2007 etc.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3062527/
C: The country never had universal BCG vaccination programs.

* In Portugal the BCG vaccine was mandatory from 1965 to 2017. https://twitter.com/ruipalma79/status/1243304538469273600

The major correlations are;
  • 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.
In Latin America, Ecuador is the only country that never had universal BCG vaccination programs and all the other countries have universal BCG vaccination programs according to the map above*. Total deaths per million, Ecuador: 2, Colombia: 0.08, Peru: 0.3, Brazil: 0.3. 

* (Added on 5 Apr) A reader told me that Ecuador has its BCG program. However, it started in 1977. No strain information.  
https://www.jsatonotes.com/2020/04/please-leave-comments-here-regarding.html?showComment=1586045707606#c3278707554083878141
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)
https://www.medrxiv.org/content/10.1101/2020.03.24.20042937v1

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.



 https://www.statista.com/statistics/1107149/covid19-cases-age-distribution-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.
https://www.japantimes.co.jp/opinion/2020/03/21/commentary/japan-commentary/japan-still-coronavirus-outlier/#comment-4843977551
* 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.

Soviet/Japan strains of BCG vaccination are old-type and similar while Western European stains are recent and different.

Below is a map of German states with confirmed coronavirus cases. You can see the difference between ex-East Germany and ex-West Germany. The density of the population doesn't explain this much difference. East Germany had used the Soviet strain of BCG vaccination and West Germany had used the Western Europe strain of BCG vaccination and stopped its mandatory vaccination in 1998. The vaccination strains/policies may be the cause of the difference.




Then, look at the number of deaths by state. Summing up by ex-West Germany and ex-East Germany (excluding Berlin), the number of deaths per 100K of ex-West Germany states is 0.35 while ex-East Germany is 0.11 and Berlin is in between; 0.21 (as of 27 Mar).
(Added 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!

画像
https://twitter.com/Iku42888817/status/1246368330409099265

I obtained a map showing which strains are used in each country though this map maybe not perfectly correct.

https://twitter.com/io302/status/1243441971709894657
https://twitter.com/io302/status/1243441971709894657/photo/1

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.

In the same article, there is a table that shows the differences in each strain character. Though I don't understand any jargon in the first row, I can see there is quite a difference between BCG Tokyo/Moreau(Brazil)/Russia/Sweden and BCG Copenhagen(Denmark)/Glaxo/Pasteur/Tice. BCG Denmark is the common strain among Western Europe.

https://jata.or.jp/rit/rj/tenbo/48toida.pdf
https://twitter.com/xcvbnm67890/status/1243723927907471361

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.
(Iran: 27 deaths per million, Iraq: 0.9 deaths per million as of 27 Mar; added)
* Additional source is welcomed. The map above says it BCG Japan but http://www.bcgatlas.org/ does not have Iraq's strain info. I suspect Iraq uses a different strain.

In Asian countries, China uses a different local produced strain and Korea uses basically BCG Denmark but sometime BCG Japan. Taiwan uses the Japan strain (though the map shows a locally produced strain).

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).
https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/0000164708_00001.html#kokunaihassei

(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.
https://www.jsatonotes.com/2020/03/if-i-were-north-americaneuropeanaustral.html?showComment=1585702586835#c4287423548330968127

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).
Here in Brisbane or the other Australian capital cities, the normal social distance is much longer than Tokyo and I expected a slower spread. But the speed of spread is faster.
I was wondering about this, and so far this hypothesis may seem to be the most plausible. Maybe ~60% probability. 

4) Deaths and severe cases skew to people who probably have not BCG vaccinated. 

In Japan and Portugal, the deaths come only to the age group without the mandatory BCG vaccine program period.

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/).

In Portugal, the BCG vaccine was mandatory from 1965 to 2017 (https://twitter.com/ruipalma79/status/1243304538469273600), which means between 3 and 55 years old are vaccinated. And it looks deaths happen only to over 50 (as of 27 Mar, https://www.dgs.pt/em-destaque/relatorio-de-situacao-n-024-26032020-pdf.aspx).

Also, as Portugal introduced the mandatory BCG vaccine program very late together with Spain, in 1965, and there should be many elderly who had not BCG vaccinated, I anticipate that the number of deaths per million will be higher than the other Western European countries where BCG vaccination programs were usually imposed in the 1950s. But Portugal should be better than Spain that stopped the program in 1981, though.

However, this hypothesis is weak since the fatality basically skews to the elderly worldwide. I saw some news that the younger generation became severely ill in Western Europe or the U.S. but have never seen that in Japan. More statistics are required to examine this hypothesis.

(Added on 30 Mar)
CDC is publishing hospitalization/ICU/death cases for the U.S. cases. The chart below shows that there are many hospitalizations and ICU cases below 54 years old though the fatality rate is very low so far. (Severe cases may cause aftereffects.) From China case, we know that the fatality rate is very low for the younger generation, which is the same case with the U.S. but the hospitalization/ICU ratio might be higher for the U.S. I cannot find a comparable data regarding hospitalization and ICU cases for China. 


Please compare it with the China chart. Very different age distribution. I don't have good information of China BCG vaccine policy but my guess is that the young Chinese generation probably had a BCG vaccine.



Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) — United States, February 12–March 16, 2020. MMWR Morb Mortal Wkly Rep 2020;69:343-346. DOI: http://dx.doi.org/10.15585/mmwr.mm6912e2external icon.

https://twitter.com/DonaldDuckgo2/status/1244476092997566471?s=20

(Added on 31 Mar)
I received several inquiries regarding China. As there is little data about China's BCG vaccine policy on http://www.bcgatlas.org/, I had skipped China.
I found three facts regarding China's BCG vaccine policy.
  1. China started its BCG vaccination program in 1978 (->42 years old), not universally but partially.
  2. 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.
  3. China uses its own local strain produced in China.
This can explain why the death from COVID-19 heavily skews to the elderly, why the spread of COVID-19 varies by province. Well, China strain may be effective against COVID-19 since China controls quite well except Wuhan/Hubei. 
https://www.huffingtonpost.jp/zhang-qian/compare-vaccine-policy_b_10982252.html
https://www.sciencedirect.com/science/article/pii/S1472979209000262

(Added on 30 Mar)
This can be one of the critical supporting facts for this BCG vaccine hypothesis. Below is a death rate of COVID-19 in Spain by age group. You can see a higher death rate in 10s and 20s than the 30s or 40s. Spain had a universal BCG vaccination program from 1965 to 1981, which means from 39 to 55 years old had a BCG vaccine. Well, you can see a little higher rate in the 10s and 20s. It is a very unusual pattern from what we learned from China. Yes, the absolute numbers may be small and not statistically significant. But this is a sign!



(Added on 5 Apr)
A fantastic analysis is done by a reader. We know that the death/case is not reliable at all since the number of cases varies significantly by the country's test policy and numbers.

This reader set the death/case ratio of the 70s to 100 and see the relative mortality rate by generation. He highlights Japan's line but I would highlight Spain's line. Remember Spain had its universal vaccination program from 1965 to 1981, started late and stopped early. This may result in a relatively high mortality rate in the elderly and the young. Look at the chart below! I believe if we set the death/case ratio of the 40s to 100 and compare Spain, Italy, and Portugal, you can get a clear picture and quantify the effect of BCG Denmark.

画像

5) BCG vaccination has a long history and there seems no little downside to human beings.


BCG vaccination may not work but even in that case, there will be little downside.
CDC states the reason it is not recommended in the U.S.
In Japan, all babies since 1951 have BCG vaccination and I have not heard a problem with it.

If I were North American/European/Australian, I would take BCG vaccination now.

(Added on 28 Mar)
I had carefully avoided talking about adult or elderly people to have BCG vaccination again as I don't know anything about the risk of re-vaccination. But I found a Japanese medical article about re-vaccination to bedridden elderly people published in 2003. BCG re-vaccination significantly reduced the probability of pneumonia.

Dr. Toshio Hirano, one of the best authorities in immunology, best known for his discovery of interleukin-6, the 17th President of Osaka University, stated that this hypothesis could be right from the perspective of our immune system, citing my blog article.

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.
https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-Europe-estimates-and-NPI-impact-30-03-2020.pdf



My observation follows;
  1. 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).
  2. 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.
  3. 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.
What are the implications?
  1. 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?
  2. 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.
(Added on 2 Apr)
This analysis is done by my deep-learning machine, "Enpitsu Namename". So not explainable. Just for your reference.
  1. BCG can reduce the infection rate by half no matter what strain is.
  2. Lockdown can reduce the infection rate to 40%.
  3. 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.
Below is a table for decision making for each country. Healthcare capacity varies by country but I guess in terms of relative death rate below, 5 to 15 would be the maximum capacity.
Relative infection rate
(No BCG and Ordinary life = 100)
Relative death rate / population
(No BCG and Ordinary life = 100)
Ordinary lifeLockdownOrdinary lifeLockdown
No BCG
100
40
100
40~
Mandatory BCG with weak strain (Denmark, etc.)
60
24
10~40
4~16
Mandatory BCG with strong strain (Tokyo, etc.)
40
16
5
2

I would like to emphasize that BCG strain may matter very much. I have seen a few medical institutions have started to try BCG vaccination against the coronavirus. But I have not seen any medical institution mentioning about the strains. Please try some strains and include strong strains such as BCG Tokyo.

(Added on 3 Apr)
I read the following tweet/article. 

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%.

I hope medical experts all over the world examine this hypothesis. I hear that developing a new vaccine will take two years but the BCG vaccine is already here. (Added on 2 Apr) If BCG vaccination works for all including people infected, drive-through BCG vaccination can be a quick and real solution for the U.S. Instead of drive-through PCR testing.

(Added on 5 Apr)
The U.S. and Irish medical and scientific experts have started to work on this. Please check this recording.
https://www.urotoday.com/video-lectures/covid-19-and-genitourinary-cancers/video/1716-the-bactir-trial-bcg-vaccination-against-sars-cov-2-to-protect-health-care-workers-by-enhanced-trained-immune-responses.html
  1. BCG vaccination is safe for adults and healthcare workers.
  2. The U.S. is expecting the second wave of the pandemic in fall/winter. BCG vaccine can prevent that second pandemic.
  3. In the U.S., the BCG vaccine supply is limited and in shortage.
  4. The researchers are BATTLING AGAINST THE CLOCK.

I guess they are working with Merck which seems to supply a weak type of strain. I believe the suppliers of BCG Russia/Tokyo/Brazil should help this. 


BCG Russia/Tokyo/Brazil looks promising. BTW, I had worked at the Tokyo office of Boston Consulting Group, which is called BCG Tokyo :)

(Added on 4 Apr)
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Comments

  1. This is very interesting. I think I had the BCG Tokyo 172 strain as a baby.

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  2. I am a Japanese doctor. I agree with your opinion. I was thinking the same. German data is shocking. The reason why COVID-19 became popular in USA, Italy, France, Finland and Switzerland is probably because BCG was stopped.

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    Replies
    1. I am not a doctor at all. I didn't know there are many strains in BCG vaccine or how it works. There should be many mistakes in detail. Please correct me!

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    2. in 2006 in Finland the national BCG coverage was over 98% https://www.ncbi.nlm.nih.gov/pubmed/16567879

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    3. Finland looks doing well. The high BCG coverage could be the reason. But , As Finland had used BCG Denmark, strict social distancing is very important.

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  3. https://www.france24.com/en/20200326-australians-trial-tb-vaccine-to-fight-coronavirus

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    1. This maybe a good trial. I am little worried about which strain this trial use. Soviet/Japan/Brazil strains look good while Denmark or the others may not be that effective.

      Delete
  4. Thank you for a very interesting article. I am a first year human biosciences student, so hardly an expert, but I wonder - if BCG boosts the immune system how will this affect people with undiagnosed autoimmune conditions? Because if given to children/teenagers this may not be apparent till later.

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    Replies
    1. Well, ask and discuss that kind of question with experts, please! I hardly know how immune system works..

      Delete
  5. Hi Jun, I'm a Canadian physician whose biotech company has developed an immunotherapy platform based on a similar concept (microbial derived innate immune activation). I'd like to speak with you about this. Please connect with me by email at hal@qubiologics.com Thanks!

    ReplyDelete
    Replies
    1. I'm not familiar with biotech industry (a little familiar with pharmaceutical industry) but I'm interested in all kinds of businesses. If you can send me a deck to junrontaro@gmail.com, I'll check it! Thanks!

      Delete
  6. Thank you for your great analysis. I am Japancese Scientist (not in the field of medicine). Your speculatio n is based on a kind of "Inductive reasoning", but seems to be highly persuasive. Now we must check the experience of BCG and its kind of many patients. Data of China and data of the case of "Diamond Princess" will be helpful, in which various nations were on board. Also, I remember weird information that the captain of "Diamond Priincess" was italian.

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    1. Thanks for the praise. As I am not a scientist, just a business person Shounin, there should be many mistakes in the eyes of scientists. Your input/feedback helps me.

      What I can use is only Google and Google doesn't tell me enough information about China. China data should be obtained and examined by the experts.

      Yes, Diamond Princess is the live examples. If we can track the numbers by the nationalities, there should be some findings. But I couldn't find those numbers.

      Delete
    2. Dear Jun. I was impressed by your sincere reply to increase the knowledge of the people about this issue. Thank you also for adding new figure showing income of each nation. Perhaps people in low income countries have been exposed to Tuberculosis in the life history, and have acquired bio protection systems naturally even without individual BCG experience. Off course, existence of BCG program strengthens the bio protection system socially.

      Delete
    3. I added a short description of China.

      Delete
    4. I respect your effort. Even the small content can become the great starting point. I think WHO must make pressure on China for opening medical information. Present WHO always aims to talk about something mild.

      Delete
  7. Very interesting. I know that Dutch scientists are looking into this vaccination as well.

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    Replies
    1. Yes, I'm looking forward to that result. I know I don't need to input as they are the experts, but I would like to make sure they examine several strains of BCG vaccines. BCG Denmark or the others may not be that effective. BCG Russia/Japan/Brazil should be examined.

      Delete
  8. Very interesting story.
    COVID-19 seems to harm elder people.
    I just remember older BCG was not stamp type but just usual injector type
    before around 1960 in Japan.
    I'm just curious whether same BCG had been injected or not regardless of
    method anyway....

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    Replies
    1. I think BCG Tokyo 172 strain has been injected since 1920's in Japan. After the WW2, some Japanese scientists were against the idea of injectiong BCG to the people mandatory, but the Supreme Commander for the Allied Powers (USA) insisted the importance of the vaccination. Thus Japan started to inject the BCG to every citzen in 1951.

      I met a man who was born in 1949 this afternoon, and he told me he had the injection when he was around 7 years old. He was suggesting me that many senior citizens had the BCG injected when they were young in the post-war era.

      Delete
    2. "Thus Japan started to inject the BCG to every citzen in 1951."
      I meant "Thus Japan started to inject the BCG to every new born baby in 1951."

      Delete
  9. Sato-J san, long time no seeing you. Thank you for putting up a great analysis. This really is an interesting hypothesis. I myself have written a couple of articles. The following is the recent Japanese version. You can find English version in the same Medium account. I hope you'll enjoy reading it. https://bit.ly/2UACQTh

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    1. Eisuke-san, long time no see! Your analysis is interesting.

      I guess that social distancing policy in countries where BCG vaccine is mandatory works well.
      But in countries where BCG vaccine is not mandatory, I think social distancing is not enough. Total lockdown/shutdown should be required. That's my instinct without any calculation :)

      Delete
  10. Really interesting and gives us some hope! Another thing I noticed was Equador is the only country in South America with no BCG policy. Checking the data would appear that it also has the highest rate per million of CV in South America and there is probably less movement of people(tourists) than other countries in the region. Here in the UK, Jews and Muslims have died from CV disproportionately. It appears that Orthodox Jews may have been opposed to the BCG vaccine and to a lesser extent Muslims

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    1. I added Ecuador topic half a day ago. Yes, that example strengthen the validity of this hypothesis.

      I didn't know that Orthodox Jews and Muslims have been opposed to the BCG vaccine! Thanks!

      Delete
    2. Sorry didn't read that you mentioned Ecuador but here's another for you. Nigeria used the Japanese vaccine. Other large West African countries - Ghana, Senegal and Ivory Coast have similar rates but much higher than Nigeria

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    3. Could you show the source?

      The below website says that Nigeria uses SSI as BCG strain, which seems to be BCG Denmark.
      http://www.bcgatlas.org/

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    4. https://pbs.twimg.com/media/EUK7B_eUYAADHpE?format=jpg&name=medium

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    5. The map and http://www.bcgatlas.org/ have different information. Hmm.

      Delete
  11. Thank you for the very interesting and well-founded report. I am a Japanese office worker. The content of the report was, of course, significant, but there is also a significant things. It is a breakdown of the number of infected people in Japan. In Japan, it has not been announced that non-Japanese people is 415 and Japanese is only 934 people! It was reported that the number of infected people in Tokyo increased on 28th, but from 4 days ago, half of the infected people in Tokyo were hospital-acquired at EIJU hospital and half of those returned from foreign country, that is, ordinary infected people are not increasing exponentially, but those things are not almost reported.

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    Replies
    1. The breakdown by citizenship in Japan cases is written in this article a little.

      BCG vaccination seem to reduce the risk of the novel coronavirus but it's not perfect at all. The novel coronavirus may still be a few times stronger than influenza. A few times means significantly in exponential growth. Let's take care and keep the social distance.

      Delete
  12. 日本語ですみませんが、
    肺炎予防で高齢者にBCGを摂取した臨床例があるようですので紹介します。
    赤ちゃんや子供の時ではなく高齢者になってからの摂取でも有意に効果があったという結果のようです。

    高齢者へのBCGワクチン、肺炎発症の予防に効果 2003年の記事
    https://medical.nikkeibp.co.jp/inc/all/hotnews/archives/237265.html

    その他の記事

    BCGはなぜウイルス感染予防効果があるのか(2018年1月号 Cell Host & Microbe 掲載論文)
    https://aasj.jp/news/watch/12665

    ReplyDelete
    Replies
    1. Twitterをやっているのですが、そちらで↓のようにツイートしました。
      https://twitter.com/j_sato/status/1243900209236590596

      ただ、医学・薬学的なことは私には全くわからず、BCG接種済みの健常者が再度接種すると悪影響もありえると思われ、そこは専門家の意見・臨床結果を待ちます。

      Delete
  13. https://www.medrxiv.org/content/10.1101/2020.03.24.20042937v1

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  14. https://www.medrxiv.org/content/10.1101/2020.03.24.20042937v1

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    Replies
    1. Thanks, Victor's Feat! I didn't know that there is an article analyzing the correlation. I added one chart from this article. Thank you!

      Delete
  15. This has been one of the most interesting write-ups I have read on the pandemic, thank you!

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    1. Thanks! I hope BCG vaccine help stop this pandemic (and my business comes back) !

      Delete
  16. 大変興味深い分析です。
    データ分析でCOVID-19に貢献しようという試みはいろいろと行われております。
    こちらに書き込まれてはいかがでしょうか。
    https://www.kaggle.com/data/139140

    ReplyDelete
    Replies
    1. Well, if you read this carefully, you'll notice that I don't even use Excel or spreadsheets by myself. My colleagues usually take care of analysis part and I'm not good at those things ...

      Delete
    2. kaggleのコメントの方にGCGワクチンの接種、株を追加した方が良いのではということで記載させていただき、リンクを張らさせていただきました。

      Delete
    3. ありがとうございます!

      Delete
  17. 1 / 3 of the Japanese cases are none-Japanese. It favorites your hypothesis.

    https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/0000164708_00001.html

    ReplyDelete
    Replies
    1. It is mentioned in my article. But, I don't like the statements like "Japanese are safe" because 1) The risk of infection is not 0 or 1. The more your are exposed to the virus, you'll get infected anyway with/without BCG vaccine. 2) Japan could be lucky but it's just a luck.

      This pandemic is a global crisis. I would like to discuss and solve globally. This is the reason I wrote this post in English, which I am not good at writing.

      Delete
  18. I am an ex journalist from Germany. All your data and comments on the situation here are correct! Chapeau!

    ReplyDelete
    Replies
    1. Thanks! As I am not familiar with German geography/history, I welcome analysis by German experts...

      Delete
  19. This comment has been removed by the author.

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  20. Jun, good day! How may I contact you for possible business opportunity?

    ReplyDelete
    Replies
    1. Good day to you, too. you can email me to junrontaro@gmail.com. Thanks.

      Delete
  21. Bravo! Very good observations

    ReplyDelete
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    1. Thanks! Yes, I do only observation, not analysis :)

      Delete
  22. Thank you for this careful and well-reasoned analysis. You raise some interesting points.

    I would like to offer a rebuttal to some of the arguments here. Firstly, the quality of the data is very variable between different countries so I will focus on countries for which I have some perspective on how good the data is likely to be.

    1. Regarding your map of Germany, the distribution has a much simpler explanation: those red regions are the ones closest to France and Italy, with which Germany shares a free travel area. (The German data is likely very good because they are doing extensive testing. Note the cases to deaths ratio.)

    2. Young people are more likely to develop serious symptoms in areas with major outbreaks, especially among frontline medical staff, because of prolonged exposure and exhaustion. Overall the mortality rate for young people remains well below 1% so countries with few cases are unlikely to see any. I think your observation on this matter is not statistically significant.

    3. The difference between Australia and Japan may be due exclusively to testing rates. Note that Australia has recorded only 16 deaths to date, compared to Japan's 52. Japan's government has repeatedly stated it sees no point in extensive testing.

    I'll post more later.

    ReplyDelete
    Replies
    1. Thank you for your valuable inputs. Very constructive arguments.

      1. I agree that Germany case is weak. I picked up Germany case because I would like to have a case that the factors other than the BCG vaccine policies are almost same. But as you point out, many factors are also different between ex-West and ex-East. Maybe I should cut it down.

      2. Yes, this younger generation point is not statistically significant. As this disease is naturally skew to elderly, we see fewer data points for the younger generation.
      But, I found and added the death rate by age group in Spain. This fact may not be statistically significant but looks convincing. Please check!

      3. Death rate per million: Japan 0.4, Australia 0.7.
      The following important factors are different and it's hard to compare.
      - The timing of the virus arrived: Japan --> Australia
      - The normal social distance, population density: Japan >> Australia
      - The timing and strictness of social distance policy: Japan <<< Australia

      Delete
    2. Please, don't cut down Germany. Your hypothesis fits better than proximity of borders. Thuringia and Hesse are both inside of the country and differs drastically. Also, to the south of Germany is Austria and Switzerland, not Italy. And this countries should suffer more according to the proximity theory.

      Delete
    3. Hi chilicoder, thanks for the comment. Your comment helps a lot since I know little about Germany. I'll keep the Germany part in the article.

      Delete
    4. Switzerland has a very serious outbreak in terms of per capita infections/deaths. Austria profile looks similar to Germany.

      I accept that I didn't consider many cofactors in the Japan/Australia comparison. I just wished to highlight that the cases/deaths ratio in Japan and Australia look very different. I suspect this is because of more extensive testing in Australia. But I didn't take into account how long the cases have been developing.

      Delete
    5. Japan certainly seems anomalous in the world data. Why haven't we had an outbreak here? And why was Italy hit so hard? The idea that vaccination programs have something to do with it is tantalising.

      Perhaps the most appealing part of your data to me is that the European countries that have never had a mandatory BCG programme (Italy, Belgium, Netherlands) are, discounting countries with very small populations, at the top of the list in deaths per capita. Only Spain sneaks above Belgium and the Netherlands.

      By the way, I haven't yet read through all of your arguments, but I intend to.

      Delete
    6. I accept that German case is somewhat controversial. But as I said this would be the only one country that had different BCG policy in the past. So, let me keep this.

      BCG vaccination seems not to stop getting infected but stop getting severely ill/pneumonia. I guess that not a small number of Japanese are already infected with symptom or without symptom but they don't go bad as the younger generation in Wuhan didn't die. Not a small number of people in Tokyo said they had a cold. But there's no data. This is just my guess.

      Delete
    7. >日本は、他の肺炎の死者に、covid-19の死者を含めている

      肺炎死亡者は「必ず」CT検査→PCR検査します。covid-19の「見逃し」はありえません。
      PM Abe「肺炎で死亡した人は必ずCT検査し、間質性肺炎の人は必ずコロナを疑いPCR検査する。間質性でない人は細菌性等でコロナではない。新型コロナが見逃されることはない」
      Abe会見1:03ー
      https://youtube.com/watch?v=a9xFi8g7eiI

      Delete
  23. It doesn't explain high mortality rates in UK and France where BCG stopped recently. Those number of death capita are not that high but they are in the beginning compared to Italy and Spain.

    ReplyDelete
    Replies
    1. West European countries have used BCG Denmark strain and that strain may not be as effective as BCG Russia/Japan/Brazil. But BCG Denmark is better than no BCG. This is my hypothesis/observation.

      Delete
  24. did post yesterday but not showing, in Poland, the first vaccinations were carried out in 1926 (according to other data, they were already available in 1924). The production of the Moreau Brazilian vaccine and vaccination began in 1955.
    https://www.mp.pl/szczepienia/specjalne/199144,czy-w-polsce-powszechne-szczepienie-bcg-jest-nadal-uzasadnione

    ReplyDelete
    Replies
    1. I looked at Poland data for the first time. Poland has been doing quite well against COVID-19! BCG Moreau(Brazil) looks working!

      Delete
  25. The biggest problem here is that we have the same 20%/day growth of the number confirmed cases in Russia as anywhere else: https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_Russia
    The only difference is the starting point. https://s3.zona.media/entry/70793a3f5aac07413fa151a84425669e
    Also you should divide the Germany #cases map by the population density of each region.

    ReplyDelete
    Replies
    1. From what I see, Russia is doing well comparing with the other countries.
      https://www.ft.com/coronavirus-latest

      Of course, BCG vaccine is not perfect. The more you expose yourself to the virus, more likely you'll get infected. Social distancing is important. If you keep the distance, I guess Russia can manage this.

      Delete
  26. It seems UK continued with BCG from this article: https://www.healthcentre.org.uk/vaccine/who-gets-the-bcg-vaccine-in-the-uk.html?fbclid=IwAR2dXQf9CJjEvXLVL-_e7z4zEDvl6-YLbErq8N9T503GcAvw89PN7sS9VXo

    ReplyDelete
    Replies
    1. West European countries have used BCG Denmark strain and that strain may not be as effective as BCG Russia/Japan/Brazil. But BCG Denmark is better than no BCG. This is my hypothesis/observation.

      Delete
  27. I performed an additional analysis to examine Mr. Jun Sato's BCG hypothesis on immunity enhancement against COVID-19.
    (pdf) https://www.dropbox.com/s/56763vddeybclv1/COVID-19%20death%20vs.%20BCG%20policy.pdf?dl=0
    (excel) https://www.dropbox.com/s/1q0p19at2pwys0r/COVID-19%20death%20vs.%20BCG%20policy%20%28full%29.xlsx?dl=0

    The focus here is on the increase rate of the number of deaths, not the number of confirmed infections nor fatality rate. The doubling time is calculated by comparing the date when the number of death exceeded 10 for the first time with the current figure, so that we can better reflect the slope on the logarithmic graph. The analysis only covers 22 countries with more than 50 deaths. As a result, in six countries where the doubling time exceeds 4.0 (Indonesia, Iran, Philippines, Japan, S. Korea, and China), BCG vaccinations are being performed for younger generations. On the other hand, Portugal, Brazil, and Turkey have BCG vaccinations, but the rate of deaths is increasing rapidly. The reason may be that the statistics period is too short.
    According to this calculation, Iran would rather classified as a calm group.

    ReplyDelete
    Replies
    1. The increase rate of the number of deaths might depend on many parameters like the population density. For instance, a huge country like Russia would take much longer period to double the number of deaths than that of Japan if other condistions were the same.

      Anyway, we should wait for weeks or maybe months to see if this hypothiese was something meaningful.

      Delete
    2. Thanks for your analysis.

      I checked the year introduced and the strain of BCG program. Portugal: 1965, the strain is unknown, Brazil: 1976, BCG Moreau(Brazil), Turkey: 1952, the strain is unknown.

      Brazil is pretty late to introduce its BCG vaccine program though Brazil has its own name of first-generation BCG strain. Portugal is also late as I wrote some in the article. Turkey cannot be explained well. It is between Iran and Italy. Maybe another factors.

      Delete
  28. Hi, thank you for your article. This made my day. My son was born in the UK in 2002, and he was recommended to have BCG vaccination based on his ethnicity (half Japanese). It wasn’t mandatory for every baby.

    ReplyDelete
  29. So, what is your explanation for Canada's rates being so low? We do not have mandatory BCG vaccinations here, and those who do get it get one of the insufficient strains per your write-up.

    ReplyDelete
    Replies
    1. The USA had only 350 cases three weeks ago. We just cannot conclude if this hypothese is true or not true now.

      Delete
    2. I did s quick observation of Canada and added above. Canada case validates this hypothesis much stronger!!! Please check the above!!!

      Delete
    3. The plot of age distribution of cases in Canada is likely explained by the base rate - there are simply many more people in the 30-60 age category so even if infection rate in these age groups is lower, those groups would still dominate.

      Delete
    4. I agree. I'm looking for hospitalization/ICU/death rate by age group for Canada but so fa I cannot find. Please let me know if you find it.

      Delete
  30. My friend was born and raised in Newfoundland, Canada in 60s. She said that TB vaccination was mandatory there. https://www.heritage.nf.ca/articles/society/fighting-tuberculosis.php

    ReplyDelete
    Replies
    1. Thanks. The map seems to be wrong about Canada. Elder Canadians seem to had BCG vaccination.

      Delete
  31. This comment has been removed by the author.

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  32. Einstein was a patent officer when he wrote the three revolutinary papers in 1905. The Wright brothers were bicycle shop owners when they flew their first airplane. Sometimes an amateure starts a revolution. I hope Mr.Sato did it, too. At least in Japan, this analysis has attracted some scientists in the field.

    佐藤さんはこの研究を間違いなく楽しまれていると思います。そして結果として人類に貢献できたとしたらどんなに素晴らしいことでしょうか。仮に的外れであったとしてもこの経験は佐藤さんだけでなく私達にとって貴重なものになると思います。私も負けてはいられません。

    ReplyDelete
    Replies
    1. Thank you so much for this article. It gives us hope.

      Delete
  33. 一昨日、私はこのブログの記事に辿り着きました。まず斜め読みした段階で直感的にあなたの仮説に興味をもち、そしてじっくり読みこみました。これら統計データから導き出された佐藤さんの仮説には大変説得力があると感じました。
    今ネットでは日本株BCGワクチンが社会学者を巻き込んで話題になっていますが、これに火をつけたのはまさしく佐藤さんだと思います。医学的根拠が乏しいのでコメントできないのは理解できますが、日本の医療関係者からの発言がまだあまり出てきていないのが残念です。早く医学的な検証作業に入っていただき、少しでも可能性があるなら至急世界にBCGワクチンを広めて欲しいと思います。今後も注目していきます。良い記事を有難うございました。

    ReplyDelete
    Replies
    1. 追伸)あなたのツイッターも読んでいます。現時点で医学系専門家からの反応があまりないことに、焦らないでください。新しい情報を加えて、整理した続編を作って発表してください。期待しています。

      Delete
    2. ありがとうございます。続編書くほど余裕がないです。。

      もしこの仮説が正しいなら即解決策につながる可能性があるわけなので、専門家の方々には、目下の世界の危機の前で、評論家的に「様子見」はしてほしくないです。。

      Delete
    3. 平野俊夫先生の記事を読みました。ようやく専門家の方々からの発言が出てきましたね。しかもJun Satoさんの仮説を高く評価をされています。日本株BCGを世界が待っていると思います。とにかく早く動かさないと!

      Delete
    4. 平野俊夫先生、存じ上げなかったのですが(汗)、免疫学の世界的権威の方のようでして、光栄であります。各方面の専門家に迅速に検証して頂きたいです。

      Delete
  34. Surely all doctors are given BCG during training? And yet they have been dying at high rates.

    ReplyDelete
    Replies
    1. Some Australian health care workers are getting the BCG vaccine.
      https://foreignpolicy.com/2020/03/24/coronavirus-vaccine-health-care-workers-bcg/

      Delete
    2. https://www.clinicaltrialsarena.com/news/australia-bcg-vaccine-trial-covid-19/

      this week

      Delete
  35. Thank you for the great article and very valuable observations, Sato-san! I am just a layman from Ukraine, now living in Poland. Our spread and mortality rate here seems to be low, probably thanks to mandatory ex-soviet strain of BCG. How do you explain high mortality and spread rate in the Wuhan province? Do they have a different strain used for BCG?

    ReplyDelete
    Replies
    1. I'm sorry that I don't see a clear data set of BCG vaccination in China. I heard it varies by region and Wuhan region may be late to introduce BCG vaccination. That might be the reason in high death rate in elderly and very low death rate in the younger generation. I also heard that China use a different strain but couldn't take time to confirm the detail.

      One more important thing is that even if we are BCG vaccinated, we should take be careful with this awful virus. If we think of it as "just another flu", the Wuhan crisis can happen to the countries where BCG vaccine is mandatory.

      Delete
    2. I think you probably should mention that in your article because many readers could have this question.

      Delete
    3. Agree but not with me. If I start to write about China, I guess I will need to look into many new information and it will take at least a day, may be a few days... I'll wait for a China expert...

      Delete
    4. I was wondering about Wuhan, China claims to have 100% BCG coverage. Yet there have been serious outbreaks of TB in Hunan to the North of Wuhan very recently. Maybe cities like Beijing and Shanghai had good coverage but not so much central regions which again would make sense

      Delete
    5. The BCG vaccination is not perfect to protect from TB. They say it can reduce the cases by about 60%.

      Delete
    6. I added a short description of China.

      Delete
    7. You will find a description of China in this article:
      http://rs.yiigle.com/CN11215419829506/1087588.htm

      Delete
    8. @KR,

      Is the description in the post consistent with the article you mentioned?

      Delete
    9. Most important part: "According to preliminary statistics, the national total of vaccinations administered to children under 15 is 500 million as of 1979." + previous in selected cities.

      Delete
  36. Instead of using total cases, use cases/1000 people as metric for clarity.

    Also, region which are travel hotspots & higher income tend to have more cases.

    ReplyDelete
    Replies
    1. What part are you talking about? Germany part?

      Germany part has been updated with cases/deaths per 100,000 population by a reader.
      https://twitter.com/takainou_0907/status/1243754536138731521/photo/1

      What is your hypothesis regarding income?
      There are rich countries with disaster and without disaster; Italy and Japan. There are developing countries with disaster and without disaster; Iran and Iraq.
      I see that people in low income countries are more exposed to TB and may be more immune to the coronavirus or pneumonia. Do you think that ex-East Germany people are more exposed to TB?

      Travel hotspost may have a little impact. Your analysis/contribution is appreciated.

      Delete
    2. If we talk about travel hotpots, Bangkok is the most visited city in the world. Would have been so many visiting yet so few deaths. They used the Japanese strain of BCG previously

      Delete
    3. This is strange to us (Thai people too), as we are very late on introducing social distances, and locked down. We even welcomed tourists during the early-mid-late February from China and everywhere.

      All Thais that came back from South Korea after super spreading, they have zero rate of COVID-19

      Delete
    4. @Supawat,

      Do you think http://www.bcgatlas.org/ is correct for Thailand? It says Thailand started BCG vaccination in 1977. Don't elderly Thai have BCG vaccinated?

      Thailand uses BCG Tokyo, which seems very effective so far.

      Delete
    5. @Supawat,
      Also, don't you know the number of test conducted in Thailand? I'm googling but cannot find it.

      Delete
  37. This comment has been removed by the author.

    ReplyDelete
    Replies
    1. すみません。単なる漏れです。多方面から色々来てまして。m(_ _)m

      Delete
  38. ちょっと気になったんで調べてみたんですが、サッカーJ1選手で初の新型コロナ陽性になった酒井高徳は、2歳までニューヨークにいたそうです。もしかしてBCGをやってない可能性があるのかも? https://ja.wikipedia.org/wiki/%E9%85%92%E4%BA%95%E9%AB%98%E5%BE%B3

    ReplyDelete
    Replies
    1. BCGワクチンは、感染自体を防ぐというよりは重症化・肺炎を防ぐ働きがありそう、といったところです。なので感染だけだと何も言えないかと思います。
      もし酒井高徳選手が重症化したら、BCGワクチンを受けていない可能性は高いかと思います。

      Delete
  39. The comment system is not working properly. I posted on the behalf of "Unknown".
    ---
    Japan certainly seems anomalous in the world data. Why haven't we had an outbreak here? And why was Italy hit so hard? The idea that vaccination programs have something to do with it is tantalising. Perhaps the most appealing part of your data to me is that the European countries that have never had a mandatory BCG programme (Italy, Belgium, Netherlands) are, discounting countries with very small populations, at the top of the list in deaths per capita. Only Spain sneaks above Belgium and the Netherlands. By the way, I haven't yet read through all of your arguments, but I intend to.

    ReplyDelete
    Replies
    1. Thanks.

      Spain had its BCG vaccination program between 1965 to 1981. Short and late start. This means there are many elderly who had not BCG vaccine.

      Delete
  40. The comment system is not working properly. I posted on the behalf of "Unknown".
    ---
    I was wondering about Wuhan, China claims to have 100% BCG coverage. Yet there have been serious outbreaks of TB in Hunan to the North of Wuhan very recently. Maybe cities like Beijing and Shanghai had good coverage but not so much central regions which again would make sense

    ReplyDelete
    Replies
    1. Diving into China data will take my days... I'm waiting for a China expert examine this hypothesis.

      Delete
    2. I added a short description of China.

      Delete
  41. The comment system is not working properly. I posted on the behalf of "Unknown".
    ---
    The BCG vaccination is not perfect to protect from TB. They say it can reduce the cases by about 60%.

    ReplyDelete
    Replies
    1. Yes, I heard so. And also I heard that BCG vaccination has still a lot of mysteries for doctors. We don't really know yer how it works and for what.

      Delete
  42. フランス在住です。BCGワクチンは国ごとに遺伝的な違いがあること知らなかったです。
    ウイキペディア百科事典の日本版と他の国と比べてもかなりばらつきがありました。
    下のアドレスはBCGワクチンのウイキペディアの英語版です。
    https://en.wikipedia.org/wiki/BCG_vaccine
    フランスでは1950年から一般の人のBCGワクチン義務付けられて、1947年から看護師の学生、社会福祉、生物学、医師や、国の支援を受けている人はこのワクチン義務付けられていました。2007年7月で義務付けは解除されました。結核が多い国で生まれた人、親のどちらかが結核の多い所の子供にワクチン勧められてます。看護関係者は現在もBCGワクチンは義務付けられてます。 今回新型コロナウイルスに感染した医者5人亡くなっています。年は60から70歳です。BCGワクチン打っていると思います。フランスの医師にSatoさんの書いている事、話してみたら免疫は普通の人より高いけどやはり人によるようです。
    BCG ワクチンを使った所と使わない所の違いは、ヨーロツパの場合、移民者が沢山いるので国でグラフに当てはめても、正確にはでないよう思いました。
    後は、先月ではイタリアの患者がフランスで手当てしていたり、フランスの患者がドイツ、スイスで手当てして亡くなった場合、その場所で統計出されます。
    フランスで一番はじめに亡くなったのは観光客の中国人です。
    この方はフランスの統計に入ってます。
    BCGワクチンは大人になってから打つと50%しか効かない事も書かれているものありました。
    自分もSatoさんが言う、日本のBCGワクチンの方が新型コロナウイルスの力を弱らせているのは、考えられると思います。


    ReplyDelete
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    1. No BCG vaccination < BCG Denmark << BCG Russia/Japan/Brazil

      Delete
  43. I understand from my wife of 53 years that in the (former) Republic of South Africa, every baby got a BCG stamp. Our four children were born between 1968 and 1973.

    ReplyDelete
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    1. That's good to hear. Checking the strain would be even better.

      Delete
  44. I understand from my wife of 53 years that in the (former) Republic of South Africa, every baby got a BCG stamp. Our four children were born between 1968 and 1973.

    ReplyDelete
  45. Interesting. A bit of a head scratcher how that works, but it's possible.

    Something not being discussed is that the Americas is where the native genotype is more susceptible to death from influenza, coronavirus, adenovirus, etc.. I have a manuscript I put on hold 10 years ago when I got to where I would have to go to the national archives to comb through papers on the Indian Health Service. But, the records I do have from Plymouth Colony (easy to find) talk about 95% die-off of natives from diseases that just caused the settlers sniffles. There are accounts from the Pacific Northwest of similar death rates. The vast majority of Native Americans in the temperate zone died of the Eurasian disease pool. In the 1918 pandemic a native village in northern Canada had 50% total population loss.

    Going south, the hot deserts, warm and humid weather, and in the Altiplano a lot of ultraviolet helped keep infection rates down. As part of that thought process I did a study and published this paper. Short version is that in the tropics, due to air conditioning, these diseases propagate much better. https://www.ncbi.nlm.nih.gov/pubmed/20470403

    I am expecting that we should see higher rates of death in all age groups for people of native American ancestry.

    ReplyDelete
  46. I love this hypothesis. Yes, BCG may wear off in old age. Some kids needed extra doses in middle school. I was one of these kids growing up in Yugoslavia. Here is an idea: I am sure everyone in Yugoslavia received same BCG type until 1990 and now there are different strains used in the separate states. Compare Slovenia, Croatia, Bosnia, Serbia, Montenegro and North Macedonia (FYROM)!

    ReplyDelete
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    1. Your analysis/contribution is welcomed!

      BTW, I went to ex-Yugoslavia countries twice more than twenty years ago and I love that region. I have Stojković's autograph :)

      Delete
    2. How great!! Stojkovic (Piksi) is a hero! :)

      BTW I've lived in Chicago half of my life (since grad school - engineering), so I also have fascination with medical discrepancies in USA vs. Old country. Based on my analytics experience, there has to be something about this correlation, and I hope your research contributes to understanding of the immune system one way or another.

      I've googled the whole afternoon, and it is impossible to find comprehensive past vaccination info without full access to historic immunology journals, but so far
      - "On November 7, 1926, the Hygiene Institute in Belgrade received BCG culture from the Pasteur Institute in Paris. The strain was marked as No. 327."
      - "... In 1927, only a year after its original appearance in France, Dr M. Rankovic produced the first BCG vaccine in Belgrade. In 1937 both the Zagreb and Belgrade Institutes of Hygiene prepared toxoids for mass immunization..."
      - Bulletin of the International Union Against Tuberculosis and Lung Disease, Volume 63
      "... Pasteur strain sent every year to Belgrade ..." (not sure if Pasteur's strains had changed over time, in 1961 perhaps?)
      - Definitely mass vaccination happening after WWII (1945 or so)
      - Country started breaking apart to states in 1991
      - Slovenia follows EU recommendation
      - Serbia, Montenegro, and Republic of Srpska (Eastern Bosnia-Herzegovina) are getting the Calmette-Guerin (Pasteur) vaccine (made by Torlak in Belgrade)
      - Croatia and FBiH (Western Bosnia-Herzegovina) are getting the Calmette-Guerin substrain Brazilian Moreau (Biomed Lublin)
      - Not sure of North Macedonia strain - (I would bet it's Torlak) and not sure if it is completely mandatory in Macedonia nowadays either.
      I'll be following this closely! Cheers, and thank you so much!!!

      Delete
    3. Thank you for your search and detailed info. It's really hard to gather the detailed BCG vaccine information.

      So far, ex-Yugoslavian countries are doing better than western Europe countries but not as good as Japan or Thailand. The strains may not be as effective as BCG Tokyo.

      I recommend to keep strict social distancing.

      Delete
    4. Greetings from Chicago, where it is ... not that great.
      Seems ex-Yu will indeed get it under control faster.
      All the best!

      Delete
  47. Hi, thanks hugely for this, as a layman's hypothesis it is very interesting. Particularly to me, and many other foreigners living in japan, as we can probably get this vaccine very easily (I'm going to try this morning). I am about to rush a very rough japanese translation of your article, however if you already have done that could you post a link so I don't waste time duplicating your efforts? thanks. I'm from the UK and have been shouting like crazy on social media all week about coronavirus in Japanese, see my posts on youtube, also twitter @tensaimon instagram kusaimon and Facebook Simon Robinson. I really hope this has an effect, if the Japanese strain really is even moderately helpful and doesn't have risks, Japan can probably ramp up production very quickly and start exporting. Thanks!

    ReplyDelete
    Replies
    1. An healthcare expert has cited my blog and add some medical information in Japanese.
      https://nosumi.exblog.jp/28020527/

      If you know both U.K. and Japan, especially the city parts, you agree that there's something different and BCG vaccine policy/strain may be the one.

      Delete
  48. The comment system is not working properly. I'm posting on the behalf of "Keiko Fukuda".
    ---

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3710928/

    1988年に日本からの輸入が完全にストップ。それまでは50%のシェアと最後の方に書いてあります。

    https://www.statista.com/statistics/1102730/south-korea-coronavirus-cases-by-age/

    韓国の20代の感染者が突出しているのと関連?メガクラスターとなった新興宗教に若い人が大勢いた、という可能性もあるのですが。

    別のところの指摘で、日本の外国人率が高いのは、渡航歴があるからpcr検査受けられる、ということが言われていました。それにしても多いとは思いましたが、なるほど、とも思いました。
    BCGをしているから感染しないわけではなく、重症化しない(しづらい)、ということを考えると、陽性者数ではなく、重傷者、死亡者とBCGの関係を比較することがより有益かもしれませんね。
    個人的にはR0との関係(スーパースプレッダーはBCG非接種?)に興味があります。

    ReplyDelete
    Replies
    1. これは面白いデータですね。

      Delete
    2. The summary of the above comment:
      Korea imported the Tokyo 172 strain, and the market share was 50%. But Korea stopped using the strain in 1988. If you take a look at the age share of the cases, 20-29 has the largest.

      Delete
  49. Very interesting analysis. I am from Myanmar, the county in which BCG vaccine is routingly given to children since 1978 (not sure what strain it is). Coincidently Myanmar is also one of countries still doing well compared to others. For a country of over 50 millon, confirmed case is only 15 (as of March 31) with one death (the patient was already suffering from cancer). This hypothsis may sort of explain Myanmar situation.

    ReplyDelete
    Replies
    1. Good to hear! Let me know if you get strain information.

      Delete
  50. Hi Jun - a great blog post you have put together. Thank you for sharing your comprehensive thoughts and findings. Sometimes it takes an amateur to spot the simple things that experts will overthink and miss.

    Saying that, it seems this has truly been picked up by the experts now - many citations in the UK mainstream media (even the most awful of all publications: https://www.thesun.co.uk/news/11292581/anti-tb-injection-protect-against-coronavirus/) with trials running in healthcare workers in Australia, and in the elderly here at the University of Exeter.

    As a 29 year old English citizen, with the tell-tale BCG mark on my upper left arm, I wanted to find which strain I would likely have received (unfortunately seems like the Denmark strain - better than nothing!). This website (https://vk.ovg.ox.ac.uk/vk/bcg-vaccine) sums up the UK approach:

    "The BCG vaccine was introduced into the UK schedule in 1953. At first it was offered to children of school leaving age (14 years old) because TB was most common in young adults at this time. Rates of TB in the UK were already falling, and they continued to fall after the vaccine was introduced. In the 1960s it was realised that there were higher numbers of TB cases in people coming to the UK from countries with high rates of TB. At this point BCG vaccination was introduced for babies born in the UK to parents from countries with high rates of TB. Vaccination of all children aged 10-14 continued until 2005, when it was decided that TB rates in the general population had fallen to such a low level that universal BCG vaccination was no longer needed. The UK programme now targets babies and children who are most at risk of exposure to TB, with the aim of preventing the more serious childhood forms of TB."

    In my research I have found some very interesting papers, which I'm not sure if you've come across yet (apologies if these are some of the sources you've already cited). Some explain more about the theories of different strains being more useful with COVID-19 - e.g. T-Cell activation - and some give evidence to which strains have been/are used in other countries. These are a few of the favourite papers I've come across:

    "History of BCV Vaccine"
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3749764/

    "Strain-Dependent Variation in Mycobacterium bovis BCG-Induced Human T-Cell Activation and Gamma Interferon Production In Vitro"
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1932901/
    [funded by Glaxo]

    "Influence of BCG vaccine strain on the immune response and
    protection against tuberculosis"
    https://academic.oup.com/femsre/article/32/5/821/2399125

    Also, this article is very interesting, taking this theory one step further - looking at giving IMM-101 as a vaccination, with similar but better actions than BCG:

    https://www.telegraph.co.uk/news/2020/03/30/have-found-missing-ingredient-coronavirus-vaccine/
    (You can bypass the paywall using your favourite method, for me that's simply by clicking 'stop' in the browser as soon as the article loads but before the paywall appears. It is criminal these mainstream publications are still using paywall for COVID-19 articles.)

    I am also particularly interested to see where the UK goes. We are often left out of these comparisons/discussions, or seen as some kind of outlier, but there's nothing to say our numbers aren't following in the footsteps of, and are soon going to be near Spain/Italy... unless our Denmark BCG gives us a little something extra.

    I have always been a fan of reading, writing, research and am a layman-turning-professional myself in another health science field. I hope to follow further updates to your blog post and see where the next weeks and months take us. I also agree overall that this is only going to be an added benefit, not a cure-all, and we still need to take social distancing and all other measures very seriously.

    Thank you for your time spent on this so far.

    Eleanor

    ReplyDelete
    Replies
    1. Thanks for sharing this Eleanor. It looks like IMM-101 could be really a game changer.

      Delete
    2. Hey Eleanor, IMM-101 could be really a game changer!!! I know nothing about it but the article says we can have it multiple times as we get infected!

      I know little about BCG vaccination either but my worries are;
      - Can adult or elderly have it? There are some articles saying that elderly can have BCG vaccines, though.
      - Can we have it again? When can we have it again? This question is not answered yet and IMM-101 could be a better option!

      Delete
    3. I cut the IMM-101 part because
      1) The writer of the article is an advisor of the maker. The article might be beneficial to himself.
      2) Effectiveness of IMM-101 is not proved like BCG Russia/Tokyo. Below is a comment by Dr. Toshio Hirano, one of the best authorities in immunology.
      https://gyazo.com/e7e9422d476ce8726c63584678d3ba0a

      Therefore, I would say BCG Russia/Tokyo would be a surer choice, with ongoing epidemiologically prove.

      Delete
  51. 日本語失礼します。
    数日前に下手な英語でコメントさせていただいたものです。どんどん注目を浴び、どんどんエビデンスが出てきますね。春節で大量に中国人も受け入れ、そして在宅勤務が進んでるにも関わらず今日も結構混んでる東京の通勤電車に押し込められていたら、個人的には東京がイタリアにならないのは手洗いマスクだけじゃ無理、絶対理由があるはずだと思っています。
    今日はこんな論文を見つけて統計の裏付けを楽しみました。各国の治験結果がたのしみです。
    https://www.medrxiv.org/content/10.1101/2020.03.24.20042937v1.full.pdf

    ReplyDelete
    Replies
    1. I cited a chart from that article on 29th!

      Delete
  52. Really interesting hypothesis! I am a molecular biologist but not expert of immunology. Then it's difficult for me fully to understand the mechanism behind. But this paper clearly shows how BCG Tokyo has an ancestral property of BCG strains in the genome.

    "Genome Sequencing and Analysis of BCG Vaccine Strains", Zhang et al., PLoS One, 2013
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747166/

    The following sentences in the Discussion are enough to know how this strain is special.

    "BCG strains have strain-specific RDs. The strains most commonly in use, such as BCG Glaxo, Danish and Pasteur, have the largest number of RDs. It has been proposed that one of the reasons behind the partial BCG vaccine efficacy is that it has become too attenuated to successfully mimic natural MTB infection [35]. Some empirical evidence favoring this hypothesis is provided by the finding that the BCG Japan strain induced greater cytotoxicity and T helper 1 responses in infants than the BCG Danish strain [36]. The BCG Japan strain was also proven to induce higher frequencies of mycobacterial-specific polyfunctional and cytotoxic T cells and higher concentrations of Th1 cytokines than that of the BCG Russia strain [37]. Our results showed that the 13 BCG strains have different numbers of T-cell epitopes. The BCG Tokyo strain, which is non-virulent and lost only Group 2 epitopes (Figure 4a), has the largest number of T-cell epitopes that can be recognized by the immune system. It might be the only strain with the same number of epitopes as the first BCG vaccine strain in 1921. We propose that BCG Tokyo is the best candidate strain for use in the development of a new and better vaccine."

    ReplyDelete
    Replies
    1. This can be a piece of medical evidence that BCG Tokyo works well against COVID-19! I added a link to this comment!

      Delete
  53. The comment system is not working properly. I'm posting on the behalf of "Supawat Pugkhem". https://www.blogger.com/profile/01898894137860795500
    ---

    This is strange to us (Thai people too), as we are very late on introducing social distances, and locked down. We even welcomed tourists during the early-mid-late February from China and everywhere.

    All Thais that came back from South Korea after super spreading, they have zero rate of COVID-19

    ReplyDelete
    Replies
    1. The reason could be that Thai uses BCG Tokyo strain. But be careful. Thai introduced its BCG vaccine program in 1977 according to http://www.bcgatlas.org/. Elderly people may not have vaccinated. Additional information regarding Thai BCG policy is welcomed.

      Delete
    2. I have checked, the BCG was started since 1953 not 1977. My parent who was 73 also got BCG while he was young as well.

      Delete
    3. Wow, that's really a good news! Can you add a source for that?

      I'm very frustrated because http://www.bcgatlas.org/ is not only imcomplete but sometimes wrong.

      Delete
    4. Finally, found in English version

      https://www.tm.mahidol.ac.th/seameo/1993-24-3/1993-24-3-410.pdf

      on page 2, 2nd paragraph.

      Delete
  54. Mihai Netea and Marc Bonten from two univesities (Radboudumc and UMC Utrecht) in the netherlands are researching the bcg vaccine on medical personal.

    ReplyDelete
    Replies
    1. Great! Do they consider the strains of BCG vaccine?

      Delete
  55. For Canada case, do you put the header on picture wrongly? Shall be Canada rather than Spain.

    ReplyDelete
    Replies
    1. https://www.statista.com/statistics/1107149/covid19-cases-age-distribution-canada/

      Delete
  56. One thought I've had after reading through your arguments is that some of the hardest hit parts of the U.S. (at this time) also have large immigrant populations representing a wide variety of countries. Given that recent immigrants tend to congregate together in neighborhoods, you would have to go through towns/neighborhoods with a fine-toothed comb to see who lives there and who might or might not have had a TB vaccination and then see how badly those towns/neighborhoods have been affected.

    Here are examples of immigration maps. One is for New York City and the other is for New Jersey, the two hardest hit areas in the U.S. as of today.

    https://www.6sqft.com/map-shows-where-foreign-born-new-yorkers-live/

    https://nj1015.com/all-the-nations-where-nj-immigrants-come-from-and-where-in-nj-they-now-live/

    ReplyDelete
    Replies
    1. In the UK Muslims make up just 5% of the population but 25% of CV deaths. This could be due to living with parents as in Italy. However a quick check reveals Pakistan and Bangladesh only introduced BCG in 1978 and 1979 respectively. Any elderly Muslims who migrated to the UK in the 50s and 60s wouldn't have received BCG and it stands they are at greater risk than those of a similar age born in the UK

      Delete
    2. The USA has never had the universal BCG vacctination program, however if you were an immigrant from a TB Infected area, you would be required to get the BCG vaccination. So, the thing is not that simple to analyze, I guess

      Delete
  57. Hi im from Mexico, i hope your analysis is right because we are not counting on medical services, the doctors here dont even have face masks or gloves, some dont even have hand sanitizer, there are doctor strikes going on, im very worried
    Sorry for the miss spellings, english is my second language

    ReplyDelete
    Replies
    1. I hope so, too! Though the strain seems BCG Denmark, Mexico has its universal BCG vaccination program.

      Delete
  58. I read the Imperial College report you added on April 1. Norway's reproduction number became less than 1 after the lockdown, and the lockdown order is kind of moderate : "Only people living together are allowed outside together. Everyone has to keep a 2m distance." On the other hand, most of the other European nations have much strick lockdown orders, and stil their reproduction numbers are larger than 1. Power of BCG?

    ReplyDelete
    Replies
    1. Thanks for adding the description of the degree of lockdown.

      Let me add that Norway's reproduction number was lower than the other western European countries from the beginning.

      Delete
  59. Just saw in the news more young Australians (under 29)have tested positive than the 65+ age group. BCG stopped in the mid 80s, everyday more and more evidence appearing to support your theory

    ReplyDelete
    Replies
    1. That's a supporting fact but not good news...

      Delete
  60. If experience of BCG can increase the resistance on Coronavirus, we, Japanese, may have to shed light on somewhat scandalous “Specific Substance Maruyama” again. I individually believe that “Maruyama Vaccine” does not have enough effect on cancer. But production process of “Maruyama Vaccine” seems to be appropriate to strengthen Lung immune system.

    ReplyDelete
    Replies
    1. I agree the deletion of this comment, if JSato think the comment contain the commercial issue about specialized drug.

      Delete
    2. Anyway, specialized vaccine may be developed in future. Introduction of BCG for people as rehearsal before the possible main performance is smart even in US, although the efficiency of BCG is not 100%.

      Delete
  61. Hi JunSato-san, thank you for sharing your great findings. I am sure you are one of the people who uses quarantine time into most productive one.
    I am a Japanese student living in the West coast of the U.S.
    I shared your blog in the comments of an article on Japan Times FB page. Someone commented that Japan should do anti-body testing asap. If they do that, your theory might be proved true or not.

    ReplyDelete
    Replies
    1. Thanks! But I am not sure anti-body testing.

      BCG vaccination seem to increase natural/trained immunity against severe COVID-19 cases but does not produce anti-body, does it?

      Delete
  62. This comment has been removed by the author.

    ReplyDelete
  63. Thank you very much, Jun Sato-san for your article. I was so relieved when my niece sent it to me. We live in Kazakhstan and we also were asking ourselves why this epidemic has not hit us as hard as Western Europe while we are so close to China and have extensive ties with it. I agree with you that BCZ map and further research on BCZ answers all the questions on different statistics of complications and mortality from COVID19 that are unexplainable otherwise. Statistics of Kazakhstan support this theory. We have mandatory BCZ vaccination for everyone at birth, at 6 yo (before of start of school) and a boost vaccination at 12 yo.

    With regard to anti-bodies, we also are waiting for those tests to arrive. Not because of BCZ though, but because we are already past the peak of this epidemic. We believe we had it in Jan-Feb, before lockdown. If the anti-bodies test will confirm it, we will have a chance to go back to less restricted quarantine before we completely destroyed our economy and our currency.

    I believe most of the Asian countries had corona virus before Western Europe, but we did not get severe complications because of BCZ. We sympathize with horrible situation in Italy, Spain, Netherlands and Belgium, USA and GB may have to do everything to avoid it. But every country should make a decision based on its own unique situation.

    Thanks a LOT again!

    ReplyDelete
    Replies
    1. Kazakhstan people have BCG vaccine for the three times! That sounds encouraging.

      It is very interesting that Kazakhstan had the peak of this epidemic in Jan-Feb before the lockdown. Do you have a source for this?

      If we can get infected without severe complications and have anti-body, that's awesome. It really saves the world. I'm still skeptical about this point as I don't see any evidence yet.

      Delete
    2. This has the latest statistics:
      https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_Kazakhstan

      Delete
    3. Officially, the first COVID-19 case was reported on 13 Mar. We cannot see any data for Jan-Feb.

      Delete
  64. Indians were given BCG from 1948. There are significant number of indians in New York area. If corora infection / death rate these ethnic indiansyis less then the general population, then BCG vaccination must be working.

    ReplyDelete
    Replies
    1. That would be an evidence. Please let us know when you have that kind of information!

      Delete
    2. I'm quite sure this is the case in the UK. There would be a similar number of elderly Indians and Pakistanis. The former would have been vaccinated before moving to the UK as children. But it wasn't introduced till 78 in Pakistan so they would have missed the window. I'm certain deaths among Pakistanis is much greater than Indians ie Sikhs but unfortunately there is not enough data yet to prove this

      Delete
    3. Interesting prediction but needs to be verified by data.

      Delete
  65. Thanks to your note, I found BCG is very promising!
    My friend, who is a doctor, also support this hypothesis.

    However, my concern is that Taiwan and Korea have ever suffered from SARS / MERS respectively.
    Do you have any remarks about the correlation between SARS/MERS and BCG?

    ReplyDelete
    Replies
    1. I'm afraid I know nothing about SARS/MERS...

      Delete
    2. Thank you for your response.

      I found the web site for the analysis of cases/death per million.
      https://web.sapmed.ac.jp/canmol/coronavirus/death_e.html

      Logarithm vertical axis can be selected.
      There seems to be the correlation between the gradient of the curve and BCG policy.

      Delete
    3. Death per million chart is the best and surest chart to compare countries!

      Delete
  66. Just a small comment. BCG vaccination is not universal in Norway. It is only given to children in "risk groups":
    https://www.fhi.no/en/id/vaccines/childhood-immunisation-programme/vaccines-in-CIP/vaccine-against-tuberculosis/
    The criteria is here (in Norwegian):
    https://www.fhi.no/nettpub/vaksinasjonsveilederen-for-helsepersonell/vaksiner-mot-de-enkelte-sykdommene/tuberkulosevaksinasjon---veileder-f/

    ReplyDelete
    Replies
    1. From http://www.bcgatlas.org/, I read that Norway stopped its universal BCC vaccination program in 2009. It doesn't have a starting year but I guess that Norway had a long history of universal BCG vaccination program until 2009, 11 years ago.

      Delete
  67. Interesting analisys Jun Sato, I'm not a doctor as well, but I find that your hypothesis makes an even stronger case for doctor Broxmeyer's one.

    You can read his hypothesis that what we're fighting is, in fact, tuberculosis in the link below where he addresses why BCG vaccines seem to work against covid-19.

    https://www.academia.edu/42379130/IN_PRESS_PROMISING_ANTIMICROBIAL_HOPE_FOR_CORONAVIRUS_BUT_IS_IT_WORKING_AGAINST_A_VIRUS_......................................................................Dr._Lawrence_Broxmeyer_MD

    ReplyDelete
    Replies
    1. nessuno, thank you very much.

      I downloaded the article and read it...but I think I understood only a fraction of it.. I hope medical experts help...

      Delete
  68. Hi Jun

    You article is very interesting but about the BCG not being universal in Ecuador it is some kind of miss understanding. You can check this fact in this vaccination scheme of the Health Ministry of Ecuador. https://www.salud.gob.ec/wp-content/uploads/2012/10/ESQUEMA-2018.1.pdf

    ReplyDelete
    Replies
    1. gersonZaragocin,

      Oh, the map is wrong (again) about Ecuador. Could you tell me what year did Ecuador start its universal BCG vaccination (and what year did it end)? Also, if you let me know the strain, that would be of help.

      Delete
  69. This comment has been removed by the author.

    ReplyDelete
    Replies
    1. I'm really sorry to hear that. I personally think all countries which have more than enough BCG vaccines should export them immediately. I think drive-through BCG vaccination can be a quick and real solution for the U.S. and the other west European countries. I think we should raise this issue to the public/politics.

      Delete
  70. I found this: an article stating that BCG vacinne has been used successfully as a treatment for pneumonia in older people (article in japanese ) https://medical.nikkeibp.co.jp/inc/all/hotnews/archives/237265.html

    ReplyDelete
    Replies
    1. I added a link to that article on 28 Mar.

      Delete
    2. Simon, I did not know you can get a BCG vaccination shot as an adult in Japan.

      Delete

  71. Introduction of BCG Japan on USA army staying in Japan is probably nice idea for the first step. It increases resistance of the army for the pandemic. Japanese people around the USA militaries can take ease. This should be nice test before the substantial introduction of BCG on main land. There is not so much time, I guess. I heard that the virus has penetrated into USA aircraft carriers.

    ReplyDelete
  72. Hey, I ended up spending the morning writing a blog post thinking a little more about this issue, here it is ( I link to this post by Sato-san)

    http://www.tensaimon.com/2020/04/03/is-the-foreign-born-and-over-70s-population-in-japan-at-more-risk-from-covid-19-than-the-general-population/

    ReplyDelete
    Replies
    1. Great work! Your post is very relevant and urgent information for foreign-born Japan residents.

      Delete
  73. 日本語の訳も書いた:
    外国人と高齢者は一般より新コロナリスクが高い?
    http://tensaimon.com/2020/04/03/japanese-translation-foreigners-and-elderly-at-higher-risk-of-covid-19-in-japan/

    ReplyDelete

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日本人が現代英米式・他アジア式の子育ての考え方と作法を理解するための良書: 『世界標準の子育て』 船津 徹 (著)