Please leave comments here regarding the BCG hypothesis, the correlation between COVID-19 and BCG vaccination

There have come many comments on the previous post and new comments don't seem to get published anymore. From the initial, some of the comments didn't get published properly. I guess Google is not working on this Blogger seriously.

Please leave your comments/inputs here regarding the BCG hypothesis, the correlation between COVID-19 and BCG vaccination.


Please be aware that the Blogger comment system seems buggy and some comments don't get published. I try to check the incoming comments and post the comments if I notice they are not published, but I'm not perfect and my time is limited on this.




Additional information for reference

Germany table was updated on 4 Apr by @takainou_0907
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(Added on 6 Apr)
Another pre-print article was published regarding the correlation between COVID-19 and BCG vaccine. This pre-print article cites my previous post.
https://www.medrxiv.org/content/10.1101/2020.03.30.20048165v1.full.pdf

(Added on 8 Apr)
From various sources, we guess the BCG vaccination policies in Germany as below. As most information is in German, German experts' inputs are highly appreciated.

BCG vaccine strainMandatory start yearMandatory end year
FDG(ex-West Germany)BCG Denmark1955(?)1974
GDR(ex-East Germany)BCG S4-Jena1951~19531990(?) or 1998(?)

The policies seemed to be different by states in FDG but we couldn't get clear information. 


https://twitter.com/shirogoma_kinak/status/1247091133903024128

https://mra.asm.org/content/4/2/e00296-16.full
https://twitter.com/bokudentw/status/1247659393203580929
https://europepmc.org/article/med/302786
https://www.aimspress.com/fileOther/PDF/MBE/mbe-16-06-364.pdf
https://www.egms.de/static/en/meetings/gmds2017/17gmds025.shtml
http://www.bcgatlas.org/
https://twitter.com/Iku42888817/status/1247156660612681729
https://twitter.com/iku42888817/status/1253020689025495040?s=12

(Added on 8 Apr)
Another fantastic correlation analysis was published. This analysis uses the doubling time of deaths. This figure is best for comparing the countries since 1) infected cases depend heavily on test policy and test number 2) no matter what the size of countries is 3) no matter when the virus arrived. 
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http://www.bi.cs.titech.ac.jp/COVID-19/Death_vs_BCGpolicy.html

(Added on 9 Apr)
Sapporo Medical University School of Medicine has created an excellent website where you can compare countries graphically by using deaths/cases per 1M population regardless of the sizes of the countries. 
https://web.sapmed.ac.jp/canmol/coronavirus/death_e.html

I picked up 12 countries and categorized them as below.



  1. No mandatory BCG: Italy
  2. Past mandatory BCG using a weak strain: France, U.K. 
  3. Current or until recent mandatory BCG using a weak strain: Ireland, Norway
  4. Current or until recent mandatory BCG using a middle strain (BCG Russia/Bulgaria/S4-Jena): Poland, Hungary, Bulgaria
  5. Current or until recent mandatory BCG using a strong strain (BCG Tokyo): Japan, Thailand, Taiwan
  6. Mixed BCG policy of 2) and 4): Germany

Please look at the chart below. You can see that deaths per 1M population are 1>2>3>4>5 and Germany is in between 2 and 4.


By looking at the deaths per 1M population chart above, there is a possibility that east European countries are just late starters and they might catch up west European countries.
So let's look at cases per 1M population which are a lead indicator of death tolls.

From the case chart below, you can see all countries are close to a plateau. I guess east European countries will continue to increase their death tolls for a month or so but they will not become like west European countries.



In addition, you can see clearly that the countries using BCG Tokyo strain are doing very well. BCG Tokyo strain seems to be more effective than BCG Russia.

Comments

  1. The comment system is not working properly. I'm posting on the behalf of "Youhan Kim". https://www.blogger.com/profile/04215787831546519937
    ---
    Hello! This is Youhan Kim from South Korea. A generalist/philanthropist. I've started studying COVID-19 and all the matters related to it, and I find your analysis incredible. I'm not a data scientist nor a medical professional, but I've been taking a general approach for fighting the pandemic, researching for Psychological Intervention, Ethics, Economy, Case Studies and many others. The group I've been running gained significant interests from institutions, hospitals and some governments. Thought you might be interested thereby I'm sharing it here. Kudos for all your hard works, you're saving lives by doing so! Link to the FB database: https://www.facebook.com/groups/covid19global/

    ReplyDelete
  2. The comment system is not working properly. I'm posting on the behalf of "Unknown".
    ---
    I think you are incorrect about Ecuador. It's obligatory to get the BCG vaccine for a birth certificate there.

    ReplyDelete
    Replies
    1. Thank you! I am waiting for the correct and detailed information. Please follow up the comment below.
      https://www.jsatonotes.com/2020/03/if-i-were-north-americaneuropeanaustral.html?showComment=1585898668653#c5477630837743686270

      Delete
  3. The comment system is not working properly. I'm posting on the behalf of "JoBil".
    ---
    Brazil does not look that great. https://www.reuters.com/article/us-health-coronavirus-brazil-cemetery/at-brazils-biggest-cemetery-grave-diggers-take-own-measure-of-coronavirus-toll-idUSKBN21K3J3

    ReplyDelete
    Replies
    1. I agree that Brazil does not look good. http://www.bcgatlas.org/ says that Brazil introduced BCG vaccination in 1976. This means that most elderly people may not get vaccinated. Probably this would be similar to China. Brazil should be take precautions as China did/does.

      Delete
  4. The comment system is not working properly. I'm posting on the behalf of "Raly".
    https://www.blogger.com/profile/11593303746400464840
    ---
    Need time 3-6 months after bcg vaccination to build up immunity, in this time the immunity is dropped.

    ReplyDelete
  5. The comment system is not working properly. I'm posting on the behalf of "Amazing Places on Our Planet".
    https://www.blogger.com/profile/16153025108186640618
    ---
    The Bulgarian producer of BCG vaccine warned today not to use it for Corona virus, because building immunity with this vaccine takes 3-6 months and during this time the immune protection is lower than usual https://www.mediapool.bg/proizvoditelyat-na-btszh-vaksinata-kategorichno-ne-na-masova-imunizatsiya-sreshtu-covid-19-news305684.html

    ReplyDelete
    Replies
    1. Hi Amazing Places on Our Planet,

      Thank you very much. This information is very important. After reading the article you mentioned, I thought I should change my message. However, then I wonder why did Netherlands and Australia start to try BCG vaccines to its medical staff? If the general immunity falls for 3-6months after BCG vaccination, I don't think Netherlands and Australia try it to its medical staff.

      Delete
    2. Did this doctor say that BCG vaccination reduces his/her general immunity no matter of his/her pre-conditions? I understand that BCG vaccination is not recommended when we are ill.
      I'm reading through Google translate and I may not read it right.

      Delete
    3. The trained immunity paper (Arts et al 2018, Cell Host Microb) indicates that the trained immunity appears at latest 28 days after the vaccination. It means that the immune system is boosted rather than “dropped” already 1 month later. Normally the BCG vaccines are injected to babies less than 1 year old. That figure, "3-6 months", might have come from the case of the babies, who definitely need more time to establish full immunity.

      Delete
    4. Takazo-san, thank you for the explanation. This is very important information.

      I remember you wrote that you are a molecular biologist not immunologist. But your comment looks like a immunologist one!

      Delete
  6. The comment system is not working properly. I'm posting on the behalf of "Unknown".
    ---
    この記事をお読みの専門家の方に伺いたいのですが、中高齢者は(小児期に接種を受けていても)BCGを再接種した方がいいのでしょうか? また、再接種に伴うリスクはありますか? 一般的な肺炎に対しても効果が期待できるようなので、もしリスクがなければ接種したいとおもっています。 どなたか、お詳しい方、よろしくお願いいたします。

    ReplyDelete
    Replies
    1. I am also waiting for the medical experts to announce on this matter.

      Below are the relevant information.

      https://www.jsatonotes.com/2020/04/please-leave-comments-here-regarding.html?showComment=1585962931633#c5006308503677265687

      https://www.jsatonotes.com/2020/03/if-i-were-north-americaneuropeanaustral.html?showComment=1585885263540#c7431007044487135066

      https://medical.nikkeibp.co.jp/inc/all/hotnews/archives/237265.html

      I don't have more information about the clinical trial to the Australian medical staff than the public articles but I guess this BCG vaccination includes re-vaccination since Australia had its mandatory BCG vaccination program from 1950s to mid 1980s according to http://www.bcgatlas.org/ .

      Delete
    2. ↓の記述を見つけました。
      https://jata.or.jp/rit/rj/332P15-16.pdf
      医学的には生後6ヵ月を過
      ぎたどの年齢でもBCG接種の効果と安全性は確かめら
      れていますが,このような場合は,国が予防接種法で
      「勧奨」している予防接種としては扱えない

      Delete
  7. Hi, Jun
    Japanese academism is now at the stage of supply control of the BCG vaccine, I guess. I agree that supply on Japanese children has the highest priority. Next may be elder Japanese people beyond the age of 70, or USA nations in Japan including the USA armies and navies. Anyway, they seem to be fragile cluster for this pandemic, potentially.

    ReplyDelete
  8. The comment system is not working properly. I'm posting on the behalf of "Unknown".
    ---

    すばらしい仮説でうなるばかりです。

    4/2に追加された相対的な効果の表ですが、再生産性の値(絶対値)とだいたい合います。
    少し古いですが、3/19日本の専門家会議は日本の再生産性≒1としました。
    これをベースに欧米の再生産性を計算すると、だいたい2+αくらいになります。
    (再生産性=3だともっと短期間にPCR検査能力の上限まで行ってしまうので、たぶん2+αでしょう)

    表で言えば、
    左上枠が2+α これが都市封鎖で1くらいになる。 1だと感染は増えませんが減りもしません。
    左一番下枠が1 これがもし都市封鎖すれば0.4。 これなら見る見る感染は減ります。

    日本の場合、バカなことをする連中(いまだにライブハウス行く、カラオケ行く、風俗行く)や院内施設内感染で一度に多数の患者が出るので、感染が増えていますが、それらがピシャリと押えられれば再生産性が1以下になり、結構沈静化するのではと感じていた事と合致します。

    ReplyDelete
  9. For Japan, it seems inevitable that the number of cases will begin to increase in Japan. I really hope that the population is more immune to this whether it be because of BCG or other reasons. I suppose we will find out if we watch the number of deaths. There is debate whether Japan is not categorizing Covid-19 related deaths. There are approximately 100K pneumonia related deaths in Japan each year or around 200 a week so it could have been the case that a % of the pneumonia deaths were actually Covid-19 deaths. Prime Minister Abe did mention they check 'most' pneumonia related deaths routinely via x-rays but that did not sound convincing. I wonder if we will every be able to find out the truth on this matter.

    We have all heard this phrase already too many times during this ordeal but 'the next few weeks will be important'.....

    ReplyDelete
    Replies
    1. I am now living at middle size city in Osaka. Hospitals are almost vacant. Even sound of cough, I can not hear in the city and the hospitals. Since Japan does not shut down the activity of the economy, the number of the cases may increase and the control of increasing rate is highly important. Percentage of the death to the cases, however, unlikely increases so rapidly.

      Delete
    2. I asked some doctors and they all say that all medical staff suspects COVID-19 for every case/death. And positive cases per tests are not so high even though Japan tests only people with high probability. A hospital overcapacity problem cannot be hidden even by the Chinese dictator. Don't worry about a number manipulation.

      However, I am not optimistic about the future prospect of Japan.

      My estimation/simulation tells me that the death tolls of Japan will accelerate if we don't impose strict social distancing.

      - Normal life: 8,300 by the year end, R(t) becomes less than 1 around Oct
      - Social distancing life from today: 500 to 2,000 by the year end, R(t) becomes less than 1 when implementing a strict social distancing policy
      - Lockdown from today: 200 by the year end, R(t) becomes less than 1 when implementing a lockdown

      This tells us EVERY NEXT WEEK will be important.

      You don't need to be too careful and destroy the economy but you should treat COVID-19 as 3-times dangerous influenza in Japan. Japan is very lucky. For the U.S. or Italy, COVID-19 is 20-50 times dangerous than influenza.

      Delete
  10. The comment system for the previous post is not working anymore. I'm posting on the behalf of "MxmaSantana".
    https://www.blogger.com/profile/05661081113093255946
    ---
    Yes, they have it but it started on 1977.
    The information was obtained from:

    Evaluación de la
    Estrategia Nacional
    de Inmunizaciones
    Ecuador 2017
    Ministerio de Salud Pública del Ecuador (MSP)
    Secretaría Nacional de Planificación y Desarrollo (Senplades)
    Organización Panamericana de la Salud / Organización Mundial de la Salud (OPS/OMS)
    Representación en Ecuador de la Organización Panamericana de la Salud

    No information of strains was indicated.

    ReplyDelete
    Replies
    1. MxmaSantana, thank you!

      I added the information and a link to your comment in the previous post.

      Delete
  11. The comment system for the previous post is not working anymore. I'm posting on the behalf of "miyomiyo".
    ---
    I am not sure but this article says scientists is seeking the possibility.
    https://www.google.com/amp/s/www.physiciansweekly.com/explainer-how-an-old/amp/

    ReplyDelete
  12. The comment system for the previous post is not working anymore. I'm posting on the behalf of "miyomiyo".
    https://www.blogger.com/profile/06599684241191592551
    ---
    Hello again JunSato-san, I found this NPO is fundraising for a Harvard proprofessor's research, using BCG against COVID-19.
    stathttps://www.abundance.org/crucial-research-assessing-efficacy-in-preventing-covid-19-of-widely-used-vaccine-for-tuberculosis-called-bcg/

    I was glad to know a research is starting in the U.S. but disappointed with that they had to start from fundraising!! I already donated but could pay just a little as a student. Hopefully the company you work BCG could help them in some way?! Please forgive my rudeness if I said 'too much'.

    ReplyDelete
    Replies
    1. This project should have the highest priority. I think governments or Bill Gates should put the high priority on this. I left Boston Consulting Group two decades ago...But let me try...

      Delete
  13. The comment system for the previous post is not working anymore. I'm posting on the behalf of "miyomiyo".
    https://www.blogger.com/profile/06599684241191592551
    ---
    I found this NPO info from Newsweek Japan version. I don't know why but I couldn't find same info from Newsweek (U.S.). https://www.newsweekjapan.jp/stories/world/2020/03/bcg.php

    ReplyDelete
  14. まったくの素人の高齢者が日本語ですみません。高齢者仲間から貴ブログを知りました。

    日本ワクチン学会のBCGワクチンの効果に関する見解が、2020年4月3日付で公開されていました。
    http://www.jsvac.jp/pdfs/kenkai.pdf

    私も日本での感染者・死亡者が少ないのは単にPCG検査が少ないからだと思っていました。
    BCGワクチンが新型コロナの重症化抑圧に効果があることを願っています。

    大隅典子教授のブログの中の図解で説明のあるBCG接種で細胞にエピジェネティックな変化が起こるのではないか?
    https://nosumi.exblog.jp/28020527/
    というエピジェネティックの意味も知らないのですが、子供期のBCGで作られた抗体が何らかの防御をしているのではないかと思います(であってほしい)。
    高齢者で高血圧・糖尿病などの持病のある人の死亡率が高いと言われますが、それらの病気を抑える薬が、自分の体の抗体を少なくしているのではないでしょうか。
    何も裏付けのある思いではなく、単なる推測です。

    ReplyDelete
  15. 日本ではPCR検査が抑制されており、致死率が高めになります。
    そこで70代の致死率で正規化して、相対的年代別致死率を諸外国と比較してみました。
    明らかに、日本の60代は相対的に致死率が低いです。
    BCG Japan  効果なら、ラッキーです。

    relative mortality rate by generation:
    https://twitter.com/shigetajyuuta/status/1246635554847899648

    ReplyDelete
    Replies
    1. Thank you for a brilliant analysis! I added it to the previous post.

      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.

      Delete
  16. Jun Sato様、素晴らしい分析をありがとうございます。
    とてもとても、重要な提案です:できれば、政策決定者や研究者の目に止まりますように・・・・

    現在日本では乳児に対する市町村BCG集団接種が次々中止になっています。理由は、人が集まる「3密」を避ける為です。
    ここ数日で聞かれる、高齢者にBCGを接種すると「本来必要な乳児に接種ができない」というのは至極賢明な意見で、十分理解できます。その一方で「BCG集団接種の中止」に対し、「大変な事態だ!」という評価は聞きません。つまり、少々の延期は小児結核に対する防衛策として問題ない可能性があります。
    重要なのは、感情論ではなくデータに基づく分析です。

    「小児結核診療のてびき(第1 版)」https://jata.or.jp/dl/pdf/data/syouni_tebiki.pdf
    によると近年の小児結核患者は年間50例程度。1歳以下に限ると2015年(掲載最新データ)は18例です。もちろん、この症例数はBCG接種を前提にした集団での発生数です。しかしながら1歳以下の乳児は自分で外出せず、かつ現在の日本は全年代で大幅な外出抑制下にある事を考えると、2020/4から例えば年末まで、一人の乳児が小児結核に罹患する可能性は極めて、極めて低いと言えます。
    2019年の出生者数は約86万人(総務省)です。恐らくBCGは毎年、この程度の数の接種を前提に生産されているはずです。仮に、90万人分とします。もし、乳児への接種を一斉にストップすれば、現在の日本には、1年間で90万人分(一気に90万人ぶんの在庫はないはずです。赤ちゃんはいっせいには生まれません)のBCG接種を行う余力があります。
    上記の事から、下記の事項を提案いたします。

    1 日本全国においてただちに、乳児へのBCG接種の一時停止、半年~1年程度の接種延期(これによりBCG在庫を確保)
    2 現在重症化率が高い年齢層の高齢者(BCG非接種年代を中心に)に対する、早急なBCG臨床試験の開始
    3 諸外国の臨床試験の途中経過である程度の効果が確認され(日本株を使っているかの確認が必要です)、我が国の治験でも安全性が確認されれば、重症化率が高い年齢層の高齢者へただちにBCGの接種を開始
    4 接種にあたっては政府が定めた基準に従い、都道府県市町村単位で接種予定者へ連絡、3密を避ける為屋外テントやドライブスルー方式により、各保健所で一斉に接種開始。BCGは専用キットの管針法でありシリンジも用いない為、接種スタッフへの針刺しリスクも低いです。短時間で非常に大量の対象者に対し接種が可能と考えます。極論、自主接種キットを整備して配布する事も検討すべきと考えます。
    5 政府はBCG接種の方針となるまでに、技術移転をすればBCGの大量増産可能なメーカーを選定し、個別に依頼。治験で効果が出れば、大量増産を依頼。世界への日本株の緊急供与も開始(菌株を供与する事で日本国民の在庫が減る事は無いと考えます。諸外国はその菌株で、自分たちで菌を増やし、BCGを製造します)。この事で日本が本当に、世界を地獄から救えるかも知れません。
    6 半年~1年以内に国内が落ち着いたら、必ず、延期されていた乳児に全国でBCG接種を行う。そして日本国民全員が、まだ言葉もしゃべれないが、日本を救ったこの子供達に、感謝を。

    安全性調査の面では、東北大学の研究https://kaken.nii.ac.jp/ja/grant/KAKENHI-PROJECT-15590794/において既に、数十人規模の高齢者にBCG接種が行われています。当時の臨床情報が慎重に精査されれば、重大な国家緊急事態につきこれをもって第一相試験とする事も、可能ではないでしょうか。
    総務省統計局HPによれば2018年時点の70歳以上人口は2618万人です。とても90万人分のBCGでは足りませんが、疫学の専門家などにより、特に重症化率の高い集団(循環器系の持病がある、がん治療中、等)を抽出し、そのような集団から接種開始とするのが上策でしょう。

    乳児より高齢者を救うのか?という批判的な意見も必ずあるはずです。
    しかしながら、世界一の高齢化大国日本で、2千数百万人も居るBCG非接種年代の高齢者は恐らく今後罹患者が激増し、死亡者も大幅に増加するでしょう。接種者の年代による集団免疫効果を考慮してもです。そのような状況ではいわゆる医療崩壊が予想され、国内病院機能の大半がコロナ患者に占有されます。そうなると本来救えるはずだったコロナとは関係の無い妊婦の疾患や、乳児・小児の疾患が救えない可能性もあります。手術をすれば助かる小児に、呼吸器がない可能性もあります。そのような形で全国で失われる命は、前述の18人を大きく上回るはずです。それだけではありません。重症例の激増による国家経済への負担は計り知れません。そのような景気悪化で、二次的に失われてしまう命も数多く発生するはずです。私は30代の若者ですが、上記のような分析から、今はBCG非接種者年代の高齢者を救う事に全力を傾けるべきと考えます。

    「ではBCGが延期された乳児が、そのせいでコロナで死ぬ可能性はないのか?」という議論も発生します。しかしながら、未解明な点ですが、BCG非接種国においても、乳児の罹患率・死亡率は極めて低い。時折センセーショナルな乳児死亡例がニュースになりますが、そういった例も当然あるけれど、全体に占める割合は極めて低いという事は、重要な点です。ですから、これに関しては「可能性は大きくない」という答えになるかと思います。

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    1. 私の家族も70をすぎていますが、小学生の時に集団接種を受けています。おそらく70代以上の方でも集団接種を受けている方は多いのかと思います。ですので日本では人口のほとんどがBCGの接種経験があると考えていいと思います。BCGの訓練免疫の効果は遺伝的背景の影響を受け、個人により大きなばらつきがあることが予想されます。Arts et al 2018, Cell Host Microbでは、効果を大きく左右する遺伝的多型(rs16944)が特定されていますが、これによれば50%の日本人の遺伝型は訓練免疫の効果をうけられないものです。(この部分に関してはサイトカインの上昇のみで議論しているので、訓練免疫の効果を直接的には調べられていないです。また、相加効果のため、ヘテロ接合でもある程度は効果をもちます。)したがって、個人がBCGを接種したからといって過度に効果を期待することはできないと思います。現にBCGを接種しても亡くなられている方は多いはずです。BCGの効果は特に集団免疫において重要だと思われます。日本ではすでに多くの方がBCGによってコロナウイルスへの免疫力の強い状態があるため、感染スピードが衰え、BCGを受けてない方もその効果を享受しているわけです。人命を救うという観点から言えば、BCGを受けていない国や集団において集団免疫を高める効果としてBCGの集団接種を実施するということが最優先なのかと思います。

      Delete
    2. Takazo-san, thank you for your comment and insight. Here is my understanding. Is it correct?

      1) BCG Tokyo can increase trained immunity for 50% of Japanese.
      -> What about the other strains? What about the other ethnicity?
      2) Therefore, herd immunity is more effective than individual immunity.
      3) As half of people don't have individual immunity, COVID-19 cases/deaths can surge if those are exposed to the virus more than a certain level.

      Delete
    3. Colors-san, thanks for your comment.

      Before discussing the BCG vaccination distribution priority, I would like to know how much more and how fast BCG vaccination can be produced. I know it's hard to do a mass production because they are living bacteria. But, I believe production can be increased to some extent and I would like to know that extent.

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    6. Jun-san, thank you very much for your reply!!
      It seems to be difficult to rapidly massively increase the production of BCG vaccine. However, I think that it is possible to inoculate several times the number with the now-existing vaccine stock.
      Actually, I'm a clinical doctor of Japan.
      In Japan, we use "Kan-shin-ho" for the injection of BCG. This PDF has an easy-to-understand figure.
      https://www.bcg.gr.jp/medical/text_k_bcg.pdf
      This injection procedure is very effective, sophisticated and low risk. However, with "Kan-shin-ho", 99% of the volume of vaccine liquid will not enter the under-skin space. Because "Kan-shin-ho" will spread the vaccine liquid on skin and push it into the under-skin space with thin needles. You can understand it easily with this PDF.
      https://www.meitetsu-hospital.jp/app/wp-content/uploads/2019/12/yobou_193.pdf
      As you see, over 99% of the volume of vaccine liquid will not enter the under-skin space, just be spread on the surrounding skin. This amount is wasted. Of course, I understand this procedure is very simple and sophisticated, and I strongly recommend this method under the normal situation.
      However, this is a global very extreme situation. Under this situation, I strongly propose a method using a simple needle like “Bifurcated needle”.
      https://en.wikipedia.org/wiki/Bifurcated_needle
      This needle had been used to smallpox vaccination. I think the thickness of the needle should be much thinner than Bifurcated needle for BCG because of the characteristic of making ulcer.
      With this type of needle, doctors can fully use the amount of vaccine liquid. For example, after make the vaccine liquid 0.15ml, an injector will divide the liquid into 0.03ml each for 5 patients. “AFTER” the divide, for one patient, one bifurcated needle will be used to make 18 pricks to the under-skin space. The bifurcated needle will be soaked to the 0.03ml BCG and make a prick to the skin, and again be soaked to the 0.03ml BCG and make a prick to the skin.........
      Again, I want to emphasize that THIS IS AN EMERGENT SITUATION. I strongly await that very effective thin-bifurcated needle will be manufactured rapidly, and global BCG vaccination will be started. It possible I believe. Japanese thin acupuncture needle can also be used for this method probably.

      Delete

    7. Thank you for your reply, Jun-san.
      >1) BCG Tokyo can increase trained immunity for 50% of Japanese.
      >-> What about the other strains? What about the other ethnicity?

      First, the trained immunity is a candidate of the mechanism explaining correlation between BCG and Covid-19 infection or death rate. But this is still unclear since BCG makes complicated effect and we don't know about Covid-19 as well. Second, also we don't know how extent the trained immunity is different between BCG strains and between genetic background in each case. The trained immunity paper shows the data of Dutch people with Danish BCG strains. In this combination, we know the trained immunity is not observed in homozygous alleles of the polymorphism (rs16944). But this is possibly different in the case of Japanese people with BCG Tokyo. The data suggests potential much variation but cannot tell exact amount of variation. Nevertheless, if you just assume the effect is similar to Japanese cases, under the Hardy-Weinberg equilibrium, 25% Japanese people has a genotype that doesn't have the trained immunity. 50% (heterozygote) has a weak trained immunity and remainder (25%) has a strong trained immunity.

      2) Therefore, herd immunity is more effective than individual immunity.

      The herd immunity is important for slowing down infection rate of populations that even save life vulnerable to the infection. It is not easy to compare herd immunity and individual immunity. But the effect on the herd immunity is more expected (predictable) when single cases have much variation (unpredictable).

      3) As half of people don't have individual immunity, COVID-19 cases/deaths can surge if those are exposed to the virus more than a certain level.

      Yes if it’s true that those people don't have individual immunity. Even if the herd immunity by BCG Tokyo much reduces infection rates, some people having BCG Tokyo vaccination are possibly completely vulnerable to Covid-19. Anyway you need to save your life on your own.

      Delete
    8. @Takazo-san,

      Thank you for your explanation. I think I understand more and I understand that many things are unknown.

      @Colors-san,

      That can be a miracle idea! I didn't know that 99% of the vaccine doesn't go to under-skin space and wasted. Switching to the bifurcated needle method can increase the number of people getting BCG Tokyo vaccine 100 times!

      Delete
    9. Jun-san, thank you very much for your reply!
      に関し、先に英文で投稿いたしましたが、日本の多くの方にも知っていただきたく、日本語でも投稿させていただきます。

      Junさん、御返事をありがとうございます!詳しくはありませんが、BCGワクチンの生産を急速に大幅に増やすことは難しいようです。ただ私は、現有のワクチン量のストックで、数倍の人数に接種できると思っています。

      私は日本の臨床医です。日本では、BCGの注射に「管針法」を使用しています。下記のPDFには分かりやすい図があります。
      https://www.bcg.gr.jp/medical/text_k_bcg.pdf
      この注射法は、非常に効果的で洗練され、低リスクな方法です。しかし実は管針法では、ワクチン液量の99%が皮内に入りません。管針法はワクチン液を皮膚に塗り広げ、細い針で皮内に押し込む方法だからです。下記のPDFで、注射の様子がよく分かります。
      https://www.meitetsu-hospital.jp/app/wp-content/uploads/2019/12/yobou_193.pdf
      ご覧の通り、用意したワクチン液量の99%以上は皮内には入りません。管針により皮内に入るごく微量以外は、周囲の皮膚に塗られているだけです。この量は無駄になります。

      もちろん、この素晴らしい接種法は多くの変遷の後に確立され、シンプルで大変洗練された方法です。そのため通常の状況下ではこの方法が強く推奨され、それ以外の方法は用いるべきではありません。しかし現在は、目を覆うような世界的緊急事態が日々進行しています。

      私はここに、この非常時おいて、「二又針」のような単純な針をBCG接種に使う事を強く提案します。下記は二又針の情報です。
      https://en.wikipedia.org/wiki/Bifurcated_needle
      この針は旧来、天然痘ワクチン接種に使用されていました。BCGの特性(潰瘍など)を考慮すると、BCGの場合は通常の二又針よりもかなり細い針が良いと思います。

      このタイプの針を使用すると、医師は多数への接種に際し十分な量のワクチン液を確保できます。たとえば、ワクチン液を0.15mlで準備した後、注射者は5人の患者に対してワクチン液をそれぞれ0.03mlに分割します。分割した後に、その0.03mlのワクチン液を使い、1人の患者に対して1つの二又針を使用して、皮内に18のプリックを作成します。つまり二又針を0.03mlのBCGに浸し、皮膚に刺し、そして再び0.03mlのBCGに浸し、皮膚に刺し・・・・これの繰り返しです。

      繰り返しますが、我々は今、世界レベルで一刻の猶予もない緊急事態のただ中にあることを強調したいと思います。

      もちろん治験での効果確認の後になりますが、BCG接種に対し効果的な、特に細い二又針が迅速に製造され、病の惨禍にある各国で一刻も早くBCG接種が始まるのを私は願っています。細い二又針の代用には、おそらく日本の細い鍼灸針も使えるでしょう。

      @Jun-san,
      It is inevitable that a very small amount of vaccine liquid will adhere to the upper surface of the needle that does not enter the skin. Such a small amount of vaccine liquid will be inevitably wasted. So, I think 100 times increase is difficult. However, I believe it is definitely possible 5-10 times increase the number of people getting BCG Tokyo vaccine.

      @Junさん
      皮内に入らない針の部分表面にどうしても微量のワクチン液が付着するのは避けられません。そのような微量のワクチン液は、どうしても無駄になります。だから100倍の人数への投与は難しいと思います。しかし、5-10倍の人数への投与なら、間違い無く可能と考えます。

      Delete
    10. Colors-san,

      Thank you for your detailed input. I understand that wwitching to the bifurcated needle method can increase the number of people getting BCG Tokyo vaccine 5-10 times. Still, this is a miracle idea!

      Delete
  17. Dear Jun, thank you so much for your in depth analysis of the data! I am a former biosafety specialist/USG contractor turned organic farmer, I also hold MPH from UC Berkeley and MS in Biochemistry from USF. I am a US citizen but grew up in ex-USSR and was vaccinated with BCG vaccine in my childhood. I currently live in Kazakhstan. About 2 months ago (before Kazakhstan's shelter in place order of March 19th), I was ill with what seemed like the flu. Yet the respiratory symptoms I had felt different from anything I've had before in terms of seasonal flu which I've had 2-3 times in my life. I have to mention that I have chronic colitis and other digestive problems. So, back to the respiratory symptoms, I had a real difficulty breathing and it felt like this time "the bug" was hiding really deep inside my lungs. I had a dry cough and couldn't get it to become productive... I also had a fever of 39C for 3 days. The sickness lasted for a week, plus a week of recovery. I have a huge suspicion that it was COVID-19 but will get the confirmation once they lift the lockdown of Almaty (the city we live close to) and I'll get hold of the antibody test system. Can't wait! P.S. The dry cough resolved after I started taking elecampane root (Inulae Rhizomata) tea.

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    1. Thanks mertskhali!

      Your comment is the second comment from Kazakhstan.
      https://www.jsatonotes.com/2020/03/if-i-were-north-americaneuropeanaustral.html?showComment=1585794699839#c7158906526427412152

      This is just anecdotal and cannot be proved but Kazakhstan may have already passed the epidemic in Jan-Feb and have herd immunity already from the two comments.

      Delete
  18. Prof. M. Miyasaka of Osaka University has introduced this brog of jsatonotes and an old work by T. Hashimoto (結核 62:51 (1987))in his interview. In the work by Hashimoto, the numbers of living bacteria in BCG Japan and BCG Russia were assigned to be large, while that in BCG Brazil was not so large. It means that BCG Brazil may not be as effective as BCG Japan and Russia. It also indicates that synthesis or extraction of effective chemical species for enhancing lung immune system would be difficult, because living system is sometimes very complex.

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    1. Thank you for your input!

      I hadn't looked into the countries with BCG Brazil but your input sounds right. I take note when I look into the BCG Brazil countries.

      Delete
  19. Dear Sato-san, Thank you for your blog and your work on this theory. Concerning Japan, one of the key indicators is the low death rates in Japan. As Japan has been exposed to the virus longer than the U.S. and there has not been a lockdown in Japan, I would have expected the total deaths due to Covid-19 and the death rate (% of deaths of total confirmed cases) to be much higher than they are currently. As of this writing, total Japan deaths = 85 and total death rate is 2.3% (3,865 confirmed / 85 deaths). This may be due to the BCG vaccine (or some other reasons) effectively denting the deaths due to Covid-19 in Japan, or to Japan being at an earlier phase in the cycle for a potential outbreak. One of the things I'm curious about is whether there is evidence that Japan is miscounting the number of deaths due to Covid-19. Japan has a high number of annual pneumonia cases every year and some are saying that Japan is undercounting the number of Covid-19 deaths by labelling them as flu induced pneumonia. If there is evidence that Japan is not doing this and are properly counting the number of Covid-19 deaths, that seems to be a good indication that whatever Japan is doing or have done, is making Japan an outlier in both infections and deaths.

    In summary, if you can trace when Japan was exposed to the virus and if Japan is properly counting Covid-19 deaths, those two factors would suggest that Japan, for whatever reason(s) will be an outlier to the pandemic.

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    1. I heard that the number of deaths due to pneumonia has not increased.

      Anyway, if there is a pandemic in Japan, we can definitely see an overflow to the hospitals.

      No one can hide that. Even Xi Jinping of China.

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  20. this is interesting reading, I am from indonesia and (I think) I got vaccinated with BCG. Maybe you already know that we have one of the highest death rate of covid-19. A lot suspect because we are undertesting.

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    1. According to http://www.bcgatlas.org/, Indonesia introduced BCG vaccination in 1999, which is pretty late. I suspect many Indonesian people, especially elderly people have not BCG vaccinated.

      Delete
    2. I wonder if the year is accurate. This article said that BCG introduced in Indonesia in 1973 https://www.guesehat.com/perkembangan-kesehatan-dan-imunisasi-di-indonesia-dari-masa-ke-masa (the article is in indonesian, but there is a nice table that show various vaccine and year of introduction)

      Delete
    3. Hi a nuha r,

      Thanks for the additional information.
      1973 seems correct as http://www.bcgatlas.org/ is sometimes wrong.

      1973 is still late. I guess elderly people have not BCG vaccinated.

      Delete
  21. The comment system for the previous post is not working anymore. I'm posting on the behalf of "Ichizu Wakabayashi".
    ---
    Dear Sato-San,



    Here is my comment on your article seen here: https://www.jsatonotes.com/2020/03/if-i-were-north-americaneuropeanaustral.html (I was unable to post online):



    Thank you for aggregating these helpful resources and analyses! I have found them fascinating. I had similar suspicions that the childhood vaccination schedule might offer some clues as to why certain countries are faring better with COVID-19 than others. I live in South Africa (which has had universal BCG vaccination since 1973) and we have been rather perplexed by the low COVID-19 death rates so far, compared to other countries (it seems we had the Tokyo BCG strain until 2000 and then switched to Denmark strain after 2000).



    I think what you might find interesting in support of your thesis are studies looking into the non-specific beneficial effects of BCG vaccination in third world countries. The following study, for example, found that BCG vaccination reduced childhood mortality from all kinds of infections (not just TB) in Guinea-Bissau - even death from malaria. I quote, "We therefore believe that our study suggests that the effect of a BCG scar may be related to a general enhancement of the immune response to many infections rather than providing protection against specific infections. This possibility is supported by studies of the impact of vaccination status on the case-fatality rate at the paediatric ward in Bissau.[...] Furthermore, BCG vaccination has been found to be associated with non-specific enhancement of both antibody and cellular immune responses. Hence, the beneficial effect may in fact be related to the immune response induced by a correctly given BCG vaccination."



    BCG vaccination scar associated with better childhood survival in Guinea-Bissau

    https://academic.oup.com/ije/article/34/3/540/682234



    The BCG vaccine, as you might know, is also used to treat bladder cancer. It seems to have a variety of non-specific immunological effects in relation to bacteria, fungi, viruses and even cancer.



    Kind regards,

    Ichizu Wakabayashi

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    1. I didn't know that South Africa had used BCG Tokyo until 2000. And South Africa's death per 1M population is 0.2, very low!

      I believe many researchers will look into the general benefits and many aspects of BCG vaccination and the differences by the strains after this COVID-19 pandemic. As I am a business person, let me go back to business after this pandemic!

      Delete
    2. The comment system is not working properly. I'm posting on the behalf of "Ichizu Wakabayashi".
      ---

      I wonder if BCG vaccination offers a sufficiently protective effect, or if TB prevalence in a country plays a role too? TB prevalence would ensure that the immune system is regularly challenged by the pathogen. Here is a global overview of TB prevalence: https://erj.ersjournals.com/content/erj/54/3/1900655/F2.large.jpg?width=800&height=600&carousel=1


      It might also explain lower efficacy of BCG vaccination against COVID-19 in European countries (in addition to the theory about differing BCG vaccination strains).


      For those who are skeptical about the efficacy of a BCG vaccine against a virus, here is a list of studies that look into the mechanism according to which BCG vaccination may protect against infections above and beyond TB:

      1. Immunometabolic Pathways in BCG-Induced Trained Immunity
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5177620/

      “The protective effects of the tuberculosis vaccine Bacillus Calmette-Guerin (BCG) on unrelated infections are thought to be mediated by long-term metabolic changes and chromatin remodeling through histone modifications in innate immune cells such as monocytes, a process termed trained immunity.”

      2. Bacille Calmette-Guerin induces NOD2-dependent nonspecific protection from reinfection via epigenetic reprogramming of monocytes.
      https://www.ncbi.nlm.nih.gov/pubmed/22988082

      “BCG induces adaptive trained immunity based on functional reprogramming of mononuclear phagocytes that induces protective effects not only against tuberculosis, but also against other infections.”

      3. BCG Vaccination Protects against Experimental Viral Infection in Humans through the Induction of Cytokines Associated with Trained Immunity
      https://www.cell.com/cell-host-microbe/fulltext/S1931-3128(17)30546-2?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1931312817305462%3Fshowall%3Dtrue

      “The tuberculosis vaccine bacillus Calmette-Guerin (BCG) has heterologous beneficial effects against non-related infections.”

      4. Anti-mycobacterial activity correlates with altered DNA methylation pattern in immune cells from BCG-vaccinated subjects
      https://www.nature.com/articles/s41598-017-12110-2

      “Our findings suggest that BCG-induced epigenetic reprogramming of immune cell function can enhance anti-mycobacterial immunity in macrophages.”

      Delete
    3. I heard that the team of Tsuyoshi Miyakawa is trying to incorporate TB prevalence in their analysis.
      https://twitter.com/tsuyomiyakawa/status/1247140506275987456

      As BCG vaccine is a kind of TB itself, I agree with your thinking.

      Will see the analysis result!

      Delete
  22. Hi Jun. I appreciate your work. Nevertheless Germany is the proof that your thesis is probably wrong. I was born in 1964 but I don't know of any BCG vaccination, it must have been non-mandatory. Still we have some of the lowest death rates. Currently I am in Thailand. Bangkok Hospital doesnt even answer questions concerning BCG vaccination.

    You ask why some medical staff gets it though it will only work in 3 to 6 months? Because they hope to be safe when the 2nd and 3rd wave of infections arrive. It is like betting on chloroquine or Avigan which they bought in Thailand. Its more hope than science right now.

    By the way BCG was also not recommended in some countries anymore due to a number of side effects.

    ReplyDelete
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    1. Hi GiDo,

      We added a table of BCG vaccination policy in Germany above. Your input is highly appreciated since most of the documents are in German...

      BCG vaccination boost human trained immunity no later than within 4 weeks and you don't see a drop of immunity during that initial term. That's why Netherlands, Australia and some other countries have already started to get their medical staff BCG vaccinated.

      Regarding the side effect, please consult medical doctors. It may depends on the strain of BCG. What I know is that basically all Japanese are BCG vaccinated, almost zero side effects are reported and Japanese have long life expectancy.

      Delete
    2. Ok. S.th from Russia Beyond "Sowjetisches Serum gegen Tuberkulose...). 1) Vaccine has to be given to children, not adults, to have significant immunstimulating effects. 2) They last about 10 years, thus East Germany's vaccinations ( stopped more than 10 years ago) would not work. 3) China is still vaccinating but was hurt vehemently.

      It seems to me that you are desperately looking only for facts supporting your theory.

      Delete
    3. GiDo,

      BCG vaccination is for tuberculosis and tuberculosis is very rare among adults. So most studies are done for young people.

      You can find the following sentences in the Wikipedia page.
      https://en.wikipedia.org/wiki/BCG_vaccine
      The duration of protection of BCG is not clearly known. In those studies showing a protective effect, the data are inconsistent. The MRC study showed protection waned to 59% after 15 years and to zero after 20 years; however, a study looking at Native Americans immunized in the 1930s found evidence of protection even 60 years after immunization, with only a slight waning in efficacy.

      What is your point regarding Germany?

      I checked deaths/1M population as of 8 Apr from https://www.worldometers.info/coronavirus/ and BCG vaccination info from http://www.bcgatlas.org/.
      - Germany: 15 (High in ex-West, low in ex-East), complex BCG history as above
      - Poland: 2, mandatory BCG, ongoing mandatory BCG since 1955, BCG S4-Jena
      - Netherlands: 87, no mandatory BCG in history
      - Belgium: 99, no mandatory BCG in history
      - Czechia(Czech Republic): 5, Past mandatory BCG from 1953 to 2010, BCG Moreau
      The BCG hypothesis looks fitting well with these numbers.

      Any counter-evidence is welcomed. Actually, I've been trying to find one but so far I cannot find any. Of course, I cannot look at all the data, so your help is welcomed.

      Delete
    4. Poland isolated itself early, Tcheks made their own masks effectively. The problem is that you tend to think monocausally, so you dont see the more obvious reasons.

      East Germans are poorer and less open to foreigners, i.e. that they are in less contact with them and the neighbouring states are less infected than those in the west.

      The reason for our low death rate is 1) currently the highest test rate in Europe (350.000 per week) - and they are usually free. 2) low average age of infected (49 years, France e.g. has 62). 3) Block testing of medical staff. 4) Highest rate of icu in Europe (currently about 30.000 respirators).

      And finally, counterevidence from the city where I live, one of THE tourist hotspots of the world. 30 infected, 15 foreigners mainly from Europe, 15 Thais. No death so far and no difference although Thais routinely got BCG when young.

      Delete
    5. I don't dismiss that there are many other factors; Social distancing, masks, medical capacity, etc. I agree with your hypothesis as well.

      Is your counter-evidence about Bangkok, Thailand?

      Thailand has been using BCG Tokyo strain and it's doing very well against COVID-19 though Chinese tourists visited Thailand a lot and Thailand was late implementing social distancing policy, etc. I added two charts including Thailand above.

      And the infected cases are very skew to foreigners mainly from Europe comparing with the general population. I guess they are mostly from western Europe.

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

      Delete
    7. It is Pattaya which is locked up now. We will see if Thailand is doing well. An expert already said the 200.000 Avigan ordered from China wont be enough as one patient needs 70. There are only 1000 respirators. 

      Singapore thought they did well. It just changed. 
      German numbers were up again, too.

      The highest rated hospital (BPH) here does not give BCG to adults. By the way, they use French strain for children. I contacted them directly. The 2nd biggest hospital doesnt give it at all.

      They will start testing on Phuket door to door, I read. It seems to be most infected after Bangkok.

      So we don't know because they haven't tested enough. The level of intelligence becomes obvious as we are now fined or imprisoned when without a mask in public. But in this climate a mask is useless after 30 minutes due to humidity and sweating. It makes sense in buildings. And people touch their masks often. 

      Delete
    8. Delete or correction doesnt work, sorry. U may delete the first reply with a typo.

      Delete
  23. And let me add: I personally know a couple of younger people with TB in Thailand, one died at the age of 32 last year. It is widespread in spite of the vaccination.

    ReplyDelete
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    1. Yes, I learned that the effect of BCG vaccination against TB is somewhat controversial.

      Delete
  24. http://www.bi.cs.titech.ac.jp/COVID-19/Death_vs_BCGpolicy.html

    maybe already posted but just in case

    ReplyDelete
  25. The comment system for the previous post is not working anymore. I'm posting on the behalf of "
    ivona021".
    https://www.blogger.com/profile/03165684070016237195
    ---
    So far, Serbia has about 3% death rate (Pasteur), and Croatia 1.5% (Brazilian, since '90s). Still too many other factors...

    ReplyDelete
  26. The comment system for the previous post is not working anymore. I'm posting on the behalf of "
    Unknown".

    ---
    I found this from Australian Department of Health Website. Is this a coincident?

    NSW has the highest number of cases, making up 45 per cent of the total number of infections, and NT has the lowest rate of infection.

    https://www1.health.gov.au/internet/main/publishing.nsf/Content/cda-cdi3701h.htm

    In Australia, the broad-based BCG vaccination program originated at a time when the epidemiology of TB was quite different. Initially in 1948, vaccination targeted health care workers, Aboriginal people and close contacts of active cases, especially children. In the 1950s the program was expanded to include all Australian school children except those from New South Wales and the Australian Capital Territory. This policy was discontinued in the mid-1980s (1991 in the Northern Territory) in favour of a more selective approach.

    ReplyDelete
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    1. Wow, this is another new fact.

      NSW's population is 7.5M which is 30% of Australia's population 24.6M.
      NSW's cases is 2,637 which is 45% of Australia's total cases.
      NSW's deaths is 17 which is 44% of Australia's total deaths.
      https://www.health.gov.au/sites/default/files/documents/2020/04/coronavirus-covid-19-at-a-glance-coronavirus-covid-19-at-a-glance-infographic_1.pdf

      In addition, Australia uses BCG Connaught strain which is a weak strain. From my observation, weak strains don't prevent from becoming severe or fatality while strong strains (BCG Russia/Japan) do. That may be the reason that cases-to-death rate(case fatality rate) in NSW is not different from the other states where BCG was mandatory for some period.

      Delete
    2. I calculated for VIC that has the same size of city, Melbourne(4.9M pop), as Sydney(5.2M pop) of NSW, the population density is higher; VIC 28, NSW 10.
      https://www.abs.gov.au/AUSSTATS/abs@.nsf/Previousproducts/3218.0Main%20Features702016-17

      VIC's population is 6.4M which is 26% of Australia's population 24.6M.
      VIC's cases is 1,158 which is 20% of Australia's total cases.
      VIC's deaths is 10 which is 25% of Australia's total deaths.


      Delete
  27. The comment system for the previous post is not working anymore. I'm posting on the behalf of "Keiko Fukuda".

    ---

    I wrote in a reply to my comment awhile ago, but I think it got lost somewhere, so I’ll repost:
    (Thanks to Shimizu sensei for clarifying my questions!)
    http://promea2014.com/blog/?p=12058
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3510289/
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3710928/
    It seems that Korea switched to a domestic strain in 1988, but then resumed import of Tokyo172 in the 90’s (according to data taken in 2006 from scars on 6 yr olds in 5,713 children from 121 day-care centers and kindergartens in 16 cities of South Korea, 64.5% used the Tokyo strain, reflecting BCG strain in use in the year 2000), after which in 2006 they had to return to relying on import (Tokyo172 100%?), with plans (as of the 2013 paper) to return to domestic production in 2017. (Not sure if this was achieved or not.) So apart from a short window between 1988 and the 90’s, and possibly after 2017, a large percentage of BCG in Korea is likely to be Tokyo172. At the same time, the spike in the 20’s of coronavirus positive patients is said to be reflecting the members of the religious sect, so my previous data should be disregarded.
    http://japan.hani.co.kr/arti/politics/35907.html
    https://hbol.jp/214945

    ReplyDelete


  28. Clinical trials of BCG have begun in several countries. But I am very worried that those trials are choosing the right BCG strain or not. I don't know the details of chosen strain.

    The scary thing about medical information is, once a trial results in "no significant effect", there is a tendency that only the "no significant effect" information tends to be spread. After this kind of fragmentary information, a consensus "BCG hypothesis was wrong. You still believe?" will be shaped between medical staffs.

    To prevent the situation, I think as many global researchers as possible need to shout out that BCG has multiple strains and their effects may vary widely. Once “not so effective” strain will be used and the trial results in "BCG has no effect", it will be difficult to reverse that information.



    BCGの臨床試験がいくつかの国で始まっています。しかし、それらの試験が最も有効なBCG株(Tokyo-172など)を選択しているかどうかが心配です。

    医療情報で怖いのは、いったん治験結果が「有意な効果なし」になると、詳細情報抜きに「有意な効果なし」の情報だけが一気に広がる傾向があることです。この種の断片的な情報が流れてしまうと、「BCG仮説は間違いだったよ。まだ信じてるの?」 という、不正確で極端な情報が医療スタッフ間で共有されます。

    この状況を防ぐためには、BCGには複数の株があり、その効果は大きく異なる可能性があることを、世界中でできるだけ多くの研究者が叫ぶ必要があると思います。実際に、後期の株では遺伝学的に「落ちている形質」が多くあります。「それほど効果的ではない株」が治験に使用され、いちど結果が「BCGに効果なし」となると、その情報を元に戻すことはなかなか困難になります。

    ReplyDelete
    Replies
    1. This comment has been removed by the author.

      Delete
    2. A reader found that the clinical trial in Australia is using BCG Denmark.
      https://twitter.com/nigeltwitt/status/1244576788283457536

      Not good information. We should appeal to them and the governments/public that the strains are important.

      Delete
  29. Thank you so much for the great analysis. I am a molecular biologist and I have worked with the Bulgarian BCG vaccinal strain. As a matter of fact we now vaccinate Bulgarian children not with BCG Bulgaria/Russia but some another, Pasteur, I think, although we produce BCG Bulgaria/Russia for export. Also, Bulgarian vaccination programme started in 1951, but almost all children of school age between 1951 and 1953 were tested by Mantoux test then promptly vaccinated with BCG Bulgaria/ Russia. Maybe this is why we had only 24 deaths so far, all with severe accompanying diseases and sognificant proportion of recovered elderly people. Regards, Rumena Chakarova

    ReplyDelete
    Replies
    1. Bulgaria is in between Iran and Italy. But, BCG Bulgaria maybe help.

      Why did Bulgaria switch to BCG Pasteur though Bulgaria keeps producing BCG Bulgaria/Russia for export?

      Delete
    2. Sorry, I do not think Bulgaria is in any way comparable to Iran and Italy with regard CoVID-19 prevalence or CFR. In fact, we have very low prevalence per million of population (139), lowest in EU, according to Worldometer, 6 deaths per million and a total of 966 cases so far. I do not know the reason Bulgaria switched to on other type of vaccine, although I checked specifically with the company that, at present, manufactures the local Bulgarian BCG. All they could tell me was they had concerns with local immunity reactions produced by the original strain.

      Delete
    3. I mean Bulgaria is geographically in between Iran and Italy. But, apparently, BCG Bulgaria has been working pretty well.

      It looks BCG Bulgaria is better than BCG Pasteur. I would think switching back to BCG Bulgaria worth considering.

      Delete
  30. The comment system for the previous post is not working anymore. I'm posting on the behalf of "Gergely".
    https://www.blogger.com/profile/08349536542331193351
    ---
    Just a note.

    As you have pointed out, the data obtained from BCG World Atlas is not accurate. For example, they list Hungary as a country that has used and uses the BCG Denmark strain.

    However, a 1986 publication points out that they have used Paris 1102 and P1173 BCG Seed-Lot strains. And I guess this was true until the publication of the paper. Hence, the vulnerable population has not been inoculated by the BCG Denmark strain (and this was likely introduced after the fall of the iron curtain).

    Moreover, I suspect the same is true for many other Soviet bloc countries. For example, BCG World Atlas lists Slovakia, Czechia, Latvia, Estonia, Lithuania, and some countries that were formerly part of Yugoslavia as nations that have used and using the BCG Denmark strain.

    Your theory would explain why these countries have a much lower infection and fatality rates than Western European countries.

    Reference:
    BCG policy and tuberculosis control in Hungary.
    https://www.ncbi.nlm.nih.gov/pubmed/3596027

    -Gergely

    ReplyDelete
    Replies
    1. Gergely, thanks for the info of BCG in Hungary and the other eastern European countries.

      I believe if the BCG World Atlas is accurate and complete, this hypothesis can be validated much faster and easier...

      Delete
  31. What about Vietnam phenomena?

    ReplyDelete
    Replies

    1. Does anyone have any information of the BCG vaccination policy/strain history of Vietnam?

      Delete
    2. Vietnam closed schools etc early, month ago. Probably due to good information flow between communists.

      What you call "phenomena" is the measures taken all over the world, social distancing etc. No one relies on their BCG vaccination.

      Delete
    3. https://www.google.com/amp/s/amp.dw.com/en/how-vietnam-is-winning-its-war-on-coronavirus/a-52929967

      Delete
    4. GiDo, I'm explaining the same thing again. I don't dismiss the other factors. Actually, I've included the effect of social distancing in my post.

      More scientists are working on this hypothesis. Wait for it.
      https://www.irishexaminer.com/breakingnews/ireland/bcg-could-be-first-approved-vaccine-for-covid-19-993442.html

      Delete
  32. The comment system for the previous post is not working anymore. I'm posting on the behalf of "AP".
    https://www.blogger.com/profile/17071688286568858877
    ---
    Unfortunately, due to very incomplete base data the hypothesis is no more than anecdotal at this point. It clearly looks like the data in BCG Atlas is inaccurate and then to fix it, comments by people that claim they are from the area and/or random google searches were used. We can't rely on such data or we just get the garbage in - garbage out scenario.

    ReplyDelete
    Replies
    1. I agree that the BCG Atlas is inaccurate but I don't think the whole is garbage. Maybe 20% of it is garbage and 80% is accurate.

      Please check several medical articles testing this hypothesis.

      Delete
  33. The comment system for the previous post is not working anymore. I'm posting on the behalf of "Ichiro".
    https://www.blogger.com/profile/00758116207499961848
    ---
    I was impressed with your perspective as well as your efforts to summarize in every detail. I appreciate very much. I have some questions. I understand that Japan/Russian types have more effectiveness than other BCG vacctine, subtracted part, Is 6110?, and some contamination may play important role to make the difference of preventive effects to Covid-19. So why do we consider not only First generation BCG itself but also consider the subtracted parts of it comparing to second or there’d generation. I am looking forward to hearing from experts of immunology.

    ReplyDelete
    Replies
    1. I'm looking forward to hearing from experts of immunology, too!

      Delete
  34. I do agree with Jun Sato. It is not fair to focus only on trivial incorrectness, but we have to see big picture,. Mortality rate in US and Western Europe is apparently different, statistically significant from references, from in Asian countries such as Japan, Singapore and Thailand. Of course, for the future analysis correction of the misunderstanding should be corrected by people from all over the world, which will be appreciated as mentioned by Jun Asato already. In addition, I am very exciting to discuss on this specific subject like this to save tremendous number of lives in the world in any way.

    ReplyDelete
    Replies
    1. Thanks Ichiro! Yes, we can see a great potential of saving so many people's lives and so many trillions of economy!

      Delete
  35. Hello Jun Sato,
    All the up to date information that you have gathered on this blog with the help of the people's comments is extremely valuable. Thanks for that!
    We are a group of volunteers who will try to get a more accurate data for the BCG vaccines around the world and improve the  data in BCG World Atlas. Apart from that we are gathering other information that is relevant to this research. If you or anyone else has some ideas what other data will be useful, apart from the following, please let us know: number of immigrants who have died in different coutries, average age, density & urbanization Index, development Index, number of beds per 1000 people, lock down date and policy. 
    Of course we will share all this data publicly. Also if anyone has information for more accurate BCG policy for a specific country, or wants to join us in gathering this data, pls feel free to contact me at - https://www.linkedin.com/in/rkirkov/ 
    Kind regards,Rado

    ReplyDelete
    Replies
    1. Thanks Rado. Is there any place we can correct and improve the BCG policy/strain information openly? If there is, I believe not a few people join it!

      Delete
    2. Hi Jun, that's great idea.

      We created google drive folder (https://drive.google.com/drive/u/0/folders/1gbD3lOAke-1BC_ZaxNmiBS_5MrCdbiBC) with a separate spreadsheet for each country, so far we have listed few countries just to confirm if we need any further columns. Her is a description of the suggested process how the data can be updated - https://docs.google.com/document/d/1Pw6K9UU-drmScdhZ3gHSwN2iPCeP0g2eqd70eoxs9tU/edit#heading=h.v3gimps91fxn

      Please see UK's spreadsheet for example - https://docs.google.com/spreadsheets/d/1yke7aat8LqYd4MQuvqx9LF8hZNYHTpcpbQjIQhJIOAI/edit#gid=0

      We have also created slack channel for any questions and suggestions - https://bcgvaccine.slack.com/

      The reason why we choosed google spreadsheet is because it's interactive, people can work simultaneously, it has history and someone deletes data by mistake can be reverted to previous version, it can be shared for edit only with people who want to update it, and the rest can see read only data.

      Please let us know if you have any further suggestions.


      Delete
  36. Hi, Jun,
    I am sorry, if you have shown this information, previously.
    Recently, I heard that the percentage of infection of Japanese teenager is far lower than those of upper ages. I remember that effect of BCG continues strongly up to teenage, while the effect gradually decreases at higher ages. Have you checked the percentages of infection of teenagers on each country? In Japan, unfortunately, we seem to have not much data, because PCR tests have been limited. I do not believe the efficiency of the frequent PCR tests on direct reduction of the “Corona” cases. But now, we need the increase of the test number for future analysis in international scale.

    ReplyDelete
    Replies
    1. It's hard to compare among the young people since there are fewer death cases and the number of infection cases is not reliable.

      But, the new analysis I did shows that time effect. Please check it!
      https://www.jsatonotes.com/2020/04/the-bcg-hypothesis-age-group-comparison.html

      Delete
    2. Thank you for your reply. I can only find old data in "https://www.usatoday.com/in-depth/news/2020/03/27/how-old-coronavirus-patients-us-we-looked-hospitalization-data-19-states/2922646001/", which contain "Average percentage of total cases by age group in different countries". It contains data of USA, China, Spain. The percentages of cases of the age below 30th is highest in USA, while it is lowest in Spain. It may come from concentrated tests on hard cases in Spain. This data is, however, worth to be paid attension., I think.

      Delete
  37. The comment system for the previous post is not working anymore. I'm posting on the behalf of "
    Karoly".
    https://www.blogger.com/profile/09235111349372921119
    ---
    Great collection of information on the correlation of BCG and covid19 spread/fatalities! If possible, it would be great to establish a Wikipedia site, where experts from each country of the world would enter what BCG strain the country used in what period of time and what percentage/age-group of the population was vaccinated in the given period of time. Then, this information should be put on a world-map that could change as a slide goes over a time-frame. Such a map could show the most essential information on the type on BCG vaccinations. And the above experts should also provide links to support the information they provided, preferably to scientific publications or government web-sites.

    One more comment. A very recent Nature paper claims that BCG (Danish strain) administered intravenously provides superior immunity in macaques: https://www.nature.com/articles/s41586-019-1817-8 . "Most “astonishing” is that six of the 10 monkeys who received the IV vaccine never even developed an initial infection when exposed to TB, says Joel Ernst, an immunologist who specializes in TB at the University of California, San Francisco. Preventing infection, not just disease — called sterilizing immunity — is extremely rare with any TB vaccine, says Ernst, who was not involved in the study. Thwarting that infection means that no bacteria can reactivate to cause a latent or active TB infection." https://www.sciencenews.org/article/tb-vaccine-injection-blood-skin-effectiveness?fbclid=IwAR2w-ZewTKqEnOTNcr08VXeWKAxb7e4e85iGArbOF3AWgTYOGixaASQyFF8

    Revaccination also matters for a boosted immune system. Japan gives BCG after birth and between ages 6 and 12, if I remember well. Many countries do BCG revaccination, some even three or more times. https://www.ncbi.nlm.nih.gov/pubmed/27412415?fbclid=IwAR1n4QTbCt0b0p0kP5-oD6jtGx-Eii_vQ3Ltg_c9ntTL9GFWmgGDmUwjjpM

    ReplyDelete
    Replies
    1. Hi Karoly,

      Yes, the hardest part of this analysis is to collect the correct BCG vaccine information. http://www.bcgatlas.org/ is not only incomplete but also wrong. It took so many people's hours to get the ex-East Germany's BCG information.

      If anyone or you can start an open/collaborative project, not a few people including me will join!

      Delete
    2. Hi Karoly, as I just replied to a previous comment related to this question.

      We created google drive folder (https://drive.google.com/drive/u/0/folders/1gbD3lOAke-1BC_ZaxNmiBS_5MrCdbiBC) with a separate spreadsheet for each country, so far we have listed few countries just to confirm if we need any further columns. Her is a description of the suggested process how the data can be updated - https://docs.google.com/document/d/1Pw6K9UU-drmScdhZ3gHSwN2iPCeP0g2eqd70eoxs9tU/edit#heading=h.v3gimps91fxn

      Please see UK's spreadsheet for example - https://docs.google.com/spreadsheets/d/1yke7aat8LqYd4MQuvqx9LF8hZNYHTpcpbQjIQhJIOAI/edit#gid=0

      We have also created slack channel for any questions and suggestions - https://bcgvaccine.slack.com/

      The reason why we choosed google spreadsheet is because it's in table format, it's interactive, people can work simultaneously, it has history and someone deletes data by mistake can be reverted to previous version, it can be shared for edit only with people who want to update it, and the rest can see read only data.

      Once we gather the information, as you suggested we will share it with BCG World Atlas as well if they want to update it on their site, which would be great.

      Please let us know if you have any further suggestions.

      Delete
    3. This is a great project!

      Can't you make it to one spreadsheet that you can easily compare between countries?

      Delete
    4. Thanks Jun,

      The reason why we choosed to have multiple spreadsheets is that it's easier for someone who has information for a specific country to enter it and to decrease the chance that someone may delete the records from other countries.

      If you don't mind, can we keep it separate for let's say couple of weeks and after that once we gather more information we will clean and normalize the data and after that merge it in a single spreadsheet, which can be used for further analysis including with ML.

      Kind regards,
      Rado

      Delete
    5. Hi Jun,

      We just created this spreadsheet as well where everyone, even without authentication can list a datasource related to BCG - https://docs.google.com/spreadsheets/d/16ISrVB2OL9pOLLPyTRziciTjSwFH7RI-aVExadCJ25o/edit#gid=0

      So we can have all datasources in one place and after that using them to create more detailed data per country.

      Thanks,
      Rado

      Delete
    6. I think it's better.
      Still, I prefer one big spreadsheet, though.

      Delete
    7. Sure, as you wish. We created the following two spreadsheets where we can add data for all countries as you suggested, can you please let us know which one of the 2 you prefer:

      1. One that has from and to years, so we won't have too many rows for each year - https://docs.google.com/spreadsheets/d/1vXBNqFTdztyzlv4SLiid8CCkFbhSy69iIj9TJ3kefJ4/edit#gid=0

      2. This one has a separate row for each year, so we can enter more specific information https://docs.google.com/spreadsheets/d/1ux-JiFIKrWAdAcY7qP2wXr6DIzk9wU42Fq0b9__qpGE/edit#gid=0

      Also, both of them can be modified at the moment by anyone without authentication, do you think that it's better only authenticated users to be able to add data and modify the spreadsheet?

      Please feel free to add columns or remove if you think that it's needed.

      Cheers,
      Rado

      Delete
  38. Dear Jun-san,
    Great BCG works!
    Do you notice the paper from Ireland?
    "BCG vaccination may be protective against Covid-19"
    https://www.researchgate.net/publication/340224580_BCG_vaccination_may_be_protective_against_Covid-19 
    While the method is so immature that they use only a single time death rate as an endpoint and do not eliminate confounding factors among target countries with/without BCG, this not yet peer-reviewed paper reached the same point as your hypothesis. They say they will initiate a randomised, blinded, placebo-controlled trial.

    ReplyDelete
    Replies
    1. I hope the west European, Australian, and the U.S. researchers notice the difference among the BCG strains and include the BCG Tokyo strain!

      Delete
  39. The comment system is not working properly. I'm posting on the behalf of "Marianne".
    ---

    Hi Jun-San,

    You’ve done some interesting research. I have some information for you about London you may find interesting.

    The overall BCG vaccination rate in London residents of all origins is 72% which is not particularly low.

    The UK moved from a universal BCG vaccination program for 10-14 year olds to just vaccinating babies in areas (especially in London) with a high incidence of TB as BCG is generally only around 3/4 effective. I also noticed there was a very loose pattern of opposite correlation between coronavirus incidence and TB incidence in areas in London. I thought this was unusual because if areas are more affected due to overcrowding, connectivity etc then the same areas would be affected by both respiratory diseases rather than opposite correlation. In London only babies born in the areas with high TB rate were offered the BCG vaccination in the last 15 years. The 2 maps attached show the loose opposite correlation of TB incidence and COVID-19 incidence.

    To find the original source of the maps follow the links below. If you want to see The Telegraph map, you’ll have to sign up to their online newspaper but you could sign up for a free trial then cancel if you wish.

    https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/759629/TB_London_annual_review_2017.pdf

    https://www.telegraph.co.uk/news/coronavirus-uk-cases-deaths-world-map-live/

    Kind Regards,

    Keep well and curious,

    Marianne (from London but lived in Hamamatsu for 5 years, working for Yamaha Corporation).

    ReplyDelete
  40. The comment system for the previous post is not working anymore. I'm posting on the behalf of "
    Esteban".
    https://www.blogger.com/profile/10959494378072737408
    ---
    https://t.co/DrlQOAQFYY?amp=1

    ReplyDelete
  41. Australia is seting up a trial!
    https://sptnkne.ws/CcKB

    ReplyDelete
    Replies
    1. This is very good news. But they are using the BCG Denmark strain

      A blog reader contacted the coordinator of that trial to include the BCG Tokyo strain or at least read my article.

      The response of the BCG Tokyo strain manufacturer is so disappointing...
      https://gyazo.com/a7d48ded9f4b69a5aa4899087c73711b

      Delete
  42. Is there any information on bladder cancer patients who have been treated with BCG infiltrations? BCG is commonly used as an alternative to chemotherapy for cancer patients with excellent results. But does this 'rinsing' of the bladder with high-dosage BCG have the same (or better!) effect at immunizing against Covid-19?

    ReplyDelete
    Replies
    1. I heard that BCG is a registered drug for bladder cancer in some countries. I heard that in the U.S. BCG is mainly for bladder cancer, not as a TB vaccine. But I'm afraid that I don't know any details about that usage.

      Delete
  43. I’m a Vietnamese, currently living in Japan.
    Thank you for your fascinating observation. I have read many news about BCG and Covid-19, but your analysis is extremely well done, clear and many insight information to understand the whole picture.

    For the case of Vietnam, BCG was introduced in Vietnam since 1970s with some foreign aids. I don’t know which BCG type. From 1981, the BCG vaccine was produced by Vietnam’s Institute of Vaccine and Medical Biologicals and from that year BCG vaccine has been used in the expanded immunization program until now.

    In the fight with the COVID-19, Vietnamese Government has taken many protection measures from very early stage (probably before February), even before WHO announcement. It seems that the Government has learnt from its experiences in the SARS epidemic in 2003 and more important is that Vietnam has a long border line with China which may make Vietnam in difficult control.

    Infected cases in Vietnam is quite low due to strict control but currently according a newspaper in Vietnam, Vietnam scientists realize that besides their early protection measures, BCG may play important roles. They are planning tol carry out a test of BCG vaccination for 800 medical staffs to confirm if BCG vaccine may reduce the severity of infected cases from Coronavirus. They also carry out an analysis among the current infected cases, how many cases recover within 14 days, BCG vaccinated or not. Unluckily I don’t have available data for the moment. It would be interesting to have more confirmation on the correlation between BCG & coronavirus.

    ReplyDelete
    Replies
    1. Hi Miraiazuki,

      Thanks for Vietnam information.

      One important thing about Vietnam is that the prevalence of tuberculosis is relatively high in Vietnam. BCG vaccine is attenuated tuberculosis bacteria. We can see that BCG vaccine + tuberculosis correlates inversely to COVID-19 deaths.

      Vietnam and Taiwan are the best countries to block and contain COVID-19 probably because both had experienced the SARS epidemic and both are good at dealing with the Chinese government who sometimes doesn't tell the truth.

      If you can share the information of the BCG clinical trial for 800 medical staffers and the analysis of current infected cases more, that would be of great help. Both are very important and interesting. Especially, the latter is the first analysis in the world.

      Delete
  44. Dear Jun-San,

    Many thanks for your comments.

    I do agree with you regarding to the case of Vietnam.
    By the way, I'm not a medical staff but I'm very interested in your hypothesis of BCG.
    I will follow the news of BCG trial and analysis of current infected case in Vietnam.
    I will keep you updated once I get any information

    ReplyDelete
    Replies
    1. Thank you, Miraiazuki-san! Please keep us updated on the Vietnam trial and analysis of BCG.

      Delete
    2. I read this article. Does Vietnam vaccinate BCG to ongoing COVID-19 patients??
      https://e.vnexpress.net/news/news/vietnam-to-test-tb-vaccine-against-covid-19-on-medical-workers-4087436.html

      Delete
  45. The comment system for the previous post is not working anymore. I'm posting on the behalf of "
    Truth Teller".
    https://www.blogger.com/profile/08258273191454710345
    ---
    I only know of Merck that manufacturers BCG. Also, why can't we get this into the world wide news?
    Terry Traster Doctor of Pharmacy USA

    ReplyDelete
    Replies
    1. I believe BCG worths much more attention, especially in west Europe and the U.S. I'm hoping that BCG can get the medical, political and the public attention much more now and BCG can stop the second wave of this pandemic in fall/winter.

      Delete
    2. MEDAC in Hamburg, Germany, makes BCG

      Delete
    3. MEDAC should accelerate its BCG vaccine production.
      Do you know what strain does MEDAC produce?

      Delete
    4. bactéries BCG (Bacille de Calmette-Guérin) provenant de Mycobacterium bovis, germe RIVM dérivé du germe 1173‑ ‑P2

      ..................................................................................................................2 x 108 à 3 x 109 unités viables

      Delete
    5. Oh, that strain is a pretty weak one. Still, it's much better than no BCG.

      Delete
  46. The comment system for the previous post is not working anymore. I'm posting on the behalf of "いぬ".
    https://www.blogger.com/profile/13634259789124783542
    ---
    To Mr.Jun Sato

    I am very interested in reading the BCg hypothesis.

    Because it is interesting, I thought carefully and searched for points that have an influence on the differences between Western European countries and North America.

    The point is
    1. Number of foreign tourists (accepted)
    Https://www.globalnote.jp/p2336/
    -> I assumed that there was a correlation with the number of Chinese tourists flowing into each country during the Spring Festival .

    2. Average temperature
    https://www.data.jma.go.jp/gmd/cpd/monitor/mainstn/nrmlist.php#reg2
    -> I assumed that the higher the temperature, the weaker the virus.

    Deaths / 1Mpop as of 4/18
    https://www.worldometers.info/coronavirus/

    ReplyDelete
    Replies
    1. Dear いぬ-san,

      I've told this more than 50 times that I don't dismiss other factors. Sure, there are many factors. But, the BCG seems to be the most impacting factor so far and I'm focusing on it. If you know any example/data that can deny the BCG hypothesis, that would be helpful.

      Delete
    2. To Mr.Jun Sato

      Thank you for your reply.

      I'm sorry.

      I haven't read your 50+ comments.

      Delete
  47. Poland here:

    Polish researchers are going to test the effects of BCG vaccine, whether it's helpful in boosting resistance against covid
    https://www.tvp.info/47706376/szczepionka-na-gruzlice-pomoze-z-covid19-sprawdza-polscy-naukowcy

    - Biomed Lublin, the supplier is joining them. They're producing Brasil-Moreau strain.
    source for the strain: https://biomedlublin.com/pl/produkty/szczepionka-przeciwgruzlicza-bcg-100/

    ReplyDelete
    Replies
    1. Another good news though the strain, Brazil-Moreau, may not be that effective.

      The article is saying "Similar trials have already begun in Japan, the Netherlands, Germany and Australia", but I don't see any trial in Japan yet.

      Delete
    2. I don't know what were their sources for tests in other countries. However I found this article that mentions PL scientists responsible for the trials.
      https://pulsmedycyny.pl/szczepienia-przeciwko-gruzlicy-a-covid-19-kolejny-projekt-z-dofinansowaniem-agencji-badan-medycznych-989142.

      Poland is not doing bad so far, but Polish government also introduced lock-down and restrictions quite early (and yet too late all things considered). Also, in the middle of March many companies started working remotely

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

      Delete
    4. There is also a quite interesting for laywoman like me study from 2016 about evolution and differences between BCG strains. Sadly, it's available only in Polish

      http://www.phmd.pl/api/files/view/117054.pdf

      Delete
  48. The comment system for the previous post is not working anymore. I'm posting on the behalf of "ARAK".
    https://www.blogger.com/profile/09289452304763738958
    ---
    I think you have to calculate the number of tourists per 1Mpop and compare those numbers against the numbers of death/1Mpop). Then bCG is the only factor I can think of for the differences between Spain-Portugal, UK-Ireland, or Italy-Croatia

    ReplyDelete
    Replies
    1. Can you do it?

      As Japan and Thailand are the top two countries that Chinese tourists visit and both of them didn't block Chinese in the early phase, I don't think it worth spending my time.

      Delete
  49. just so you know
    https://www.rt.com/news/485206-tb-vaccine-covid-19/

    ReplyDelete
  50. The comment system for the previous post is not working anymore. I'm posting on the behalf of "MaGa".
    https://www.blogger.com/profile/01749302665398830017
    ---
    The map is not wrong, vaccination in Ecuador was introduced in 2018 and the map is from 2009.

    There is a very much discriminant explanation for Latin American countries where media as been super fast diagnosing "undertesting". I think the BCG hypothesis will just a hypothesis is more robust. Please analyze this note: https://elpais.com/sociedad/2020-04-26/las-nuevas-tumbas-retratan-el-impacto-de-la-pandemia-en-brasil.html.
    The photographies of dead bodies or mass graveyards can not be hidden. And they appeared first in Manaos, a selvatic state of Brasil where population is most probably not vaccinated as they were not even on the census until 2 decades ago.
    Quote from a graveyard worker in S.Paulo : "the cementery is working 20% more". Only 20%. In Ecuador and NY they report 400% more.
    They also don't understand why young people is having complications BUT only in extremely low income levels. This is probably because they are immigrants from selvatic states.
    Also, local estimations says # of deaths could by 2 or 3 times higher but studies from American universities talk about 12 or 13 times higher. That's because they are extrapolating NY and Europ death rates to Brasil. They did the same with China.
    While there might be undertesting happening, there's no way to hide massive graveyards in times of social media.

    ReplyDelete
    Replies
    1. Hi Maga,

      Thanks for the info.

      I agree that nobody can hide massive deaths.

      Do you have a source for Ecuador BCG vaccination program?

      And also, a source for Brazil BCG vaccination program? It sounds it had differed by state.

      Delete
  51. The comment system for the previous post is not working anymore. I'm posting on the behalf of "Carlos Aguinaga".
    https://www.blogger.com/profile/13754721561595210001
    ---
    Good afternoon Mr Sato. We are a grup of politicians from Argentina, interested in your "hypothesis" about BCG vaccination and Covid 19. It could be a great news for us since Argentina has been having a universal BCG vaccination program since many years ago. We would like to have a meeting with you by Zoom. Is it possible?

    ReplyDelete
  52. Hi all, here is a list of BCG - COVID-19 clinical trails that I am aware of:
    * 30 April, Brazil, Which strain?, https://clinicaltrials.gov/ct2/show/NCT04369794?term=bcg&cond=COVID&draw=2&rank=6
    * 24 April, Colombia, Which strain?, - https://clinicaltrials.gov/ct2/show/NCT04362124?term=bcg&cond=COVID&draw=2&rank=1
    * 24 April, USA, Texas and Harvard Uni, BCG Tice strain (procured from Merck), https://clinicaltrials.gov/ct2/show/NCT04348370?intr=bcg+vaccine&draw=2&rank=4
    * 23 April, Poland, Which strain?, https://www.tvp.info/47706376/szczepionka-na-gruzlice-pomoze-z-covid19-sprawdza-polscy-naukowcy
    * 20th April, Egypt, Danish strain, https://clinicaltrials.gov/ct2/show/NCT04350931?intr=bcg+vaccine&draw=2&rank=3
    * 25th March, The Netherlands, Radboud University, Which strain?, https://clinicaltrials.gov/ct2/show/NCT04328441
    * Australia (BRACE), Royal Children's Hospital, Denmark strain, https://clinicaltrials.gov/ct2/show/NCT04327206
    * Vietnam - https://vnexplorer.net/vietnam-seeking-to-work-out-bcg-vaccine-and-covid-19-connection-a202025829.html

    I couldn't find information which strain is used for half of them, but 2 of the are using the Danish strain.

    Kind regards,
    Rado

    ReplyDelete
    Replies
    1. Hi Rado,

      Thank you very much for wrapping up the clinical trials in the world!
      This may worth to create a spreadsheet to track the status.

      Let me add a few I remember.

      Ireland
      https://www.irishexaminer.com/breakingnews/ireland/bcg-could-be-first-approved-vaccine-for-covid-19-993442.html

      Peru, Taiwan, etc. I'm asking them to disclose the outline. The trial in Taiwan will use the Tokyo strain but the funds are insufficient to start...
      https://www.abundance.org/covid/

      Germany: VPM1002, based on the Bacillus Calmette-Guérin (BCG) vaccine
      https://www.fdanews.com/articles/196528-germany-tries-out-tuberculosis-vaccine-against-covid-19

      Delete
    2. Thanks June, I created this spreadsheet where anyone can add information for new clinical trials and added the ones that you have listed above - https://docs.google.com/spreadsheets/d/1ucYQgKPmFjDkcNwwwqyVrJmEkZ9kxjmeznD85LQeEuQ/edit#gid=0

      Also, there is one more spreadsheet with information for BCG strains that we started to gather - https://docs.google.com/spreadsheets/d/13Y0raaZnNF-KcgBIY5frGsxaSIIGPNKPZUcXyE9tfKo/edit#gid=0

      Cheers,
      Rado

      Delete
    3. Thaks Rado!

      My twitter friends created a spreadsheet to track the clinical trials.
      https://docs.google.com/spreadsheets/d/16ISrVB2OL9pOLLPyTRziciTjSwFH7RI-aVExadCJ25o/edit#gid=821329594

      https://twitter.com/tototo045/status/1256855134316793856

      I hope you guys can collaborate.

      I'm a kind of very sad to know that the earliest result of the clinical trials will be in December. I'm hoping that BCG vaccine can stop the second wave in fall/winter in the Northern Hemisphere...

      Delete
    4. Hi Jun, sure we will keep updating the spreadsheet that you shared above.

      Here is relatively new research which hypothesis is that BCG helps if people have been vaccinated in the last ~15 years -
      https://www.medrxiv.org/content/10.1101/2020.04.23.20077123v1.full.pdf

      Delete
    5. HelloJ. Sato,
      American country doctor here. Japanese death per million 100 times less than the worse case countries. Confounding with whatever you want and I'll still buy all the BCG Tokyo you can sell.
      That this is nowhere on the American government or universities radar is incomprehensible.
      Great work. Keep it up. Blessings to you!

      Delete
    6. I have found an update on Polish trials here:

      https://www.rynekzdrowia.pl/Badania-i-rozwoj/Czy-za-lagodniejszy-przebieg-epidemii-koronawirusa-w-Polsce-odpowiada-szczepionka-BCG,208045,11.html

      Trials are performed by consortium of 5 institutions. By name are known these:

      Kolegium Nauk Medycznych Uniwersytetu Rzeszowskiego,
      Śląski Uniwersytet Medyczny w Katowicach,
      once again Biomed Lublin is listed as willing to share their product for the sake of trials.

      Some hospitals, which are participating:
      - Wojewódzki Specjalistyczny Szpital Dziecięcy im. św. Ludwika
      - Szpital Specjalistyczny im. Stefana Żeromskiegow Krakowie, Szpital Bielański
      - Szpital Praski w Warszawie
      - Kliniczny Szpital Wojewódzki im. Św. Jadwigi Królowej w Rzeszowie
      - Podkarpacki Ośrodek Onkologiczny w Brzozowie

      According to the aricle, one of coordinators is prof. Łukasz Krzych. It's said the results might be available in Autumn at earliest.

      Delete
    7. Hi Nee and Rob,

      Thanks for your comment. I hope the American government notice factor and act before the second wave in fall/winter.

      Hi Unknown,

      Thanks for the updated info regarding the trial in Poland. We've gathered info on the clinical trials and listed them up.
      https://sites.google.com/view/covid-19-bcg-vaccine/home

      Delete
  53. To give you some other opinion of a retired expert (Prof. Bhakdi, born Thai, now German):
    1) The Coronavirus will most certainly not have any second or third wave.
    2) As it is not an esp. deadly virus, vaccinations do not make sense.
    Dr. Bhakdi won't get one and doesn't wear a mask.

    Although you do all this to help the economy, I feel you are a victim of the panicmaking yourself. This virus has killed people with an average of 81 years in Germany - which is exactly our life expectancy.

    Furthermore: A boost of the immune system is not the answer. To fight Covid 19 you need antibodies. They are simply not produced by BCG but by an exposition to the virus itself.

    ReplyDelete
  54. Also the table on top about Germany is no longer valid. Brandenburg in the East has 122 deaths, Schleswig Holstein in the West 112, although they have more population. That means we already have counterevidence for BCG vaccination theory.

    ReplyDelete
    Replies
    1. Thanks for pointing this out.

      Interestingly, Soviet seemed to implement a BCG vaccination program in Schleswig Holstein from 1947.
      https://pub.uni-bielefeld.de/download/2435135/2479204/Healing_democracy_Diss_Ellerbrock.pdf
      https://www.ncbi.nlm.nih.gov/pubmed/23241911

      Delete
    2. After World War II, Schleswig-Holstein was part of the British occupation zone, although some municipalities of Schleswig-Holstein east of Ratzeburg were exchanged for municipalities of Mecklenburg in the Soviet occupation zone (Barber Lyashchenko Agreement). The British-occupied section became the new German state of Schleswig-Holstein on 23 August 1946, which joined the Federal Republic of Germany on 23 May 1949.[2]
      https://en.wikipedia.org/wiki/Province_of_Schleswig-Holstein

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

    ReplyDelete

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