Can Pakistan's TB Vaccination Program Help Reduce Impact of Coronavirus?

Can Pakistan's 88% BCG vaccination rate against tuberculosis (TB) help reduce the impact of coronavirus? A New York Institute of Technology study using data from 178 countries has concluded that both the incidence and mortality of COVID-19  are significantly lower in countries with BCG vaccination programs against TB. Will this study help prove Dawn News' alarming forecast of over 2 million confirmed cases by June 1 and 20 million actual infections wrong? 

Pakistan's Dawn News Coronavirus Forecast

The study has found that the coronavirus has hit US and Italy which do not have universal BCG vaccination programs much harder than countries like Japan which do.  Scientists say it will take several months to get results from ongoing trials testing the BCG vaccine against COVID-19.

TB Vaccine May Lower Death Rates From COVID-19. Source: NYIT Colleg...

Scientists have speculated that BCG vaccine may boost the innate immune system not just against TB but also against a variety of other pathogens from invading the body or from establishing an infection. Here are some of the key findings of the study summarized below:

1. Countries that do not have a BCG vaccination policy against TB have seen 10X greater incidence and deaths from Covid-19 than the countries that do, according to a study of  data from 178 countries by New York Institute of Technology researchers.

2. BCG, or Bacillus Calmette-Guérin, is a vaccine for tuberculosis (TB). It is administered at birth in many developing countries that have historically suffered from the disease, such as India and Pakistan. Most of the developed nations, including US, Italy and the Netherlands do not have universal TB vaccination programs. Japan is among the few developed OECD nations that still do. The East Asian nation had some of the earlier cases, but the mortality is low despite not having adopted some the more stringent social distancing rules.

3. The study looked at Covid-19 instances and mortality for 15 days between March 9 and 24 in 178 countries and concluded that incidence of Covid-19 was 38.4 per million in countries with BCG vaccination compared to 358.4 per million in the absence of such a program.

4. The death rate was 4.28 per million in countries with BCG programs compared to 40 per million in countries without such a program. Out of the 178 countries studied, 21 had no vaccination program, while the status was unclear in 26 countries. The latter group was treated as not having a policy for the purpose of this study.

Scientists do not have data yet on the effect of BCG vaccination on coronaviruses in general or SARS-CoV-2 in particular, according to Reuters. There are also many BCG vaccines, with different capacities to protect against various TB strains. Scientists need to determine which BCG vaccines might have the best ability to boost the innate immune system to fight COVID-19.  Scientists say it will take several months to get results from ongoing trials testing the BCG vaccine against COVID-19.

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Comment by Akhtar Hussain on April 2, 2020 at 10:47pm

Thank you Riaz, again very useful information indeed.

Comment by Akhtar Hussain on April 2, 2020 at 10:49pm

By the way Riaz, is it possible to have a share option from your posts. 

It would be very useful.  Thank you.

Comment by Akhtar Hussain on April 2, 2020 at 10:50pm

Sorry just found it.

Comment by Riaz Haq on April 3, 2020 at 6:25pm

Pakistan with a score of 35.5 ranks 105/195 countries on global health security index.

It is rated as more prepared on a scale from most to least prepared.

Comment by Riaz Haq on April 4, 2020 at 11:25am

Testing facilities have been established in all the provinces, Azad Jammu and Kashmir and Gilgit-Baltistan, it said.

The National University of Science and Technology (NUST) indigenously developed COVID-19 testing kits which have been sent to DRAP Technical Assessment Committee for comprehensive checking.

It said 13,000 surveillance centres had been set up across the country with public awareness messages disseminated through all modes of media.


The government submitted on Saturday to the Supreme Court of Pakistan a report on its national action plan for combating the coronavirus epidemic spreading across the country.

In its report, the government detailed the situation arising in the wake of the pandemic and the severity of suspected cases.

“By April 25, the number of the coronavirus cases are feared to reach 50,000,” the report stated at one point.

According to the breakdown provided in the report, around 7,000 cases of the total are expected to be critical in nature while around 2,500 could be a cause for concern. The government estimates that a further 41,000 cases could be of a mild nature.

The report notes that confirmed cases are expected to be lower than that of countries in Europe, and assures that the government is trying to maximize its testing capacity.

The federal government has said that it has put in place an emergency plan costing $366 million and guidelines have been prepared in consultation from the medical experts.

“All the airports have special counters to monitor coronavirus,” it mentions in the report, adding that around 222 suspected patients have been traced thanks to entry and exit point checking at airports.

The areas adjacent to Iran and along the Balochistan border have declared an emergency to cope with incoming infected individuals, it says.

“Preparations were made to place patients in 154 districts under quarantine,” said the government report.

As of Saturday, Pakistan has recorded more than 2,700 cases and 40 deaths.

Comment by Riaz Haq on April 6, 2020 at 11:32am

#Pakistan reports death of 3rd doctor from #coronavirus. Dr. Abdul Qadir Soomro, 70, a veteran physician in #Karachi, managed a #charity #hospital for Jamaat-e-Islami's Al-khidmat Foundation -- among largest relief agencies in Pak. May his soul RIP. Amen.

Pakistan on Monday reported the demise of another doctor from coronavirus, raising safety concerns among health professionals who have been complaining about lack of proper safety gears.

Dr. Abdul Qadir Soomro, a veteran physician, breathed his last at a local hospital in southern port city of Karachi, becoming the third doctor in the country who succumbed to the virus.

Soomro, 70 was the administrator of a charity hospital, run by Al-khidmat Foundation -- the country's one of the largest relief agencies -- in the eastern outskirts of Karachi, where he had established an isolation ward for suspected coronavirus patients, the Health Ministry said in a statement.

His death brought the number of casualties from COVID-19 to 52 in the country.

The number of infection cases in the country has risen to 3,277, as 397 news cases were reported over the past 24 hours.

A total of 257 patients, of them 130 on Monday, have recovered, while 17 are in critical condition.

So far, the northeastern Punjab province reported 1,493 cases, Sindh 881, Khyber Pakhtunkhwa 405, southwestern Balochistan 191, northern region of Gilgit Baltistan 210, the capital Islamabad 82 and Azad Jammu and Kashmir confirmed 15 cases of the coronavirus.

Meanwhile, the virus also spread into the country's jails, with 49 cases confirmed in jails of Punjab province alone.

"We have 1,493 confirmed cases in Punjab, among them 49 are prisoners who are currently under quarantine," Usman Buzdar, chief minister of Punjab, said on Twitter.

Since appearing in Wuhan, China last December, the novel coronavirus has spread to at least 183 countries and regions, according to figures compiled by U.S.-based Johns Hopkins University.

The data shows more than 1.29 million cases have been reported worldwide, with the global death toll nearing 70,800, and more than 270,300 recoveries.

Comment by Riaz Haq on April 6, 2020 at 8:16pm

Pakistan: WHO and UNICEF estimates of immunization coverage: 2018 revision

Comment by Riaz Haq on April 9, 2020 at 11:10am

Fragile health facilities may face corona catastrophe

In a little more than a month since patient zero, Pakistan has registered over 4,200 coronavirus cases – the government estimates that the case will exceed to 50,000 by the April end.

The crippling national healthcare system is expected to collapse if the outbreak continues to spread by leaps and bounds, as it is not capable enough to address the global pandemic, Bloomberg reported on Wednesday.

The World Health Organisation statistics show that Pakistan spends just 2.9% of the gross domestic product on health, a number significantly below neighbouring India and less than half the global average.
The country is one of only three with ongoing polio transmission, and it has reportedly struggled in recent years to contain AidsIDS and dengue outbreaks.

Health care in Pakistan “continues to suffer from coordination challenges and an acute shortage of resources,” says Arsalan Ali Faheem, a consultant at DAI, a Bethesda, Md.-based company that advises on development and health projects. “The country has been hard-pressed to find resources for health delivery.”

He said that health care in Pakistan “continues to suffer from coordination challenges and an acute shortage of resources”.

Most of the health services including ambulances, hospitals are mostly funded by charitable organisations whereas paramedics staff lack training to operate critical-care equipment, said Asad Sayeed, an economist at the Collective for Social Science Research in Karachi.

Commenting on Pakistan’s economic conditions, he added that finance is an issue, whereas it is also about priorities since budget for health is meager when it is compared to the country’s defense budget.

Sayeed also said that after the 18th Amendment of the Constitution, the federal government has a very limited role to play in the health care sector. Collectively, federal and provincial health spending in the last fiscal year was the lowest since 2016.

There has been a lot of debate over the mishandling of pilgrims that had entered from Iran to Pakistan via Taftan border in Balochistan and the airports, many believe that the country failed to screen most of the pilgrims that become of of the source for the pandemic to spread in the country.

Thousands of travellers without symptoms were waved through the border. Those who felt ill were sequestered in a makeshift tent city on the Pakistani side that, according to patients, had no soap or hand sanitizer. “If one is affected, everyone would get it,” says Mohammad Hussain, 42, who spent more than two weeks there. “The camp was a breeding ground for the virus,” he added.

The government is trying to curtail the numbers by banning public gatherings and restricting the movement of the citizens. After quite an effort, it reached a deal with religious scholars to close down mosques and shrink crowds at Friday prayer.

Officials are going door to door looking for possible cases, with assistance from military personnel, a daunting task in one of the world’s most populous countries. In Karachi, local authorities have converted a convention hall into a 1,200-bed field hospital in anticipation of a surge in patients.

On the other hand, the federal government had submitted a report in the Supreme Court stating that they estimate 50,000 patients of coronavirus in the country by 25 April 2020.
The number of tests for COVID-19 performed in Pakistan is less than 50,000 as of now.

The country has done a very limited number of tests, fewer than 50,000 whereas US has done about 2 million tests.

Comment by Riaz Haq on April 9, 2020 at 7:55pm

National Heath Chief Zafar Mirza: Fewer Covid-19 deaths in #Pakistan doesn't mean we stop being careful. 73% #COVID19 deaths among patients with pre-existing health issues, 85% of those who died from #coronavirus above age 50 while 78% of them were males.

Special Assistant to the Prime Minister on Health Dr Zafar Mirza on Thursday said low Covid-19 deaths in Pakistan does not mean people start becoming lax about preventive measures against the virus outbreak.

Speaking at a news briefing in Islamabad, Mirza said: "I am seeing reports on some media programmes that Pakistan's Covid-19 death rates are lower as compared to projections made through modelling. While it is true to some extent that Pakistan has lesser coronavirus cases and a lower death rate than projected by experts, it is not a reason for citizens to become lax."

He said the restrictions imposed by the government on large gatherings and social contact had an effect on the infection rate, "but if people think we don't need those preventive measures and we don't need social distancing, it would be a very big mistake".

Stressing the need for more prevention and responsibility, Mirza warned that the country could see a sharp rise in the number of cases and deaths if people were not careful and started going out.

Talking about Covid-19 deaths he said that 73 per cent of Covid-19 deaths in the country were of people who had pre-existing health conditions, adding that 85pc of those who died from Covid-19 were above the age of 50 while 78pc of them were males.

Mirza added that the government was creating a mechanism whereby personal protection equipment (PPE) would be provided to health professionals in hospitals in such a way that shortage was not observed.

He said the National Disaster and Management Authority (NDMA) after its calculations had provided PPEs, including N-95 masks, gowns and gloves to 152 hospitals for a week. These are the hospitals where most coronavirus patients would be brought, he added.

"We have a list of some 400 hospitals and all of them will be provided PPEs, and on a priority basis."

The PM's aide on health said the government would facilitate firms wishing to manufacture ventilators locally through a committee formed under the Drug Regulatory Authority of Pakistan (Drap).

Through the committee, the firms' applications would be processed as soon as possible so that production could be started in order to overcome shortage, he revealed.

'Burden on hospitals will increase by month's end'
Meanwhile, Prime Minister Imran Khan during an earlier media briefing said that he believed the burden on the country's healthcare system would increase by the end of this month, but Balochistan might not face a worsening situation due to sparse population.

He added that the government was analysing data of coronavirus cases not just in the country but also in the United Kingdom and United States as well.

He said that the government was also looking at the numbers in India and Bangladesh as their population trends were similar to Pakistan's.

Comment by Riaz Haq on April 11, 2020 at 1:34pm

#Pakistan's #Coronavirus case curve is flattening faster relative to #India and other #Asian peers.

Despite the slight tapering this week, India’s trajectory continues to be steeper than several Asian peers such as Singapore, Japan, and even Pakistan. But it is flatter than that of the US, which has emerged as the new epicenter of the global pandemic, with the most number of active cases and deaths at the moment.


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