Epidemics Past and Present: Polio and COVID-19

in hive-196387 •  last month 

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An unvaccinated @agmoore, a few years before introduction of the Salk vaccine

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In 1954 I took part in an audacious public health experiment. I was a recruit, not a volunteer. The stakes were so high that public health officials went forward despite significant risk. This was the first widespread test of the Salk polio vaccine. 1.6 million children across the U.S., Canada and Finland were enrolled.

I remember, in those days, we feared polio, even the youngest among us. We were haunted by images of afflicted children in iron lungs. Many of us personally knew of classmates, or neighborhood children who had been stricken.

Patients in Iron Lungs: Mechanical Respirators
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Henderson and Both Respirators are shown. Image credit: Wellcome Trust. Used under a CC 4.0 license

The iron lungs, as they were called, enabled polio sufferers to breathe if their chest and diaphragm muscles were paralyzed. Sometimes this intervention was temporary, and sometimes it became a life sentence. I think, more than anything else about polio, this image struck terror in the hearts of children.

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There was a diffuse, palpable fear about polio, not unlike the fear surrounding COVID-19 today. When the Salk vaccine was finally introduced, Jonas Salk was regarded as a savior.

There are parallels between polio of that time and the COVID-19 pandemic of our time. These parallels may help to illuminate some of the challenges we face as we move forward toward treatment, management and vaccination.
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1963 Poster Promoting the Sabin Oral Vaccine
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Image credit: CDC, public domain.

The competition between Salk and Sabin was quite intense. Salk used a 'killed' virus and Sabin used a weakened 'live' virus. Sabin's was cheaper and easier to administer, but in a very small number of cases actually caused paralytic polio. Eventually, this risk led, in the U.S. at least, to discontinuing use of the oral vaccine.

Asymptomatic Carriers and Mortality

One similarity between COVID-19 and the polio virus is the role of asymptomatic carriers. In children with polio, only about 24% of those who contract the virus will show symptoms.These symptoms are generally a low-grade fever and sore throat. And, of all those who contract the virus, only about 1% will experience paralytic polio. Of these, between 2 and 5% will die. In the adult population, mortality from paralytic polio is much higher--between 15 and 30%. In this, polio is like COVID-19, in that adults afflicted with severe disease suffer a higher mortality.

1957 March of Dimes Poster
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Image Credit: March of Dimes Foundation, public domain

Every year, during the campaign to find a polio vaccine (and once it was discovered, to get people to use it), the March of Dimes Foundation would pick a poster child to be the face of the organization. The child in the 1957 poster was identified as Martha Ann King. She is said to have contracted polio when she was four days old. I tried to discover what her future was like after the poster campaign, but couldn't find any information.

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It was once thought that adults could not be asymptomatic carriers of the disease, and it was believed that older children and adults were largely immune. The focus was always on vaccinating children under the age of 5. However, a recent study out of India showed that a significant portion of older children and adults may contract the disease and also be asymptomatic spreaders.
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R0 (R Naught) Diagram Showing How Infection Spreads in Two Diseases (Ebola and Sars)
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Image credit: Kiera Campbell used under a CC 4.0 license
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R0 (R Naught) Values for COVID-19 and Polio

R number stands for "effective reproduction rate" in "a completely susceptible population". R0 values are helpful in estimating what percent of a population needs to be vaccinated in order for herd immunity to kick in. According to the Johns Hopkins Bloomberg School of Medicine, the R0 value for polio is 6. According to an article in Science ("Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV-2", May 1, 2020), the R0 rate for COVID-19 is 2.38. Of course, so much more is known about polio than COVID-19. With polio, it is estimated that 83% of the population would have to be vaccinated in order to achieve herd immunity (according to Johns Hopkins). One source, writing in Science Alert ("Here's Why Herd Immunity Won't Save Us From The COVID-19 Pandemic", March 2020) estimates that herd immunity for COVID-19 will be achieved when 70% of the population is vaccinated.

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Lockdowns and Quarantines
In 1916, in the midst of a raging polio epidemic, the U. S. Public Health Service declared that there was "no specific treatment of established value in poliomyelitis". In that circumstance, health officials were left with scant tools to fight the disease. Two of these tools were the institution of hygiene/sanitation measures and, control of people's movements.

Quarantine Notice Threatening Imprisonment
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This notice was placed in the window of homes where someone had been diagnosed with polio. All who lived there were in mandatory 'lockdown', on pain of fine and//or imprisonment. It is assumed this image is credited to a government agency, but in any case the picture is in the public domain.

Today, health officials find themselves in a similar position as they try to battle COVID-19. There is no vaccine, and, as the Mayo Clinic reports, "Currently, no medication is recommended to treat COVID-19, and no cure is available".(the slight benefit noted for remdesevir in severely ill patients notwithstanding). The only effective public health measures available for fighting this disease are the institution of hygiene/sanitation measures and following a policy of behavior control--recommending/requiring social distancing and mask wearing.

Just as there are people today who doubt the efficacy of social distancing and mask wearing, there were people in past polio epidemics who doubted public health efforts to address the situation. During the 1916 polio epidemic, for example, Town of Oyster Bay (NY, USA), Supervisor, James H. Cox, "repeatedly questioned the scientific basis for quarantine regulations, arguing physicians seemed divided about the cause and spread of polio."

First Electron Microscope, Invented by Ernst Rusk, 1933
Electron Microscope Ernst Ruska credit Brew uploaded on the English speaking Wikipedia by en User Hat nCoat.jpg
Image credit: J Brew, uploaded on the English-speaking Wikipedia by en:User:Hat'nCoat. CC 3.0 license

As researchers today try to develop a treatment/vaccine for COVID-19 they have one advantage over those who fought early polio epidemics: They understand exactly what a virus is and can work with it in the laboratory. In 1916, researchers had "discovered" several viruses, but had not been able to visualize a virus under a microscope. That ability would not be theirs until the invention of the electron microscope.

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Microscopic Images of Polio and COVID19 Viruses
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COVID 19 image Credit: NIAID CC license 2.0
Polio credit: F.P. Williams, U.S. EPA public domain

The polio virus (there are several strains) has a simple structure. Like all viruses, it is a bit of genetic material looking for a cell that it can invade and take over. The polio virus is described as relatively featureless, unlike COVID-19, which has a spiky envelope that looks a little like a crown (corona), as you can see in the picture. Viruses have to find a way to get inside a cell, a doorway that will open and let them pass through the cell membrane. It's like aliens in the movie "Invasion of the Body Snatchers": the virus needs to hijack a cell in order to carry on its work. What is that work? Propagate, and send millions of virions into the host's bloodstream to take over more cells.

Poster From the 1956 Movie, Invasion of the Body Snatchers
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Image credit: Allied Artists Picture Corporation. public domain, published before 1978 without copyright notice

With their limited knowledge of the polio virus, health officials during early polio epidemics were at a loss to explain its spread and understand its mode of transmission. Today, not only has COVID-19 been directly observed with instruments even more powerful and precise than the electron microscope, but the full genomic sequence of the virus is also available for study.

Routes of Transmission
Polio is an enterovirus and COVID19 is a corona virus. As an enterovirus, the polio virus favors spread through the oral/ fecal route. However, any close contact with an infected person can lead to infection. Indirect infection is also possible--one route is through swimming in contaminated water.
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Diagram Showing Fecal Oral Route of Transmission
fecal oral route UNICEF Philippines and Luis Gatmaitan  Gilbert F. Lavides public.jpg
Image credit: UNICEF Philippines and Luis Gatmaitan, Gilbert F. Lavides. CC 2.0 license. This F-diagram (feces, fingers, flies, fields, fluids, food) was obviously designed to show children how to protect themselves from infection by an enterovirus.

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COVID19 is spread mostly through droplets and fomites (surfaces). According to Johns Hopkins, aerosolization is a distinct possibility, which would mean the virus hangs around longer in the air than a larger droplet and may also go farther than the highly publicized 6 feet. Hopkins' website states that "Stool shedding (of the virus is) also described later in disease, but (it is) uncertain what role, if any, that plays."

Bogus Treatment Claims Abound
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Image credit: U.S. FDA. Parents were desperate to protect their children from the polio virus. This ad promises to help take them "safely through the summer".

Search for a Vaccine: Polio and COVID-19
A New England Journal of Medicine article published in March 2020 (updated May 21) describes "developing Covid-19 Vaccines at Pandemic Speed", and U.S. President Trump has launched Operation Warp Speed in order to find an effective vaccine against COVID-19. The impression given is that never has the world seen such a concerted effort to find a vaccine.
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U.S. President Franklin Roosevelt, in a Wheelchair
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Image credit: American Political History, Public domain
Franklin Roosevelt had been stricken by polio as an adult.
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However, a look back at history reveals that there was at least as great, if not a greater ambition to develop a polio vaccine. This campaign was inspired not only by the thousands of children who were afflicted, but also by the fact that the President of the United States, Franklin Roosevelt, was afflicted. He and his powerful allies helped to spearhead a vaccine development campaign. It was President Roosevelt who founded the March of Dimes, then known as the National Foundation for Infant Paralysis. It was the March of Dimes which funded Jonas Salk's vaccine research.
March of Dimes Poster, 1943
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Image credit: U.S. Office for Emergency Management, Office of War Information, Domestic Operations Branch, artist Charles Henry Alston. Public domain
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Research Subjects: Polio and COVID-19
Humans are the only natural hosts for polio, whereas COVID-19 is a zoonotic virus. It survives in both animals and humans. As research on COVID-19 takes place, it begins with animal studies and then, when found safe there, moves on to humans. The humans in these studies are all volunteers. Even so, ethical concerns are raised about putting lives at risk. In the early phase of polio vaccine development researchers were not so constrained by ethics. Not even Jonas Salk. This was true partly because there was not the option of testing vaccines on animals (because humans are the only natural hosts). Test subjects had to be human, or at least primates. The earliest vaccine trials in the 1930s actually killed, and paralyzed, children.

Almost twenty years after the death of these children, Jonas Salk, and others, moved forward, perhaps more cautiously, but still with very questionable ethics.

Polk State School
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Image credit: National Park Service. Public domain

The human subjects in these trials were disabled children who had neither the awareness nor ability to volunteer themselves. These trials took place at several public institutions: The Polk State School, The Watson Home for Crippled Children, and Letchworth Village Home for the Feeble Minded and Epileptics. Fortunately, no children died or became ill from these experiments. People were so desperate for a vaccine, that little attention was paid to how one was achieved.
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In Memoriam
As I end this blog I take note that for me, this is not just about science, or history. This is about people who are suffering and dying today from COVID-19. I know, or personally know of, some of those people. Below I've included obituaries for others in my region who recently lost their lives to COVID-19. These obituaries put faces on the tragedy of the COVID-19 pandemic. They represent hundreds of thousands who have lost their lives across the world.

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And a report from a local funeral home:
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Some Sources Used to Write This Blog

1.World Journal of Virology https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3782271/
2.Seniors News https://www.seniorsnews.com.au/news/view-one-of-the-original-iron-lungs-at-grafton-mus/3225215/
3.Virtual Museums https://www.samhs.org.au/Virtual%20Museum/Medicine/Bothurinlung/bothironlung-netley.html
4.Research Gate: https://www.researchgate.net/publication/227992491_Viral_Capsids_and_Envelopes_Structure_and_Function
5.Annual Review of Microbiology https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1500891/
6.Nature public health emergency Collection https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4369385/
7.Antiviral Research https://www.sciencedirect.com/science/article/pii/S0166354213003781
8.Journal of the Royal Society of Medicine https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1383764/
9.Wellcome Library https://wellcomelibrary.org/item/b16759369#?c=0&m=0&s=0&cv=0
10.World Wide Virology https://www.virology.ws/2014/10/08/oral-polio-vaccine-associated-paralysis-in-a-child-despite-previous-immunization-with-inactivated-virus/
11.CDC https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/polio.pdf
12.The History of Vaccines https://www.historyofvaccines.org/content/articles/history-polio-poliomyelitis
13.Ann Harbor District Library https://aadl.org/N032_0005_001
14.Journal of Infectious Disease https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4663665/
15.World Economic Forum https://www.weforum.org/agenda/2020/05/covid-19-what-is-the-r-number/
16.CDC Emerging Infectious Disease https://wwwnc.cdc.gov/eid/article/25/1/17-1901_article
17.Science Alert https://www.sciencealert.com/why-herd-immunity-will-not-save-us-from-the-covid-19-pandemic
18.National Museum of American History https://americanhistory.si.edu/collections/object-groups/antibody-initiative/polio
19.Mayo Clinic https://www.mayoclinic.org/diseases-conditions/coronavirus/diagnosis-treatment/drc-20479976
20.New England Journal of Medicine https://www.nejm.org/doi/full/10.1056/NEJMoa2007764
21.Research Gate https://www.researchgate.net/publication/21550198_Revolt_against_quarantine_community_responses_to_the_1916_polio_epidemic_Oyster_Bay_New_York
22.Medical Net https://www.news-medical.net/health/Virus-History.aspx
23.Principles and Practices of Clinical Virology https://books.google.com/books?id=4il2mF7JG1sC&pg=PA602&lpg=PA602&dq=relatively+featureless+polio+virus&source=bl&ots=NCMjsTAmFO&sig=ACfU3U3f7TKXoP0Br4fkXQvUGfJJvhRsWA&hl=en&sa=X&ved=2ahUKEwi106bbl9jpAhVAgnIEHUxyBc0Q6AEwDXoECAkQAQ#v=onepage&q=relatively%20featureless%20polio%20virus&f=false
24.Merrium Webster https://www.merriam-webster.com/dictionary/virion
25.National Library of Medicine https://pubmed.ncbi.nlm.nih.gov/32149036/
26.EnteroVirus Foundation https://www.enterovirusfoundation.org/the-facts
27.Merck Manuals https://www.merckmanuals.com/professional/infectious-diseases/respiratory-viruses/coronaviruses-and-acute-respiratory-syndromes-covid-19,-mers,-and-sars
28.Clinical Infectious Diseases https://academic.oup.com/cid/article/47/5/624/295712
29.Water 1st International https://water1st.org/problem/f-diagram/
30.Johns Hopkins https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540747/all/Coronavirus_COVID_19__SARS_CoV_2_
31.Medscape https://www.medscape.com/viewarticle/741245_3
32.New England Journal of Medicine https://www.nejm.org/doi/full/10.1056/NEJMp2005630
33.National Dialogue for Healthcare Innovation https://www.ndhi.org/files/5613/8990/1147/Polio_Vaccine.pdf
34.Eric.ed.gov https://files.eric.ed.gov/fulltext/EJ978264.pdf
35.Microbiology Australia https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7086482/
36.Science Magazine https://www.sciencemag.org/news/2020/04/mice-hamsters-ferrets-monkeys-which-lab-animals-can-help-defeat-new-coronavirus
37.Medical Xpress https://medicalxpress.com/news/2020-05-ethical-guidelines-human-covid-infection.html
38.History of Vaccines https://www.historyofvaccines.org/content/early-polio-vaccine-trials
39.Cite Seer X http://citeseerx.ist.psu.edu/viewdoc/download?doi=
40.The Vintage News https://www.thevintagenews.com/2016/07/10/abandoned-for-twenty-years-the-letchworth-village-was-once-a-model-institution-for-the-mentally-physically-disabled/
41.World Meters https://www.worldometers.info/coronavirus/?utm_campaign=homeAdUOA?Si%23countries

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Dear AG,
I would like to thank you for the article on this current topic. The research effort must have been immense, as one can see from the sources. I'am looking forward to take a closer look at your post in a quiet hour tomorrow.

Let me just say for now, that I'm touched by the reverence you give to the people who died of COVID- 19.

Stay well and confident. 🌷
Your friend,

Dear Anna🌿🌾,
Thank you so much for that supportive comment. I hesitated to include those obituaries, because I didn't want to "use" tragedy in any way that was self-serving. But every time I read a statement by someone who denies the pandemic is real, I feel it is an affront to those who have suffered. And so I wrote this blog, for them, and for all of us who have to fight this disease.

Now you can see why I'm ready for ice cream cake :)) Already I'm playing with fantastical creatures for my collage.

It is a beautiful, sunny day🌞 here. A gift. I hope you are enjoying wonderful spring weather there.

Good health, happiness and peace,

Already I'm playing with fantastical creatures for my collage.

I'm quite curious what sea monsters and other fantastical creatures will await us. 🐙

I don't know if you celebrate Pentecost. Here in Austria tomorrow is still a holiday. Unfortunately with us this weekend is literally "falling into water". It's raining and the temperatures are unusually chilly for this time of year.

How nice that the weather is better at your place. Enjoy sunshine and life! 🌞

Keep well and fit.
With great affection,

Dear Anna,
I love your sea monster :))

"falling into water"

This must be a colloquial expression, because it is not familiar to me. I like it very much.

Pentecost is only observed here by the truly observant (that is my experience anyway). In my family, this was not ever noted, and my mother was quite devout.

I hope the rain abates and you enjoy the flowers that will surely blossom because of the downpour.

Your friend, who is cheerful but perhaps not fit 😅
With affection and regard,🌷🌷


What an interesting parallel between the polio and the covid! At least, today, we have (slightly) more ethics when dealing with medical tests :)

I have a couple of extra comments:

One source, writing in Science Alert ("Here's Why Herd Immunity Won't Save Us From The COVID-19 Pandemic", March 2020) estimates that herd immunity for COVID-19 will be achieved when 70% of the population is vaccinated.

That’s weird. As far as I know, it is not even sure herd immunity could be reached at all.

This notice was placed in the window of homes where someone had been diagnosed with polio. All who lived there were in mandatory 'lockdown', on pain of fine and//or imprisonment. It is assumed this image is credited to a government agency, but in any case the picture is in the public domain.

This is maybe how COVID lockdowns should have been managed: testing everything and locking down only those who contracted the disease? This is at leat how I would have handled things, giving the country the means to do those massive tests (like in Korea I think).

Hi @lemouth,
Thanks for taking time from your busy day to comment.

This is maybe how COVID lockdowns should have been managed: testing everything and locking down only those who contracted the disease?

Of course. I don't know how France handled this, but in the U.S. there was complete denial. Anyone could see the epidemic coming. I remember ordering extra supplies, including rubbing alcohol for steralizing, in mid January. But there was no organized, intelligent approach to the contagion by government or health officials.

And I agree about herd immunity. At this point, we know so little. Everything is all conjecture. The only thing we know for sure is that the virus can't get us, if we don't give it an opportunity. Hygiene and social distancing: as you pointed, this approach has worked (in South Korea). New Zealand managed to get itself free of the disease.

I'm off to play with cartoon characters now, for my collage. Much happier place 😊 to spend my hours.

Have a wonderful Sunday, whatever is left of it for you.

Of course. I don't know how France handled this, but in the U.S. there was complete denial. Anyone could see the epidemic coming. I remember ordering extra supplies, including rubbing alcohol for steralizing, in mid January. But there was no organized, intelligent approach to the contagion by government or health officials.

Better than the US for sure. But many decisions look random (and are actually random), even inconsistent. My impression is that the government is just not capable to say that sometimes, they don't know everything. As you said, we do not know much today, and I don't see why this would be a wrong thing to claim for a government member. They also have the tendency to use science for political matters, which is a bad practice. But that is another debate.

At least, everything is back into control for a couple of weeks thanks to the imposed confinement. My worry is that now, the confinement phase is over and many people just think the virus is gone. Which is wrong and this is how a second wave may appear: crazy behaviours in those hard times. My predictions is a second wave by the end of the month. This is also what many at the hospitals expect :(

crazy behaviours in those hard times


@agmoore, such a good write up on pandemic . Seriously,i didn't know that Adults could suffer from polio. I have only know that its affect when one is below 5yrs thereabout. Also, i knew that Franklin Roosevelt was paralized but never knew that it was polio. Seriously, social distancing and wearing of nose mask has become what we will have to live with now as a result of covid-19. Anyway, government all over the world are doing their best to curtail the spread.
This is a nice writeup.

Thank you so much for that nice comment. I learned a lot myself in writing this. That's the best part of doing a research article...always an adventure for me (maybe because I don't know a lot 😃) The other part that's satisfying is sharing valuable information. I think it's really important that people understand adults can spread polio.
When I get a comment like yours it makes writing and researching very rewarding. Have a wonderful, healthy day.

Just as there are people today who doubt the efficacy of social distancing and mask wearing, there were people in past polio epidemics who doubted public health efforts to address the situation.

This is why it's so important to know about history - it always repeats. You would think that we would have learned from our mistakes by know, I hope that someday we will.
Amazing article, I know you didn't have a choice, but I still want to thank you for your role on the vaccine tests, how it must feel to be part of something so important for recent human history!

Thank you so much for that kind and thoughtful comment. I must admit I didn't enjoy the vaccination 😅. I was in the first grade and had never received an injection before. In those days, we didn't go to the doctor so much but toughed out all the childhood illnesses.
I do love history and agree with you, it teaches us.
I wish you and your family a peaceful and healthful day.

Thanks for your contribution to the STEMsocial community. Feel free to join us on discord to get to know the rest of us!

Please consider supporting our funding proposal, approving our witness (@stem.witness) or delegating to the @stemsocial account (for some ROI).

Thanks for including @stemsocial as a beneficiary, which gives you stronger support. Using the STEMsocial app could yield even more supporti next time. 

Thank you very much for that support! I tried to use the app but had trouble with hivesign. I have to figure out how to use keychain, which apparently is more stable. I have supported the proposal, approved the witness and delegated. I think STEMsocial is amazing.

Have you checked the link between the BCG vaccine and this new coronavirus? Apparently, the rate of infections and severity of the illnesses are a lot higher where this vaccine is only optional, instead of mandatory. In most of African and European countries this vaccine is mandatory. One of the exceptions in Europe is precisely Italy, where the BCG vaccine has become optional. Maybe that was a mistake... 🤔

Hi, Thanks for that interesting input. I've looked at a few studies since reading your comment, and will look at more. Apparently the potential protective effect of the BCG vaccine is intriguing to responsible researchers. I'll link you to several studies, (I disregard WHO because I think they are subject to political pressure and only offer the least controversial judgments). The most persuasive study for me was the one conducted in Israel, which tried to factor in a number of variables, including age and ethnicity. I found the Lancet article also offered a balanced discussion, which I found persuasive.

One article in The Scientist does a through review of evidence from different sources. This seemed to be a fair and well-researched discussion and left the question open. One idea covered in this article was that vaccinated children who did not form a scar after BCG vaccination showed a weak immune response. This is exactly the finding of post-vaccination immunity in smallpox: failure to form a scar resulted in poor protection against contagion.
You probably did not expect such a long response, but I do like to pursue ideas. Yours was a very interesting one:)

I didn't know what BCG is, so I looked it up. It's not mandatory any more here in Germany (since 1998) and only used for at risk people. Interestingly, it was used in the Basque Province of Spain till 2013 - might be interesting too see whether there is a difference now between this part of Spain and others...

I didn't know about BCG either. I also had to look it up. That article from The Scientist (referred to in my comment above) is quite interesting. It seems BCG does offer protection against a variety of respiratory illnesses and protection lasts for many years. The information about the Basque Province is interesting and may help to provide insight in the future.
Thank you for your comment. I really do enjoy feedback.

That's quite interesting. I'm eager to know if this information checks out to be true... because in case it is, then there's a vaccine already. And with nearly a century of data.

If the BCG vaccine is enough, there's no need for Big Pharma to push for untested vaccines on a massive scale anymore.

I wonder how these companies will react.

I think it's premature to say we have a vaccine already. The sources cited are not asserting the efficacy of BCG. Indeed, the Israeli study showed no efficacy. The Lancet study is still pondering the possible utility of BCG vaccination, and the article in Scientist describes studies going forward with guarded optimism. I am no friend of Big Pharma, and although I applaud the development of life-protecting vaccines (ex: smallpox, polio, diphtheria, etc.) I also am aware that there are risks with every medical intervention. There are also sometimes mixed motives (and often misrepresentation of safety/efficacy) in authorities that carry out vaccination campaigns. Still, I want vaccine development for COVID to go forward. I am not so angry at Big Pharma that I am willing to risk losing lives to cut their profit margin. Perhaps what might be more reasonable is to address the obscene profit margins, across the board, in healthcare.

There was no statistically significant difference in the proportion of positive test results in the BCG-vaccinated group (361 [11.7%]) vs the unvaccinated group (299 [10.4%]; difference, 1.3%; 95% CI, −0.3% to 2.9%; P = .09) or in positivity rates per 100 000 (121 in vaccinated group vs 100 in unvaccinated group; difference, 21 per 100 000; 95% CI, −10 to 50 per 100 000; P = .15). There was 1 case of severe disease (mechanical ventilation or intensive care unit admission) in each group, and no deaths were reported

Second, whether BCG will be effective remains unknown: findings from the ecological studies suggesting less COVID-19 in countries with routine BCG immunisation are weak evidence because they are based on population rather than individual data and are prone to confounding.

Also, it is unlikely that a BCG vaccine given decades ago in childhood will ameliorate COVID-19 now. One reason for this is that the beneficial off-target effects of the BCG vaccine might be altered by subsequent administration of a different vaccine.

Third, if the BCG vaccine is not effective against COVID-19, BCG vaccination could engender a false sense of security. Fourth, careful safety monitoring in randomised trials is needed to guard against the remote possibility that up-regulation of immunity by BCG will exacerbate COVID-19 in a minority of patients with severe disease.

From the Scientist
Trials are kicking off in the Netherlands, Greece, Australia, Denmark, France, Germany, and the US, says Netea...in an Australian trial “we will measure whether those who get the vaccine get less COVID-19, and if they do get it, if they are unwell for less time or have less severe symptoms,”

Of course it is... after all, there isn't enough data to conclude anything.