‘No proof yet on BCG benefits’
Focus must now be on testing and contact tracing, says epidemiology expert
- It is a cheap, readily available, safe vaccine. But we are not there yet. Currently, what we have are a few ecological studies (not peer-reviewed) which take country-level BCG and COVID-19 data, and report a correlation that countries that give BCG to children have a lower rates of COVID-19 cases and deaths.
- Based on this early signal and based on our prior knowledge that BCG does have non-specific immune-boosting properties, it is perfectly fine to conduct trials to confirm the hypothesis.
- Ecological studies offer a very weak level of evidence because correlations that are true at the country level might not hold true at the individual level.
- This is my biggest worry — even without COVID-19, TB kills 1,000 Indians every day. No country has more TB patients than India. And now, with the lockdown, things are going to get much worse.
- People on TB treatment are struggling to get their medicines on time, and people with new TB symptoms are unable to access medical care. TB patients and survivors often have lung damage and if they got COVID-19, they could be at higher risk of complications.
- TB programmes are known for public health interventions such as active case finding, contact investigations, respiratory isolation, and community-based patient support. These skills and expertise could be leveraged to tackle COVID-19.
- COVID-19 will change global health in many ways. The optimist in me hopes all countries will learn from the pandemic and invest in universal health coverage and re-affirm health as a human right. Global health must be more than just fighting one epidemic after another.