This article is from the source 'nytimes' and was first published or seen on . It last changed over 40 days ago and won't be checked again for changes.
You can find the current article at its original source at https://www.nytimes.com/2020/04/03/health/coronavirus-bcg-vaccine.html
The article has changed 29 times. There is an RSS feed of changes available.
Previous version
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
Next version
Version 11 | Version 12 |
---|---|
Can an Old Vaccine Stop the New Coronavirus? | Can an Old Vaccine Stop the New Coronavirus? |
(about 20 hours later) | |
A vaccine that was developed a hundred years ago to fight the tuberculosis scourge in Europe is now being tested against the coronavirus by scientists eager to find a quick way to protect health care workers, among others. | A vaccine that was developed a hundred years ago to fight the tuberculosis scourge in Europe is now being tested against the coronavirus by scientists eager to find a quick way to protect health care workers, among others. |
The Bacillus Calmette-Guerin vaccine is still widely used in the developing world, where scientists have found that it does more than prevent TB. The vaccine prevents infant deaths from a variety of causes, and sharply reduces the incidence of respiratory infections. | The Bacillus Calmette-Guerin vaccine is still widely used in the developing world, where scientists have found that it does more than prevent TB. The vaccine prevents infant deaths from a variety of causes, and sharply reduces the incidence of respiratory infections. |
The vaccine seems to “train” the immune system to recognize and respond to a variety of infections, including viruses, bacteria and parasites, experts say. There is little evidence yet that the vaccine will blunt infection with the coronavirus, but a series of clinical trials may answer the question in just months. | The vaccine seems to “train” the immune system to recognize and respond to a variety of infections, including viruses, bacteria and parasites, experts say. There is little evidence yet that the vaccine will blunt infection with the coronavirus, but a series of clinical trials may answer the question in just months. |
On Monday, scientists in Melbourne, Australia, started administering the B.C.G. vaccine or a placebo to thousands of physicians, nurses, respiratory therapists and other health care workers — the first of several randomized controlled trials intended to test the vaccine’s effectiveness against the coronavirus. | On Monday, scientists in Melbourne, Australia, started administering the B.C.G. vaccine or a placebo to thousands of physicians, nurses, respiratory therapists and other health care workers — the first of several randomized controlled trials intended to test the vaccine’s effectiveness against the coronavirus. |
“Nobody is saying this is a panacea,” said Nigel Curtis, an infectious diseases researcher at the University of Melbourne and Murdoch Children’s Research Institute, who planned the trial. “What we want to do is reduce the time an infected health care worker is unwell, so they recover and can come back to work faster.” | “Nobody is saying this is a panacea,” said Nigel Curtis, an infectious diseases researcher at the University of Melbourne and Murdoch Children’s Research Institute, who planned the trial. “What we want to do is reduce the time an infected health care worker is unwell, so they recover and can come back to work faster.” |
A clinical trial of 1,000 health care workers began 10 days ago in the Netherlands, said Dr. Mihai G. Netea, an infectious disease specialist at Radboud University Medical Center in Nijmegen. Eight hundred health care workers have already signed up. (As in Australia, half of the participants will receive a placebo.) | A clinical trial of 1,000 health care workers began 10 days ago in the Netherlands, said Dr. Mihai G. Netea, an infectious disease specialist at Radboud University Medical Center in Nijmegen. Eight hundred health care workers have already signed up. (As in Australia, half of the participants will receive a placebo.) |
Dr. Denise Faustman, director of immunobiology at Massachusetts General Hospital, is seeking funding to start a clinical trial of the vaccine in health care workers in Boston as well. Preliminary results could be available in as little as four months. | Dr. Denise Faustman, director of immunobiology at Massachusetts General Hospital, is seeking funding to start a clinical trial of the vaccine in health care workers in Boston as well. Preliminary results could be available in as little as four months. |
“We have really strong data from clinical trials with humans — not mice — that this vaccine protects you from viral and parasitic infections,” said Dr. Faustman. “I’d like to start today.” | “We have really strong data from clinical trials with humans — not mice — that this vaccine protects you from viral and parasitic infections,” said Dr. Faustman. “I’d like to start today.” |
The B.C.G. vaccine has an unusual history. It was inspired in the 1800s by the observation that milkmaids did not develop tuberculosis. The vaccine is named after its inventors, Dr. Albert Calmette and Dr. Camille Guerin, who developed it in the early 1900s from mycobacterium bovis, a form of tuberculosis that infects cattle. | The B.C.G. vaccine has an unusual history. It was inspired in the 1800s by the observation that milkmaids did not develop tuberculosis. The vaccine is named after its inventors, Dr. Albert Calmette and Dr. Camille Guerin, who developed it in the early 1900s from mycobacterium bovis, a form of tuberculosis that infects cattle. |
The scientists cultured bacterial scrapings from cow udders, and continued to culture bovine TB for over a decade until it was weak enough that it no longer caused virulent disease when given to lab animals. | The scientists cultured bacterial scrapings from cow udders, and continued to culture bovine TB for over a decade until it was weak enough that it no longer caused virulent disease when given to lab animals. |
The vaccine was first used in humans in 1921 and was widely adopted after World War II. Now B.C.G. is primarily used in the developing world and in countries where TB is still prevalent, where it is given to over 100 million babies a year. | The vaccine was first used in humans in 1921 and was widely adopted after World War II. Now B.C.G. is primarily used in the developing world and in countries where TB is still prevalent, where it is given to over 100 million babies a year. |
[Like the Science Times page on Facebook. | Sign up for the Science Times newsletter.] | [Like the Science Times page on Facebook. | Sign up for the Science Times newsletter.] |
Like other vaccines, B.C.G. has a specific target: TB. But evidence accumulating over the past decade suggests the vaccine also has so-called off-target effects, reducing viral illnesses, respiratory infections and sepsis, and appears to bolster the body’s immune system. | Like other vaccines, B.C.G. has a specific target: TB. But evidence accumulating over the past decade suggests the vaccine also has so-called off-target effects, reducing viral illnesses, respiratory infections and sepsis, and appears to bolster the body’s immune system. |
The idea is an offshoot of the “hygiene hypothesis,” which suggests that the modern emphasis on cleanliness has deprived children of exposure to germs. The lack of “training” has resulted in weakened immune systems, less able to resist disease. | The idea is an offshoot of the “hygiene hypothesis,” which suggests that the modern emphasis on cleanliness has deprived children of exposure to germs. The lack of “training” has resulted in weakened immune systems, less able to resist disease. |
One of the earliest studies hinting at the broad benefits of B.C.G. vaccination was a randomized trial of 2,320 babies in Guinea-Bissau in West Africa, published in 2011, that reported that death rates among low-birth-weight babies were dramatically reduced after vaccination. A follow-up trial reported that infectious-disease mortality rates in low-birth-weight babies who were vaccinated were cut by more than 40 percent. | One of the earliest studies hinting at the broad benefits of B.C.G. vaccination was a randomized trial of 2,320 babies in Guinea-Bissau in West Africa, published in 2011, that reported that death rates among low-birth-weight babies were dramatically reduced after vaccination. A follow-up trial reported that infectious-disease mortality rates in low-birth-weight babies who were vaccinated were cut by more than 40 percent. |
Other epidemiological studies — including a 25-year study of over 150,000 children in 33 countries — have reported a 40 percent lower risk of acute lower respiratory tract infections in children who received a B.C.G. vaccine. | Other epidemiological studies — including a 25-year study of over 150,000 children in 33 countries — have reported a 40 percent lower risk of acute lower respiratory tract infections in children who received a B.C.G. vaccine. |
A study in the elderly found that consecutive B.C.G. vaccinations reduced the incidence of acute upper respiratory tract infections. | A study in the elderly found that consecutive B.C.G. vaccinations reduced the incidence of acute upper respiratory tract infections. |
Updated June 24, 2020 | |
Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles. | |
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico. | A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico. |
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. | The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. |
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. | The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. |
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. | So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. |
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. | Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. |
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. | A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. |
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. | The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. |
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. | Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. |
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) | If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) |
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. | If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. |
A recent review by the World Health Organization concluded that B.C.G. had beneficial “off-target effects,” and recommended doing more trials of the vaccine against a wider range of infections. | A recent review by the World Health Organization concluded that B.C.G. had beneficial “off-target effects,” and recommended doing more trials of the vaccine against a wider range of infections. |
“This vaccine has saved as many lives as the polio vaccine — it’s an amazing story,” said Dr. Curtis, who designed and launched the B.C.G. trial in Melbourne in less than a month, hoping to stay one step ahead of the coronavirus’s spread in Australia. | “This vaccine has saved as many lives as the polio vaccine — it’s an amazing story,” said Dr. Curtis, who designed and launched the B.C.G. trial in Melbourne in less than a month, hoping to stay one step ahead of the coronavirus’s spread in Australia. |
While he described the B.C.G. vaccine as underappreciated, he emphasized that it was “not a specific Covid-19 vaccine.” B.C.G. also cannot be administered to anyone who has a compromised immune system, because it is a live-attenuated vaccine — meaning it contains live but weakened TB. | While he described the B.C.G. vaccine as underappreciated, he emphasized that it was “not a specific Covid-19 vaccine.” B.C.G. also cannot be administered to anyone who has a compromised immune system, because it is a live-attenuated vaccine — meaning it contains live but weakened TB. |
Dr. Faustman said it should not be used in hospitalized patients with active disease, because it may not work fast enough and could interact poorly with other treatments. | Dr. Faustman said it should not be used in hospitalized patients with active disease, because it may not work fast enough and could interact poorly with other treatments. |
Not everyone is convinced B.C.G. holds much promise. Dr. Domenico Accili, an endocrinologist at Columbia University, said he thought efforts to use the vaccine against the coronavirus sound “a bit like magical thinking.” | Not everyone is convinced B.C.G. holds much promise. Dr. Domenico Accili, an endocrinologist at Columbia University, said he thought efforts to use the vaccine against the coronavirus sound “a bit like magical thinking.” |
While acknowledging that B.C.G. is “a non-specific booster of the immune system,” he said, “we should be able to deploy a more tailored approach.” | While acknowledging that B.C.G. is “a non-specific booster of the immune system,” he said, “we should be able to deploy a more tailored approach.” |
One question is what effect the vaccine may have in patients whose immune systems overreact to the coronavirus, resulting in what are called cytokine storms. Dr. Randy Cron, an expert on cytokine storms at the University of Alabama at Birmingham, said it was impossible to know. | One question is what effect the vaccine may have in patients whose immune systems overreact to the coronavirus, resulting in what are called cytokine storms. Dr. Randy Cron, an expert on cytokine storms at the University of Alabama at Birmingham, said it was impossible to know. |
A recent analysis of the disparate toll the new coronavirus has taken on middle- and high-income countries found a correlation with B.C.G. policies, concluding that countries that did not implement or had abandoned universal B.C.G. vaccination have had more coronavirus infections per capita and higher death rates. (Low-income countries were excluded from the analysis because of unreliable Covid-19 reporting data and generally poor medical systems.) | A recent analysis of the disparate toll the new coronavirus has taken on middle- and high-income countries found a correlation with B.C.G. policies, concluding that countries that did not implement or had abandoned universal B.C.G. vaccination have had more coronavirus infections per capita and higher death rates. (Low-income countries were excluded from the analysis because of unreliable Covid-19 reporting data and generally poor medical systems.) |
“You can make a new vaccine,” Dr. Faustman said. “We’re really smart, and we can do that. But it’s two years off, and two years is going to be two years too late.” | “You can make a new vaccine,” Dr. Faustman said. “We’re really smart, and we can do that. But it’s two years off, and two years is going to be two years too late.” |
“If we’ve got something generic globally at hand that we can use to make the human host stronger, this is a win-win for the public right away.” | “If we’ve got something generic globally at hand that we can use to make the human host stronger, this is a win-win for the public right away.” |