April 14, 2020

COVID-19: Case count increases by more than 65,000 globally; WHO does not recommend BCG vaccine to prevent COVID-19

ECDC case count update

According to the European Centre for Disease Prevention and Control (ECDC), since 31 December 2019 and as of 14 April 2020, 1 873 265 cases of COVID-19 have been reported, including 118 854 deaths. This represents an increase of 65 957 cases and 5 341 deaths compared to 13 April. 

Cases have been reported from:

Africa: 15 292 cases; the five countries reporting most cases are South Africa (2 272), Egypt (2 190), Algeria (1 983), Morocco (1 763) and Cameroon (820).

Asia: 307 569 cases; the five countries reporting most cases are China (83 303), Iran (73 303), Turkey (61 049), Israel (11 586) and South Korea (10 564).

America: 676 116 cases; the five countries reporting most cases are United States (582 594), Canada (25 663), Brazil (23 430), Ecuador (7 529) and Chile (7 525).

Europe: 865 918 cases; the five countries reporting most cases are Spain (169 496), Italy (159 516), Germany (125 098), France (98 076) and United Kingdom (88 621).

Oceania: 7 674 cases; the five countries reporting most cases are Australia (6 366), New Zealand (1 072), Guam (134), French Polynesia (55) and New Caledonia (18).

Other: 696 cases have been reported from an international conveyance in Japan.

Deaths have been reported from:

Africa: 835 deaths; the five countries reporting most deaths are Algeria (313), Egypt (164), Morocco (126), Tunisia (34) and Burkina Faso (28).

Asia: 11 269 deaths; the five countries reporting most deaths are Iran (4 585), China (3 345), Turkey (1 296), Indonesia (399) and India (339).

America: 27 414 deaths; the five countries reporting most deaths are United States (23 649), Brazil (1 328), Canada (780), Ecuador (355) and Mexico (332).

Europe: 79 252 deaths; the five countries reporting most deaths are Italy (20 465), Spain (17 489), France (14 967), United Kingdom (11 329) and Belgium (3 903).

Oceania: 77 deaths; the four countries reporting most deaths are Australia (61), New Zealand (9), Guam (5), Northern Mariana Islands (2).

Other: 7 deaths have been reported from an international conveyance in Japan.

[Note from ECDC: The data presented have been collected between 6:00 and 10:00 CET, 14 April.]

BCG vaccination and COVID-19

In a Scientific Brief published on 12 April, WHO stated that there is no evidence that the Bacille Calmette-Guérin vaccine (BCG) protects people against infection with COVID-19 virus.

According to WHO, two clinical trials addressing this question are underway, and WHO will evaluate the evidence when it is available. Therefore, in the absence of evidence, WHO does not recommend BCG vaccination for the prevention of COVID-19. WHO added that it continues to recommend neonatal BCG vaccination in countries or settings with a high incidence of tuberculosis.

WHO noted that there is experimental evidence from both animal and human studies that the BCG vaccine has non-specific effects on the immune system. It added that these effects have not been well characterized and their clinical relevance is unknown.

On 11 April 2020, WHO updated its ongoing evidence review of the major scientific databases and clinical trial repositories. The review yielded three preprints, in which the authors compared the incidence of COVID-19 cases in countries where the BCG vaccine is used with countries where it is not used and observed that countries that routinely used the vaccine in neonates had less reported cases of COVID-19 to date. Such ecological studies, according to WHO, are prone to significant bias from many confounders, including differences in national demographics and disease burden, testing rates for COVID-19 virus infections, and the stage of the pandemic in each country.

WHO added that the review also yielded two registered protocols for clinical trials, both of which aim to study the effects of BCG vaccination given to health care workers directly involved in the care of patients with COVID-19.

SOURCE: ECDC; WHO
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