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Alternatives for Managing COVID-19

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On January 30, 2020, the World Health Organization declared COVID-19 as a public health emergency. At that time, the death toll was estimated to be 171 souls. By the end of 2020, the estimate had risen to 1.8 million, while the total number of deaths attributable to the virus was probably closer to 3 million. The latest figures indicate that mortality is down exponentially in many countries, while sub-Saharan Africa is still seeing increases in the disease. Like it or not, COVID-19 is still with us. Many experts now say we are entering the endemic phase of this pandemic, which continues to affect a large number of individuals globally. Unfortunately, the vaccines currently available — once touted as a “cure” — have not proved to be the medical miracle that many anticipated.

Drug companies worldwide are beginning to produce boosters designed for the Omicron strain of the virus. This would supersede the initial two-dose regimen, followed by one or two boosters targeting the original strains. The question then arises, will we be seeing new strains that need new vaccines? For the foreseeable future, it would seem so. Perhaps a better answer would be a universal vaccine.

One nonspecific alternative for vaccination appears to be useful against COVID-19. This is bacillus Calmette-Guerin (BCG) that has been used for many years to help prevent tuberculosis in children. Formulated from a strain of Mycobacterium bovis, this inoculation is routinely given at birth in a number of countries. It has also been used for immunotherapy against early stage bladder cancer. It is believed that BCG treatment may increase nonspecific cytokines which could potentially benefit patients with a number of inflammatory conditions. In addition, studies have demonstrated that countries which administer the BCG vaccine have experienced reduced or delayed mortality from COVID-19.1,2

It has been hypothesized that BCG offers protection by triggering trained immunity tolerogenesis through multiple cellular pathways. Tolerogenic therapy produces an immune tolerance when there is a pathological activation and overresponse of the immune system. This becomes particularly important in light of the cytokine storm often seen following infection with SARS-CoV-2. Suppression of this response to normal levels could be responsible for the reduced morbidity and mortality seen in patients who have received BCG vaccines and immunotherapy.

If this alternative approach proves effective, it could save lives that might otherwise have been lost to COVID-19 and other inflammatory diseases.

Thomas G. Wilson Jr., DDS
Editor in Chief
[email protected]

 

References

  1. Miller A, Reandelar MJ, Fasciglione K, Roumenova V, Li Y, Otazu GH. Correlation between universal BCG vaccination policy and reduced morbidity and mortality for COVID-19. Available at: https://www.medrxiv.org/ content/10.1101/2020.03.24.20042937v2. Accessed October 12, 2022.
  2. Sharma A, Kumar Sharma S, Shi Y, et al. BCG vaccination policy and preventive chloroquine usage: Do they have an impact on COVID-19 pandemic? Cell Death Dis. 2020;11:516.

From Decisions in Dentistry. November 2022;8(11)6.

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