Modelling the Impact of Nationwide BCG Vaccine Recommendations on COVID-19 Transmission, Severity and Mortality

Abstract

Coronavirus Disease 2019 (COVID-19) is declared as pandemic on 11 March 2020 by World Health Organization (WHO). There are apparent dissimilarities in incidence and mortality of COVID-19 cases in different parts of world. Developing countries in Asia and Africa with fragile health system are showing lower incidence and mortality compared to developed countries with superior health system in Europe and America. Most countries in Asia and Africa have national Bacillus Calmette-Guerin (BCG) vaccination programme, while Europe and America do not have such programme or have ceased it. At present, there is no known Food and Drug Administration (FDA)-approved treatment available for COVID-19 disease. There is no vaccine available currently to prevent COVID-19 disease. As mathematical modelling is ideal for predicting the rate of disease transmission as well as evaluating efficacy of possible public health prevention measures, we have created a mathematical model with seven compartments to understand nationwide BCG vaccine recommendation on COVID-19 transmission, severity and mortality. We have computed two basic reproduction numbers, one at vaccine-free equilibrium point and other at non-vaccine-free equilibrium point, and carried out local stability, sensitivity and numerical analysis. Our result showed that individuals with BCG vaccinations have lower risk of getting COVID-19 infection, shorter hospital stays and increased rate of recovery. Furthermore, countries with long-standing universal BCG vaccination policies have reduced incidence, mortality and severity of COVID-19. Further research will focus on exploring the immediate benefits of vaccination to healthcare workers and patients as well as benefits of BCG re-vaccination.