Covid-19 and Vitamin D : Virus and Humankind
I sometimes think that I am living in a dreamworld. Perhaps there has not been a pandemic; perhaps one morning I will wake up and all will be well. But unfortunately I must assume that what is going on around me is real, and my despair continues.
I cannot believe the continuing ignorance. I have been aware of the lack of scientific knowledge of the great majority of politicians, and also among society in general. What I am seeing and hearing now is a lack of scientific knowledge and understanding among professional scientists.
Just this morning (Tuesday July 21st) I had the misfortune to listen to BBC Radio 4. It is usually informative, during the Brexit campaign it was hilarious (very black comedy), but now it is just so sad and frustrating.
Every day there is a concentration on “The Virus”, as though there were just one, a destructive monster like Godzilla. Yes, perhaps we have been exposed to too much fiction. In Michael Crichton’s book “The Andromeda Strain” (1969) there was a sort of virus but not the DNA or RNA type that we know of. It caused havoc, and then one day the havoc suddenly stopped. “It” had mutated into something friendly, and all lived happily ever after.
There is no question that deaths from Covid-19 are declining world-wide, whereas the number of cases is still increasing. In many countries, and certainly in Europe, deaths from Covid-19 have virtually stopped. The number of cases has declined but slower than deaths. It is in the Americas that the number of cases and deaths is still increasing, reflecting the origin of the pandemic in the Far East and spreading westwards.
In Switzerland we can see that the incidence, the number of new cases each day, declined but has now risen. The number of deaths has virtually come to an end and is not matching the increase of cases.
The same phenomenon is seen in Spain.
The persistence of new cases of Covid-19 is frustrating to public health officials, but it is perhaps the inevitable consequence of relaxing lockdown. People who have been isolated will obviously emerge and come into contact with the virus to which they have no immunity. Widespread viruses cannot be killed, especially when they are inside the human host.
If the illness is only a mild upper respiratory tact infection (URTI), the number of cases is not of great consequence. It will contribute to the herd immunity that is so important for the future. The tragedy to be avoided is serious respiratory disease, or even death. We can see that is what is happening. The experience in Switzerland is matched in other countries. The increase in cases is not matched by an increase in deaths. The number of Covid-19 deaths is now extremely low, and the reason for this is the improvement of immunity of people, as we are now in the summer.
The time to develop Covid-19 infection is in the summer, when the sun is generating vitamin D. This is clear from the experience of Spain and Switzerland, and all other European countries. In the summer significant deaths are not occurring, but immunity is spreading and that is good. Vitamin D will lead to avoidance of serious illness and death from Covid-19, and as indicated by the UK chief scientific officer, take it throughout the winter.
The suggestion made on BBC News this morning was that “the virus” is mutating into a more mild form. This has been the problem during the pandemic. “Science” and politics have been concentrating on the virus and not on humankind. This blinkered approach has led to far more deaths and serious illness than need have happened. It is not difficult to think it through from simple principles. I make the assumption that viruses do not have the capability to think.
First, unlike the Andromeda Strain, there is not “a” Covid-19 virus. There are obviously very many trillions of virus copies. There could be a million inside each infected individual; I do not know the number but perhaps it could be estimated. Many are visible in tissues on electron microscopy.
|Multiple Covid-19 viruses (blue stain) in lung tissue|
With very rapid reproduction mutations will be frequent, and perhaps the same mutation on many occasions. We were told that the mutations identified at Birmingham University UK did not appear to be of great clinical significance, but they are being watched.
It is obvious that if they were all to mutate at the same time, and all with the same mutations, it would entail a remarkable level of co-ordination that even humankind could not achieve. Synchronous reproduction occurs in corals of the Great Barrier Reef, but that seems to be co-ordinated by an eternal agent – the Moon.
But synchronous mutation of trillions of virus DNA/RNA strands is would be a biochemical event of much greater complexity than shedding sperm and ova, even in response to an external agent. The chance of world-wide synchronous Covid-19 mutation would be similar to that of a two year old child when given a pencil and paper spontaneous writing the complete works of Shakespeare.
Think of evolution. In order to survive and prosper, a mutation must give an advantage to the virus. What would be the advantage of Covid-19 mutating into a milder form? Did Covid-19 realise that it was going to close down most air travel on the planet? Does it want to become milder so that air travel can resume? There would be no advantage to a virus that can already co-exist with its human host. The idea of Covid-19 mutating into something that makes us less ill is absurd. It is however the logical conclusion of those who think only of a virus and ignore humankind.
“The weather” and Covid-19
The second absurdity on BBC News this morning was a statement by another professor that the decrease in the number of cases per day since the peak in early April is because of improvement in the weather. Sorry, this in itself sounds to be reasonable, but he went on to say that the weather has become warmer and drier, and the virus does not like these conditions. The virus does not live in the external environment as it is not free-living. A virus can only live within the cells of the bodies of human and other animals (or even plants).
The fact that the Covid-19 pandemic in the northern hemisphere has declined since mid-April is nothing to do with the virus but everything to do with the human host. The professor talked about warmth and dryness, but he made not the slightest mention of the great controller, the Sun. The tilt of the Earth gives us seasons and the Sun gives us warmth.
The Sun and vitamin D
The Sun does more than that. For the past 1.5 billion years it has had an effect on plankton in the sea, splitting a molecule that plankton synthesis It is 7-dehydro-cholesterol, a fundamental substance produced by all animal life. Since the Cambrian explosion 500 million years ago the Sun has had the same effect on land animals, including Homo sapiens during the past 300,000 years or thereabouts. I have explained in a previous post about the biology of vitamin D.
For one billion years the single advantage from the production of vitamin D was the absorption of UV light, thereby reducing any damaging effect on living tissues. It was only with the Cambrian explosion of life that evolution created an intracellular enzyme now named VDR (vitamin D receptor) that by chance had to be activated by vitamin D, thus giving vitamin D a metabolic function. The activation of VDR by vitamin D enabled the cascade of defensive immunity against pre-existing bacteria and viruses. It was possibly this defence that enabled the occurrence of the Cambrian explosion of complex animal life.
|Fossil from the Cambrian explosion|
Immunity was the first and vitally important effect of vitamin D. The development of bones came much later in the evolutional story, the the bone forming cell the osteoblast (activated by Vitamin D /VDR) being derived from the defensive cell the macrophage.
45,000 UK deaths
The ignorance of scientific advisors to the government concerning the vital immune functions of vitamin D is the main reason for the deaths of more than 45,000 people in the UK, the fourth highest number of deaths per million population in the world after San Marino and Belgium, and marginally behind Andorra. Some smaller nations have been hit very badly, the highest case incidence being Vatican City 12 cases in a population of 801 (14,981 cases per million) but fortunately no deaths.
Even this morning the ignorance persists. I would have expected that scientists would be reading into the subject of immunity and would have come across vitamin D. There are hundreds of references and many excellent review articles. It might be difficult for the non-scientist to follow many of them, but not for a professor of medical-scientific subjects.
The number of cases of Covid-19 could be controlled or delayed by isolation and lockdown, but this would not have controlled the number of deaths in the same way. The virus is easily transmitted, especially in overcrowded houses and localities. Vitamin D would not have prevented infection, but would have reduced the chance of the development of significant illness and death in those individuals infected.
Seasonal change and Covid-19
The decline of deaths since mid-April was the result of the inclination of the axis of the Earth changing the season in the northern hemisphere (where most people live) from winter into summer. At the latitude of the UK (London 51.5 degrees north) it is only during April that the mid-day Sun is more that 45 degrees above the horizon. It is then that the intensity of the Sun is strong enough for vitamin D to be produced (it is a physico-chemical production not a biochemical synthesis).
You might be able to work this out from the Solar Location diagram shown below, the example being for London UK.
As we have moved the winter into summer, our bodies have been producing more vitamin D and the effects of Covid-19 have diminished. It is the same every year in respect of a variety of illnesses, especially what we refer to as flu. Vitamin D production reaches its maximum per day in midsummer, which was month ago. Vitamin D production stops during September, but by then we should have produced sufficient vitamin D to last us until midwinter if not beyond.
The bar chart shows the progressive decline of deaths per day in the UK since mid April when vitamin D production started. Superimposed is an illustration of vitamin D production during the summer months.
What will happen during the decline of vitamin D production? Will Covid-19 return during the winter when our natural blood levels of vitamin D diminish? It might happen but hopefully we will accumulate adequate reserves during the summer, especially with the air now being so much cleaner.
But we must make certain and maintain our vitamin D store by taking a supplement, 3,000 units per day or equivalent usually being adequate to establish optimal immunity. To check on adequacy it would be sensible to have blood level of vitamin D to be checked as we move into the winter.
The Chief Scientist recommends Vitamin D
I could hardly believe my eyes yesterday (Monday July 20th) when a few friends sent me emails of an article in the Times. It quoted the government chief scientist Sir Patrick Vallance stating that “millions of our population should take vitamin D to boost immunity and diminish the impact of Covid-19 so that our hospitals will not be overwhelmed”. This is the first time that “officials” have recommended vitamin D in this way. Is ignorance on the wane and is enlightenment on the ascendency? We can only hope so. By this statement the chief scientist over-ruled the very poor advice that he received from NICE last month.
Lack of action
I have previously reported observations concerning Covid-19 and vitamin D status. These were reported from the Philippines, Indonesia, India, and Singapore. In summary they indicated that if a person’s blood level of vitamin D is greater than 30ng/ml (75nmol/L), the chance of serious or fatal illness from Covid-19 is less than 10%. If on the other hand the blood level is very low at less than 10ng/ml (25nmol/L) the chance of serious or fatal illness from Covid-19 is about 90%.
This should lead the average citizen to conclude that the choice of the preferable blood level of vitamin D is what might be called a “no brainer”. The high level is obviously preferable.
But this advice from the far East, where the pandemic originated, was ignored by our UK government and its advisors, and by the National Institute of Clinical and Health Care Excellence. We have watched while 45,000 of our fellow-citizens have died when many might have survived had they received an adequate dose of vitamin D supplement.
At this time of national emergency and anticipated pandemic, the population could have been protected most simply by each receiving a single supplement of vitamin D 100,000 units by mouth as a drop of the oil on a piece of bread or directly on to the tongue. This could then have been repeated after a month or followed up by a daily smaller dose to. There is not the slightest danger from a single dose of 100,000 units. The alleged dangers in the recent NICE report were bogus.
Newcastle upon Tyne
Earlier this month we received a report from Newcastle upon Tyne that the observation studies of the Philippines and Indonesia have been repeated, this time in the UK. I must say that I had expected a large number of repeated studies as they would have been so simple to perform. Perhaps they have been performed, but if so the results are very slow to appear.
However the results from Newcastle are as follows.
Of patients with Covid-19 a blood vitamin D level less than 20ng/ml (50nmol/L) was found in:
90 out of 134 patients (67%)
and in 34 out of 42 (81%) on the ITU.
Covid-19 and vitamin D deficiency - more news from Indonesia
I have just received a copy of a paper from the Duta Wacana Christian University Medical School, Indonesia.
This is a small study but the authors are to be congratulated on making a research effort. They tested blood vitamin D levels on 10 patients with Covid-19. The results (ng/ml) were: 20.5,12.4, 11.9, 11.6, 10.6, 10.1, 8.3, <8.1, <8.1, <8.1.
It appears from other studies that a blood vitamin D level of greater than 30ng/ml (75nmol/L) is necessary for enabling optimal immunity. Therefore all these hospital patents were deficient. Less than 10ng/ml (25nmol/L) is considered to be dangerously low, and will possibly lead to bone disease (osteomalacia).
Five patients were male and five female The age range was 14 to 65. The 14 year-old was a girl with blood vitamin D 8.3ng/ml.
This paper confirms previous reports that patients with Covid-19 infection serious enough to lead to hospital admission are likely to be deficient of vitamin D. Also that living close to the equator does not guarantee vitamin D. It is an observational study with no intervention.
Observation studies are powerful
Intervention studies are not always possible, and science starts with observations. Many of these are of immense practical value, and examples are:
- vitamin D and Covid-19,
- ethnicity and Covid-19,
- atmospheric pollution and Covid-19,
- obesity and Covid-19,
- elderly and Covid-19.
- cigarette smoking and lung cancer,
- cycle helmets and head injury,
- hard hats on building sites,
- life jackets when sailing,
- blood alcohol levels and road traffic accidents,
- wearing of seat belts and outcome from road traffic accidents.
The list could go on. RCTs are not always possible.
It is clear that however desirable, randomised controlled trials (RCTs) are not always possible in the human experiences of life and death. Those (like NICE and the Royal Society) who argue for RCT results before recommending vitamin D to prevent the escalation of Covid-19 to a critical or fatal condition seem not to understand this. They must be unaware of the Criteria of Sir Austin Bradford Hill in forming practical judgement, not just differing in their ivory towers. I have reviewed this subject in an earlier Blog post in August 2015.
After more than 45,000 deaths, substantial scientific evidence, and several examples of observational evidence, It should be glaringly obvious that we should be giving vitamin D to the population, as we could have done and should have done four months ago. On March 23rd we introduced lockdown having experienced 284 deaths. What a wasted opportunity. The number of UK deaths from Covid-19-19 was 45,000 four months later. How many of these deaths might have been avoided. I hope lessons will have been learned.
There has not been sufficient time since the pandemic began to conduct clinical trials of prevention of serious disease using vitamin D supplements. However BBC News this morning provided other aspects of Covid-19 and therapeutic developments. There was great enthusiasm.
First we heard news from Southampton about an interferon preparation for use in the very sick patients with Covid-19. Interferon came to my attention when I was a medical student. It had been observed (please note) that virus diseases appear just one at a time. It is as though a current infection somehow inhibits a second infection. It was proposed that this “interference” is produced by an anti-viral substance that one virus programs its host cells to manufacture so as to discourage any competitors. It became known as Interferon. It seemed to have great therapeutic potential but realising this over many years has been fraught with disappointments.
But perhaps its time has come. Interferon beta-1α is manufactured by Synairgen, a spin-off company from Southampton University. Initial trials (observational) of 50 hospital patients with Covid-19 are promising with a 79% reduction in death or the need for mechanical ventilation. This has led to great commercial success.
Will NICE demand that Interferon beta-1α is be subjected to an RCT before it can be released for general use?
The Oxford vaccine
The other exciting BBC News item this morning was that the Covid-19 vaccine being developed by Astra Zeneca and Oxford University is looking hopeful. It has been shown to produce an antibody response in human volunteers. The UK government has bought 80 million doses, the price not yet disclosed.
There will however be a snag. The volunteers will almost certainly be healthy young people, those for whom the pandemic has not posed a problem. They have good immunity, but the at-risk groups do not have good immunity. They are the elderly, the obese, those with black or Asian ethnicity, those with diabetes and other pre-existing conditions. How will they react? We know from previous experience that less than half of the elderly exhibit a response to a vaccine.
Once again, will NICE insist on an RCT? A different RCT for each vaccine? Will NICE allow extrapolation from young healthy volunteers to frail elderly?
There is a great deal of press coverage of vaccines, but almost complete silence concerning vitamin D, apart from the comment by Sir Patrick Vallance that does not seem to have been reported in other newspapers or radio broadcasts. We can see that there is big money in the development of pharmaceuticals, but there is no big money to be made from vitamin D. Perhaps it is in the interests of the impressive Big Pharma that silence concerning vitamin D is useful.
But now a book on the subject is becoming available. Or is it?
The book that I have co-authored with David Anderson is now available from Apple as an eBook. It is almost available as a printed book, pre-ordered from:
But something strange has happened. Amazon refused to market this book. It was accepted by the distributor Kobo, but two days later it was withdrawn. The message from both was as follows:
Kobo have now removed the book from sale.
This book has not been published because the following elements are unacceptable by Kobo's publishing standards:
- Content (general policy violation)
- In the interest of public heath and safety, due to the extremely quickly changing nature of current events, Kobo is restricting the sale of Coronavirus-themed titles to certain vetted sources of information. We thank you for your understanding in our efforts to prevent the spread of misinformation during this pandemic. We reserve the right to revisit our current policy at a later date.
Clearly David Anderson and I are not “vetted sources of information” and the hand of the censor has descended. The “misinformation” of the role of vitamin D in Covid-19 infection that we provide is to be withheld from the public.
Censorship by Amazon and Kobo is not undertaken by an employee having to read all the books. It will be an Artificial Intelligence task. The computer program will have been:
If Covid-19 and Vitamin D then Reject.
There is no explanation other than this. But the program must have been defined from “the top”. Who exactly? Why must vitamin D be kept out of the Covid-19 story? The book explains it.
The problem is that vitamin D is a natural product supplied by the sun. No company can patent it, and there is no money to be made. The financial investment of an RCT would be completely pointless. And so because of the single-minded policy of vaccine development, now irrelevant at least in Europe, 45,000 deaths in the UK have occurred. Many of them could have been prevented by the prior use of vitamin D.
Will evidence concerning vitamin D be excluded from retrospective investigations into the handling of the Covid-19 pandemic? Will all mention of vitamin D be erased from the history of the pandemic?
Another thing. There were 11,842 views of my Blog posted on May 8th, 16,925 for June 7, but only 1,126 for July 6th. Perhaps my popularity is waning, but perhaps there are blocks being applied to the Blog distribution.
Deliberate spelling mistakes might be necessary to fool the commuter program.
Are the scales of justice indicating increasing evidence of the benefits of vitamin D? Or is justice being over-ruled?