Tuesday, 8 December 2020

Covid-19 & Vitamin D: Calcifediol has 96% Efficacy and very low cost

£10 to prevent ICU admission or death

Updated December 15th

We are moving forward in respect of both prevention and treatment of Covid-19. Action is needed, as in the UK we have had 60,000 deaths attributed to Covid-19.  There have been more than 1.6 million cases, but it never clear what a "case" means. Even deaths are not clear, and it is always stated on news broadcasts that "There have been 500 [or whatever number] deaths today in people who have tested positive for Covid-19 during the past 28 days". Road Traffic Accidents perhaps?

In the UK there have been approximately 25x more cases than deaths, whereas internationally it is 50x more cases than deaths. The geography of Covid-19 is another story, but the UK is not doing well. We have now reached in excess of 900 deaths per million, among the highest in the world.

How good have our interventions been? We cannot have confidence in our physical policies of distancing, closure of schools, universities, places of worship, workplaces, restaurants, sports venues, social occasions including weddings and funerals, family contacts etc. There has been a huge social and economic price to pay for little if any gain.

An immunological approach has always held more promise, with massive investment in the production of vaccines. However there has been complete neglect by governments of correcting wide-spread vitamin D deficiency. This is despite the knowledge that vitamin D is essential for unlocking defensive immunity, and ignoring several research observations of the bad outcome and death from Covid-19 in those deficient.

I will look at vaccines next time, but for today I will keep to vitamin D to explain how "efficacy" is worked out.

Córdoba, Spain

I have described in previous posts the powerful trial from Córdoba concerning the hospital treatment of patients with Covid-19 pneumonia. The study used the rapidly-acting part-activated form of vitamin D, namely Calcifediol, or 25(OH)D, a natural product. We have seen the pathetic superficial rubbishing by the UK National Institute of Health and Care Excellence (NICE), with instruction not to use Calcifediol. In contrast a detailed analysis at the Massachusetts Institute of Technology (MIT) identified no procedural fault and a less than 1 in a million probability of the positive result being due to chance.

I would like to analyse the results of the Córdoba study to assess the efficacy and economic value of Calcifediol. 

There were 76 patients in the study, all admitted to hospital on account of Covid-19 pneumonia. They were randomised into two groups, 2:1 ratio treatment:control. Treatment was started on admission to hospital with standard high quality care with or without Calcifediol. The main outcome end-points were the need for admission to ICU and death.

Calculation of Efficacy

Placebo control group of 26 patients: 

13 ICU transfers = 50% ICU transfer rate, 2 deaths

Calcifediol 50 patients:

Expected ICU transfers would be, from control group,  

50% of 50 = 25

Observed ICU transfer was 1

Therefore ICU transfers prevented by treatment were 

25 (expected) -1 (observed) = 24

24 out of 25 ICU transfers = 96 out of 100

Efficacy = 96%

Absolute or proportionate benefit

The reduction of ICU transfers was 50% to 2%

50% - 2% = 48% absolute benefit from Calcifediol

And for the usual amplifying spin:

48% of 50%

(48 x 100) / 50 = 96% proportionate benefit from Calcifediol

Calculation of NNT

In the Calcifediol treated group of 50  

1 ICU transfer = 2% ICU transfer rate

50 patients treated with Calcifediol reduced ICU transfers by


25 expected - 1 observed = 24

50 Calcifediol treatments to prevent 24 ICU transfers

50 ÷ 24 = 2 patients needed to be treated to prevent 

1 ICU transfer

number needed to treat to prevent on endpoint of ICU transfer

NNT = 2

Cost–benefit analysis   Updated December 15th

The principle is that the cost of all the patients treated must be borne by the ones who benefit. Therefore with an NNT of two, the cost of twor treatments is the cost of preventing 1 ICU transfer

= 2 x cost of one course of Calcifediol

In Spain the price charged for Calcifediol is €10.32 for 10 softgels each containing Calcifediol 266 micrograms.

In the Córdoba RCT and on the package show, the dose is expressed as 0.266mg. Decimal points can be confusing and so the dose is better written as 266 micrograms, using full text for micrograms as abbreviations can also be confusing.

The course of treatment is:

day 1, 532 micrograms

day 3, 266 micrograms

day 7, 266 micrograms

day 14, 266 micrograms

This is 5 soft gels, a total cost of €5.16, £4.68, $6.27

The cost of one ICU transfer or one death prevented 

= NNT x €5.16

=    2    x €10.32

=  €11.32,  £9.36,  $12.53

Treatment with Calcifediol will result in substantial savings of money as well as deaths. One day on an ICU cost approximately £2,000.

What about deaths prevented?

In the control group there were 2 deaths, all in the ICU.

In the Calcifediol group there ware no deaths.

2 versus 0 does not lend itself to statistical calculation.We cannot assume a 100% reduction in deaths.

There was a 96% efficacy in the reduction of ICU transfer and the must have been an  efficacy in the reduction of deaths greater than 96%.

Covid-19 Vaccines

Analysis will follow in the next post.


  1. Your analysis has confused me. What is this observed transfer of patients to ICU of 24? I thought only 1 parient was transferred to ICU and indeed you state this lower down.

    1. Thanks Madge. Slip of the keyboard. Now corrected.

  2. Your NNT has a problem as the expected ICU transfers was 25 not 13. So the real NNT is 50/(25-1) so 2.08.

    Overall excellent!

    1. Peter – very many thanks for spotting my second mathematical error. Now corrected. If the price of Calcifediol is $200 for 200 micrograms, then the cost of one treatment is half the cost of one day on ICU.
      Why is Calcifediol not being used? It is beyond belief.

  3. I see all this as indicative of one the biggest crimes against humanity all in the pursuit of profits for the elite minority. We all have a choice. Prioritise nature or prioritise profits.

    1. I agree, failing to use Calcifediol in the treatment of serious Covid-19 pneumonia is clinical neglect. Is admission to ICU and high risk of death preferable to Calcifediol? This is the choice that physicians must make.

  4. Using https://www.worldometers.info/coronavirus/country/spain/ I've compared the Daily New Deaths in Spain to Italy and France. The proportionate reduction in the C-19 second wave deaths compared to the first wave in Spain is significant. Much better than Italy and France or any other country for that matter.

    Is this evidence of the use of calcidefiol? The publication of Castillo et al was in July so its feasible the application could have been applied throughout the 15 hospitals in the country as the article indicated.

    Your thoughts?

    1. I agree. Look at this web site from Andalucía. Untick all except Falledico (deaths) and see the dramatic drop since vitamin D was given on a community preventative basis.

  5. Perhaps I'm not seeing what you are seeing. When I select for only fallecidos in Andalucia it portrays the deaths as low from June to September but then it escalates continually through to November to levels as high as was in March and April.

    BTW The url you provided is with an error. Believe it or not the i in COVID needs to be capitalized.

    1. Sorry about lower case i
      The deaths in Andalucía were low in the summer, as in all European nations. We stop producing vitamin D in September, until April. Big vitamin effect, as in the UK graph. See if it loads.

      /Users/grimes/Pictures/Photos Library.photoslibrary/resources/derivatives/A/A5372AAB-0901-4E6A-ADBE-5A42B7DC221A_1_105_c.jpeg


    2. This link does not seem to talk about vitamin D. Maybe I am missing something or the translation to English is failing. Could you please tell me when Vitamin D was given on a preventive basis? Additionally, do you think opinion on calcidiol will change once the trial results are out?

    3. 20% efficiency, 1/5 of vitamin D is converted into calcifediol (informed opinion)
      Therefore 5 mcg vitamin D creates 1mcg calcifediol
      5mcg vitamin D = 200 units -> 1mcg calcifediol
      To create 250mcg calcifediol requires 250 x 200 units of vitamin D
      = 50,000 units vitamin D

  6. https://www.bbc.co.uk/news/health-55333063


  7. ..... AND only 400 IUs (10mcg) needed! In the words of John McEnroe "You can NOT be serious!"