Thursday 9 December 2021

Covid-19 and Vitamin D: strong evidence of benefit from Israel

The importance of Vitamin D in the Covid-19 pandemic: reports from Israel





It has been known for more than 40 years that vitamin D is of vital importance in the escalation of defensive immunity at the time of infection. It is also well-established that people with defective immunity are very susceptible to infection, with a high risk of death, and this has been illustrated well by the experience of AIDS. It has also been established on numerous occasions in many countries that vitamin D deficiency is very common, leading to sub-optimal immunity in many people. 


In life in general, people are not aware of their vitamin D deficiency and the problems that result from it. Health issues such as respiratory infections, post-operative infections and recovery from surgery, problems in pregnancy, the development of diabetes, certain cancers, and multiple sclerosis are accepted as bad luck, even though they are known to have an increased incidence in people with vitamin D deficiency. 


But when faced with a pandemic of Covid-19, a virus against which we have no learned immunity, the rapid time-scale brought disadvantages of vitamin D deficiency and impaired immunity into sharp focus. It was soon after the onset of the pandemic that we learned of the high susceptibility of those with low blood levels of vitamin D to critical and fatal Covid-19.  It was obvious that a public health imperative to minimise ICU admissions and deaths, would be to correct vitamin D deficiency as soon as possible. But it was not to be.


Susceptibility of particular population groups


It became clear that the great majority of Covid-19 deaths occurred in the elderly, but we were told that they were just old, the official and unquestioned narrative that had no scientific foundation. Vitamin D is produced by the action of UV from the sun on 7-dehydrocholesterol (7-DHC) that is synthesised in the skin. It has been known for forty years that the thin dry skin of the elderly does not synthesise adequate amounts of 7-DHC and so vitamin D deficiency is inevitable, no matter how much time is spent in the sun. 



It was also clear that people of Black African and South Asian ethnicity were particularly susceptible to critical and fatal Covid-19. The official narrative is that this has been the result of socio-economic disadvantage and racism. My reporting of the fact that of 26 working doctors in the UK who died from Covid-19, 25 (96%) were of Black African and South Asian ethnicity went officially unacknowledged even though it was the paradox that invalidated the socio-economic proposal. Well-known vitamin D deficiency in these ethnic groups was the obvious and scientifically established explanation, not officialy acknowledged.


In a previous Blog post I reported that the group of people in the UK hit hardest of all by the pandemic of Covid-19 have been Haredi Jews, those who are most orthodox. I pointed out that they have sun-avoiding behaviour, not by intent but as a result of clothing and other traditions that result in virtually no exposure of the skin to the sun. 


VItamin D in Israel in 2001


Research in Israel 20 years ago investigated vitamin D status in Jewish new mothers in Israel, identifying as to whether they were orthodox (Haredi) or non-orthodox. Blood testing for vitamin D was undertaken after delivery. It was found that in the orthodox mothers the average mean blood level of vitamin D was 13.5ng/ml (34nmol/L) compared to 18.6ng/ml (46.5nmol/L) in non-orthodox mothers.


We can see in Figure 1 that extremely low blood levels of less than 5ng/ml, 12.5nmol/L, were found in 5.7% of orthodox mothers and in 2.7% of non-orthodox. Less than 10ng/ml (25nmol/L) was found in 32.7% of orthodox mothers and in 13% of non-orthodox. We will see from a later study how extremely low are these blood levels.


A very small vitamin D supplement of 400 units per day was given to some women during pregnancy and it had a small effect. As a result of this supplement, 2.2% of orthodox mothers had a blood level less than 5ng/ml, 12.5nmol/L, but none of the non-orthodox mothers. 13% of the orthodox mothers receiving the small vitamin D supplement had a blood level less than 10ng/ml, 25nmol/L, compared to 8% in non-orthodox.


Figure 1. Jewish mothers in Israel – vitamin D status



The messages from this study are that:

  • vitamin D deficiency is very common in Israel, despite a sunny environment
  • it is more common in orthodox mothers
  • vitamin D supplement of 400 units per day is of little benefit
  • blood levels of vitamin D are higher in the summer in non-orthodox mothers
  • in orthodox mothers, blood levels of vitamin D do not increase in the summer.


Mukamel MN, Weisman Y, Somech R, et al. Vitamin D deficiency and insufficiency in orthodox and non-orthodox Jewish mothers in Israel. Isr Med Assoc 2001; 3: 419-421.


Vitamin D in Israel in 2021


We now have the results of a new study from Israel. It looks at the outcome of Covid-19 related to pre-infection Vitamin D status, and "Guess What?" The outcome is far better in people with the highest (not toxic) blood levels of Vitamin D. Let us look at the details.


The study was of 1176 patients admitted to the Galilee Medical Centre on account of Covid-19. 253 of these had blood levels of Vitamin D measured prior to infection. For the purpose of analysis they were divided into four groups based on blood levels: 


  • less than 20ng/ml, 50nmol/L
  • 20 to 29.9ng/ml, 50 to 75nmol/L
  • 30 to 40ng/ml, 75 to 100nmol/L
  • greater than 40ng/ml, 100nmol/L.


The analysis shows many interesting features, as displayed in the tables and figures.


Figure 2. Blood levels of Vitamin D in advance of Covid-19

Figure 2 shows the distribution of blood levels of Vitamin D. 52.5% of those admitted to hospital had a previous blood level less than 20ng/ml, 50nmol/L. This in itself identifies a serious public health problem that was identified in new mothers in 2001 and remains twenty years later. Only 15.8% had a level greater than 40ng/ml, 100nmol/L.


Table 1 shows the relationship between the blood levels of Vitamin D in advance of Covid-19 and the severity of illness when it happened. The Table shows the numbers in each group, and also the percentages of Vitamin D status in each illness category.


Table 1. Relationship between severity of Covid-19 and pre-existing blood levels of Vitamin D

Table 2 illustrates the dramatic effect of pre-existing blood levels of  Vitamin D on death from Covid-19. A blood level of greater than 20ng/ml, 50nmol/L, makes death very unlikely. A blood level of less than this put an individual at considerable risk of death, an excess risk that can be eliminated by the public health action of correcting Vitamin D deficiency.

Table 2. Deaths from Covid-19 and pre-existing blood levels of Vitamin D


We can see in Figure 3 that most patients with mild illness have higher blood levels of Vitamin D, greater than 30ng/ml, 75nmol/L.


Figure 3. Blood levels of Vitamin D in patients with mild Covid-19



When we look at Figure 4 we find that in moderate illness the patients are predominantly those with low blood levels of Vitamin D


Figure 4. Blood levels Vitamin D in patients with moderate Covid-19


Figure 5, below, shows that severe Covid-19 occurs almost exclusively in those with low levels of Vitamin D, less than 20ng/ml, 50nmol/L.


Figure 5. Blood levels Vitamin D in patients with severe Covid-19



Figure 6 shows that critical Covid-19, patients, those who would have been admitted to intensive care, were almost exclusively those with the lowest blood levels of Vitamin D. On the other hand patients with blood levels greater than 30ng/ml, 75nmol/L, did not require intensive care unit support.


Figure 6. Blood levels Vitamin D in patients with critical Covid-19



We can look at this is another way. What is the pattern of illness that occurs with Covid-19 in people with the lowest blood levels of Vitamin D, less than 20ng/ml, 50nmol/L?


Figure 7 demonstrates that those with the lowest blood levels of Vitamin D are most likely to have severe or critical illness. 



Figure 7. Covid-19 in patients with the lowest blood levels of Vitamin D, <20ng/ml <50nmol/L



When the blood level of Vitamin D is above the critical level of 20ng/ml, 50nmol/L, the threat of severe or critical illness is very much reduced, as shown in Figure 8.


Figure 8. Covid-19 in patients with blood levels of Vitamin D
 20–29.9ng/ml, 50–74.9nmol/L


When the blood level of Vitamin D is greater than 30ng/ml, 75nmol/L, Covid-19 is likely to be mild, shown in Figure 9.


Figure 7. Covid-19 in patients with blood levels of Vitamin D
 30–40ng/ml, 75–100nmol/L



Figure 10, below, shows that when the blood level of VItamin D is greater than 40ng/ml, 100nmol/L, severe and critical Covid-19 does not occur. 12 patients out of 13 had just mild illness, and one had just moderate illness.


Figure 7. Covid-19 in patients with the highest blood levels of Vitamin D, >40ng/ml, >100nmol/L



Mortality


38 of the 253 patients died. Deaths, occurring in hospital, were almost entirely in patients with the lowest levels of Vitamin D, less than 20ng/ml, 50nmol/L. (Table 2, repeated)

Table 2. Deaths from Covid-19 and pre-existing blood levels of Vitamin D


It appears that the three patients who died with blood vitamin D levels of 30ng/ml, 75nmol/L, they did so without going to the Intensive Care units, for reasons not explained.


For the purpose of death analysis, there are just two groups, those with vitamin D less than 20ng/ml, 50nmol/L (34 patients), and those with higher levels (4 patients).


If you were to develop Covid-19, what blood level of Vitamin D would you choose?


Figure 11. Deaths from Covid-19 and pre-existing blood levels of Vitamin 


Ethnicity


The study did not distinguish between orthodox and non-orthodox Jews, but we have seen that in the UK orthodox Haredi Jews have had an exceptionally high mortality rate from Covid-19. The two main ethnic groups in Israel are Jews and Arabs, but there are several minority ethnic religious groups within Arab people. For the purpose of analysis, the study divided its sample into Arab and non-Arab.


The Vitamin D status of the two groups is shown in Figure 12.


Figure 12. Blood levels of Vitamin D in Israel



The frequency of very low blood levels of vitamin D less than 20ng/ml, 40nmol/L, is almost twice as high in the Arab group as in the non-Arab. The reason is not investigated directly, but is most likely to be the result of sun-avoiding behaviour, with very little exposure of the skin to the sun in Muslim people.


There is no mention of illness category or mortality related to ethnicity, but we can assume that the large proportion of Arab people with very low blood levels of Vitamin D would lead to a high incidence of serious and fatal disease. It is likely that, as in the UK, this will also be the case in the most orthodox Jews.


Age


The age categories for analysis are:

  • less than 50 years
  • 50 to 65
  • 65 and older


The relationship between age and vitamin D status is shown in Figure 13.


Figure 13. Blood levels of Vitamin D related to age


The result is not surprising. Older people have on average lower blood levels of vitamin D. In this study, of the patients with Covid-19 aged 65 or older (grey bars), 59.4% had blood vitamin D levels less than 20ng/ml, 50nmol/L, compared to just 13.5% of those aged less that 50 years.


We have seen above that older people progressively fail to synthesise adequate amounts of 7-dehydrocholesterol, and as a result UV from the sun is unable to produce sufficient vitamin D to enable optimal immunity.


Vitamin D levels in co-morbidities


The 2021 study from Israel provides additional data of considerable importance, an analysis of co-morbidities.


It has been recognised in the UK and other European countries that Black African and South Asian ethnicities, and increasing age were major factors in the risk of serious, critical, and fatal Covid-19. But certain pre-existing illnesses, co-morbidities, were also recognised as increasing such risk. These are not surprising to those who are aware of clinical practice. The co-morbidities recognised in the study from Israel are as follows:


  • COPD, chronic obstructive pulmonary disease
  • CHD, coronary heart disease
  • CKD, chronic kidney disease
  • Diabetes
  • Hypertension
  • Obesity, BMI >30


The relationship of these to blood levels of Vitamin D are shown in Table 3.


Table 3. Covid-19, co-morbidities, and pre-existing blood levels of Vitamin D 


Absolute numbers in each group are shown in Table 3, and it is obvious that all these co-morbidities are strongly associated with the lowest blood levels of vitamin D, less than 20ng/ml, 50nmol/L.


A study performed in the UK in early 2021 demonstrated the same thing and I have reviewed it previously. It demonstrated very similar findings to this table, but the findings were interpreted in an absurd way. If there was a high Covid-19 death rate from CHD, age, or ethnicity, then these were the stated reasons and Vitamin D deficiency was regarded as incidental. In other words the interpretation was that there was no evidence that Vitamin D deficiency was of any importance. The vitamin D deficiency of ethnic minorities was left untreated, with countless deaths resulting. The paper completely failed to follow the scientific process of finding the common factor (in this case Vitamin D), a vital step in understanding as described by William of Ockham. 


The conclusion of this well-publicised but extremely poor UK study was ultimately withdrawn, but this was not reported in the national press. 


Conclusions


The Israel study accepts that the totality of the data indicate a pivotal role of pre-existing blood levels of Vitamin D in predicting the outcome of Covid-19.


The conclusions and implications of the two studies from Israel are perfectly clear and irrefutable. The blood level of Vitamin D is the major determinant of outcome from symptomatic Covid-19. The target blood level must be 40ng/ml, 100nmol/L, so as to optimise immunity against severe and critical Covid-19. Had this approach been instituted as a public health initiative at the onset of the Covid-19 pandemic, there would have been many fewer deaths and very much reduced pressure on hospitals and intensive care units.


Blood level of Vitamin D less than 20ng/ml, 40nmol/L, should be regarded as critically low and requiring immediate correction. Testing the population for blood level of Vitamin D must become a public health policy. This is easily affordable.


More work is required to establish the dose of Vitamin D that is required to correct inadequate blood levels. The 2001 study from Israel indicated clearly that 400units per day given during pregnancy was hopelessly inadequate and did not eliminate serious Vitamin D deficiency. This is the dose that UK heath agencies advise, but they state that the more realistic dose of 4,000 units per day is safe. This is the dose that is regarded as appropriate by most medical scientists who study Vitamin D. 


I have indicated previously that by definition and before the days of physical measurement, one unit of Vitamin D was defined as the daily requirement of a 10 gram immature mouse. We can scale up from that so that the daily requirement of a 60kg human would be 6,000 units, and for a 120kg obese human 12,000 units each day. To be cautious, perhaps half of these doses would be a reasonable starting point for determining the dose that would be appropriate in achieving the blood levels of 40ng/ml, 100nmol/L. This must be the target level, as the study from Israel indicates.





The important thing is that rather than just giving Vitamin D supplement, the achievement of target blood levels must be recorded. It is standard practice in the treatment of anaemia and diabetes, and similarly blood pressure in hypertension. This must be a public health priority. 






Wednesday 10 November 2021

Covid-19 & Vitamin D: Vaccinations need Vitamin D

It is not vaccines or vitamin D, 

it must be vaccines and vitamin D



My most recent Blog post described the numbers of cases and deaths in a number of countries during the Covid-19 pandemic, and the disturbing fact that there have been many more Covid-19 cases and deaths during 2021 than during 2020. What has gone wrong? Why has the extensive vaccination process not reduced the numbers? 

The numbers of cases in most European nations are increasing,  with problems illustrated by newspaper headlines.



The increase of cases is disturbing in Germany, but much worse in Austria.

2021. Covid-19 cases per day in Germany


2021. Covid-19 cases per day in Austria

Why is this happening? 

There was until very recently something called 'full vaccination', but this is a term that is now obsolete. It meant two vaccinations, but now a so-called 'booster' dose is essential. However the second vaccination is proving to be effective for a shorter time than following the first vaccination. The six month gap before the 'booster' is being shortened. It is possible that vaccinations will be given at as little as three or four month intervals.

Such a vaccination policy would be a nuisance for the population and very costly for national public health authorities, but on the other hand extremely remunerative for vaccine manufacturers.

Our authorities assume the effectiveness of serial vaccinations. Safety remains uncertain but is likely to remain untested and unrecorded. But the vaccination policy will continue.

The curious of us will ask, "Why is it that vaccination becomes progressively less effective and of shorter duration? Surely we should expect increasing immunity with each vaccination, not decreasing immunity?"

Official UK evidence


The UK Health Security Agency (UKHSA) published its 'COVID-19 vaccine surveillance report Week 42'. In this report we read:

"N antibody levels appear to be lower in individuals who acquire infection following 2 doses of vaccination". 

'N antibodies' are antibodies to the nucleocapsid of the virus, which do not result from the vaccination, but just from Covid-19 itself. Antibodies are one component of immunity.

This statement or finding might be interpreted as suggesting that the vaccination actively damages the immune system, but this is not necessarily the case. However it is certainly of concern that people who have had two vaccinations can become ill with Covid-19 within a few weeks. Obviously something is going wrong with immunity following vaccinations against Covid-19 if they are not preventing infection. The official answer is "We need more vaccinations", but is this sensible? It would be better to understand what is happening. A general principle is that if a medical intervention does not work, then either double the dose or stop and think.

Vaccinations are given whether or not a person vaccinated has had and recovered from Covid-19. It would be interesting to know if previous infection has a negative effect on antibody response to subsequent vaccinations, but we are not informed. There is much about which we are not informed, and so some guess-work is necessary.

Vaccines are designed to produce an immune response, and the inflammatory component of this response seems to be greater with the new genetic inoculations than with traditional vaccines, hence a much higher incidence of untoward inflammatory events. There is actually a very good reason why this leads to decreasing immunity.

The evolution of the immune response 

It is necessary to understand the immune response that has developed during 500 million years of evolution. 

Evolution is full of mysteries, but a critical stage of evolution was the appearance of an intracellular protein that became the key to immunity. This protein is what we now call VDR, which stands for Vitamin D Receptor. It was the evolution of VDR 500 million years ago that was probably the initiator of the Cambrian explosion of advanced life-forms. The development of immunity meant that very primitive animal life, for example plankton, could evolve into more complex forms without being at the total mercy of pre-existing bacteria and viruses. 

And so it is today. Without immunity we would not survive infancy and we would become extinct. Immunity is vital and we have seen the effects of seriously damaged immunity in the recent AIDS pandemic. We must not forget this. We must respect immunity and the need for its optimisation. We must understand it.

The evolution of VDR was critical, but VDR would have had no function had it not been for Vitamin D which had evolved a billion years earlier. 

Plankton

Plankton at the surface of the oceans were at risk of physical damage by UV from the Sun. They ultimately developed genetically programmed diurnal vertical migration, meaning that they spend the night at the surface and descend deeper in the water during the day. 

But they developed another method of protection from UV, a chemical sunscreen. Starting from the long-chain squalene, otherwise known as shark oil, they became capable of synthesising steroid compounds, a process that is blocked by statin drugs (taken only by humankind in recent years). The important sunscreen steroid became the oil 7-dehydrocholesterol, 7-DHC. This will sound familiar to readers of the Blog. UV converts 7-DHC in the skin into cholecalciferol which we know as vitamin D. Within plankton this physico-chemical process absorbs UV energy and thus protects the plankton from damage. 

Squalene





7-dehydrocholesterol, 7-DHC, indicating the bond broken by UV


Vitamin D, cholecalciferol


For a billion years vitamin D had no function and it was merely a waste product of the sunscreen 7-DHC. But by another accident of evolution it became critical because it was able to activate VDR into the major player in the immune process. The Cambrian explosion was initiated.

Understanding our immunity

We know about T-cells that produce tissue immunity and B-cells that produce humoral antibody immunity, but the important process is the rapid escalation of immunity that is essential in response to infection if an optimal effect and recovery is to be achieved. This will also apply to the pseudo-infection of vaccination. The driving force is to switch on the genes that bring about multiplication of the immune cells and their effects, a genetically controlled amplification that can be 75-fold. 

The genes are activated by an intracellular dimer composed of VDR and RXR, Retinoid X Receptor.  However the VDR component must first be activated by 1,25(OH)D, otherwise known as calcitriol, the fully active form of vitamin D that is produced within immune cells. 

Activation of the genes will switch on or increase the production of defensive proteins including antibodies that act within tissue fluids to control and eliminate infection, the purpose of immunity.


The immune cells are able to  increase greatly the synthesis of VDR, but before the gene-activating VDR-RXR dimer can be formed, VDR must be activated, 'unlocked', by 1,25(OH)D which cannot be synthesised de novo. It can only be formed by hydroxylation (addition of an -OH group) of 25(OH)D, the number indicting the point on the molecule to which the -OH group becomes attached. 25(OH)D is the form of Vitamin D that has already been hydroxylated in the liver and which circulates in the blood.

Consumption of Vitamin D and exhaustion of reserves

Too much 1,25(OH)D produced in response to the escalation of immunity could cause subsequent problems of 'hypervitaminosis D', with an excess of calcium in the blood and in the urine. But evolution has solved this problem: the 1,25(OH)D molecule can be used only once, after which it is inactivated by conversion into 24,25(OH)D. The process of escalation of immunity requires a large number of single-use 1,25(OH)D molecules to activate a multitude of VDR molecules. Therefore a constant supply of 1,25(OH)D is essential and so there must be in the blood a good reserve of its immediate precursor 25(OH)D, the circulating form of vitamin D that is also known as calcidiol or calcifediol. 

A serious infection such as Covid-19 will consume significant amounts of 1,25(OH)D, and so we can expect to see a reduction of the blood level of 25(OH)D as a result of such an infection. As far as I am aware, such research has not been performed during the pandemic, or at least not published, despite how simple it would be. 

The magnitude of the inevitable fall in blood level of Vitamin D, 25(OH)D, following vaccination has not been reported. Perhaps it has not been investigated, but if it has been investigated by the pharmaceutical companies, the results will only be published if there is commercial benefit. Obviously, as with Covid-19, a good level of Vitamin D, 25(OH)D, in the blood (greater than 40ng/ml, 100nmol/L) would have sustained the escalation of immunity. But if before the infection or vaccination the blood level had been critically low (less than 20ng/ml, 50nmol/L), then a reduction would have reduced the level to a point that the escalation of the immune process would be halted, with a high risk of significant illness, perhaps critical or fatal.

Figure. The effect on Vitamin D of Covid-19 and Vaccinations in
two hypothetical patients with different pre-illness 25(OH)D levels.
My blood level is slightly above the green line.
The national average is the blue line



The Figure illustrates what I think is happening in respect of Covid-19 and vaccinations. I am suggesting for the point of illustration that an initial episode of Covid-19 will reduce the blood level of vitamin D by 5ng/ml (12.5nmol/L), and there is some in vitro experimental evidence of this. I suggest that the vaccination has a similar impact, reducing blood levels by the same amount. 

If the pre-Covid-19 blood level is good at 40ng/ml, 100nmol/L, then the person illustrated by the green line will be safe. Even after Covid-19 and two vaccinations the blood level will safe at about 30ng/ml, 75nmol/L. The importance of a reserve of 25(OH)D in the blood is of obvious importance.

However, if the pre-Covid-19 blood level is only 20ng/ml, 50nmol/L, the successive immunological actions will reduce the blood level of the individual illustrated by the blue line to below the very critical level of 10ng/ml, 25nmol/L. Critical or fatal illness is likely to be the result, but susceptibility to illness will extend beyond Covid-19.

The blood levels used are not arbitrary. They are very clear from a recent study from Israel that will be the subject of my text Blog post. About half of the UK population is likely to have blood level of vitmain D less than 20ng/ml, 50nmol/L.

The proposal

My proposal is that the decline of immunity following vaccinations is not because of a 'poisoning' of immunity, but because the reservoir of Vitamin D as 25(OH)D within the blood becomes exhausted by the immune responses to successive vaccinations.

The investigation of this would be very simple. Blood would be taken for Vitamin D measurement immediately before vaccination and one month later. The two samples would be analysed together, following the second blood test. Previous Covid-19 would need to be recorded, and of course the dose of any vitamin D supplement taken. 

This simple study could be undertaken in any public health vaccination centre. Ethical approval would be needed but I can envisage no conflict with ethics and what is in the best interests of individuals and the population. My view is that it has been unethical to withhold Vitamin D during this pandemic, contrasting with the official narrative that Vitamin D is of no value in the management of Covid-19. 

In some respects it is too late for serial readings with more than one vaccination. However it would be very interesting to determine blood levels of vitamin D both before and after a booster vaccination. I would predict very low Vitamin D levels.

A further study would be a randomised trial of the effect of a single large dose of Vitamin D perhaps 100,000 units, which is a months requirement, given two weeks before vaccination, giving time for it to be hydroxylated in the liver to 25(OH)D, calcifediol, the blood form and immediate precursor of 1,25(OH)D. The outcome measures would be symptoms or illness following vaccination, and also the antibody response to the vaccination.

The response

The question is whether there is any official interest in exploring disappointments with the vaccination programme, and the fact that there have been more Covid-19 cases and deaths in 2021 compared to 2020, a feature in most if not all nations. Media reports are interesting. 

The increase of Covid-19 cases and deaths in 2021 suggests that the vaccines are failing, but factual reports of this are immediately dismissed as misinformation.



The problems go beyond Covid-19 in that we are now hearing reports of increasing pressures from hospital admissions in greater numbers than are seasonal, and that most are not Covid-19. If admissions due to other conditions are increasing, it is likely that we are faced with impaired immunity due to exhaustion of body stores of Vitamin D in turn resulting from the vaccination programme. This could be corrected very easily and very rapidly.


We are also hearing official reports of excess deaths from cardiovascular disease in recent weeks. Why should this suddenly occur? Could this serious phenomenon be result of the vaccination programme? Is it the direct result of exhaustion of Vitamin D reserves due to the effects of the vaccination process? Could it be stopped by finding and correcting VItamin D deficiency? The challenge is urgent and the problem must not be witheld from the population.





Vitamin D in its metabolic forms has been very successfully ignored by official bodies during the pandemic of Covid-19. Evidence of benefit has been side-lined for the flimsiest of reasons and without any debate. The reason for this has been to protect the vaccine roll-out. The vaccines in use have still not been licensed and are still being used under Emergency Use Authorisation (EUA). This is dependent on there being no alternative prevention or treatment, resulting in the burial not just of Vitamin D but also ivermectin and hydroxychloroquine. 

At present new antiviral drugs are being tested and roll-out is anticipated in late 2021 0r early 2022. One is molnupiravir, produced by Merck and with anticipated price of  $700 per dose, about 10,000 times the price of a capsule of vitamin D. The other is manufactured by Pfizer. As the medicines must be given early in the corse of the illness, rationing on financial grounds is going be challenging.

If new anti-virals can now be used, why not Vitamin D and others? The EUAs can hardly be withdrawn at this stage as more than four billion people have now been vaccinated against Covid-19. If EUAs have become logistically irrelevant, Vitamin D can be given officially without causing the EUAs to be revoked.

It is time for Vitamin D to be released from its imprisonment.


Sunday 24 October 2021

Covid-19 & VItamin D. 2020 & 2021 : Nature and anti-nature

 

1768: Edward Jenner and smallpox vaccination


Covid-19 & Vitamin D.  2020 & 2021 : Nature and anti-nature


Has the 2021 vaccination programme been of any benefit?


Covid-19 made an impact in the UK in March 2020. By March 23rd there had been a total of 258 Covid-19 deaths and so "Lockdown" became national policy, with closure of universities, schools, places of worship, places of entertainment and leisure, and also much of the economy. The impact of lockdown on the pandemic was not very obvious, and we can see its non-effect on the time-line. 


Figure 1. UK: Covid-19 deaths per day in early 2020


Covid-19 deaths continued to increase and a peak was reached in mid-April 2020 with almost 1,000 deaths each day. After that there was a daily decline. This was entirely predictable as we know from experience that deaths from respiratory infections decline during the summer months. The reason for this is that starting in mid-April, the Sun rises to more than 45 degrees above the horizon, and thereby it has the intensity to produce Vitamin D from 7-dehydrocholesterol synthesised in the skin.


Many medical scientists were aware of the importance of the Sun and Vitamin D in optimising defensive immunity. The science of this had developed since about 1980 and many valuable research papers were readily available. I, and many medical scientists who were much more knowledgable on the subject than I was, tried to bring this to the attention of the government and its agencies, but our voices fell on deaf ears and the news media were not interested. The science was completely ignored in favour of dubious mathematics.


Covid-19 cases and deaths continued to fall steadily to a minimum in August 2020, when deaths each day were in single figures. At this time vitamin D stores would be maximal. The hospitals that had been struggling with the impact of Covid-19 found themselves almost empty with little work to do. This was of course a good thing, if only temporary.


Figure 2. UK: Covid-19 deaths per day during 2020

It was anticipated that case numbers and deaths would increase after mid-September, when Vitamin D synthesis would come to an end at the UK latitude of about 53 degrees north of the equator, and when Vitamin D stores would diminish. So it did, and the numbers of Covid-19 deaths each day increased to a plateau in late November and December, about 500 each day. This cycle was under the influence of nature, to be precise, the Sun and Vitamin D. 2020 was the year of nature, and the pattern is exactly what would have been predicted on the basis of experience of previous epidemics.


I would have hoped that the favourable impact of Vitamin D production on the pandemic during the summer, would have led intelligent and knowledgeable people to develop a public health policy of adequate dose Vitamin D supplementation for the winter, knowing of the high prevalence of vitamin D deficiency. But it was not to be: vitamin D was ignored and its potential benefits were denied.


The refusal of the government and its agencies to accept Vitamin D as a prevention and treatment of Covid-19 led to the astonishing and very regrettable fact that 26 working doctors in the UK died from Covid-19 during March, April, and early May 2020. 25 of the 26, 96%, were of Black African or South Asian ethnicity. Vitamin D deficiency was the obvious explanation. It is a disgrace that this was not acknowledged by the government and that it was ignored by medical professional bodies. But it was not ignored by my intelligent, knowledgeable, and caring medical friends, Professor Parag Singhal and Professor David Anderson. Their action was to advise by email immediate vitamin D supplement to doctors of Black African or South Asian ethnicity and to provide supplements whenever necessary. The deaths came to an abrupt end but the story was not acknowledged.


2021 the year of anti-nature


In the UK in early 2021, rather than a continuing winter plateau of cases and deaths, January saw a sudden increase from about 500 Covid-19 deaths each day to a rapid peak reaching 1,500 Covid-19 deaths each day. This was followed by a decline during February. This was all unexpected and puzzling, especially as it followed the introduction of the new vaccines in mid-December.


Figure 3. UK: Covid-19 deaths per day in 2020 and early 2021


The number of cases per day fell rapidly from a maximum of 68,053 on January 8th 2021 to 2,235 on May 23rd. At this stage we were tentatively reassured. 


Figure 4. UK: Covid-19 cases per day 2021 

Was the pandemic was going away? But this graph shows 2021 only until mid-May. 


In July, at the height of a good summer, there was a sudden increase in Covid-19 cases. The number of new cases per day increased to an astonishing 54,674 on July 17th, then reducing but stabilising at about 40,000 per day up to the present time. This was completely unexpected, especially as the vaccination programme was going so well, with most of the population double-vaccinated. The policy became third vaccinations for all.


Figure 5. UK: Covid-19 cases per day in late 2020 and in 2021


This dramatic increase in cases in July (marked in the yellow box) was against the pattern of nature, and against our experience of natural vitamin D dependent immunity. The quiet summer of 2020 was not the experience of 2021. What has been happening? Is there a causal relationship between the vaccination programme of 2021 and the peak of Covid-19 cases? Are the PCR tests identifying viruses or just spike proteins from the vaccines?


The Netherlands had the same experience, the onset slightly later than the UK, but the increase far steeper so that the peak was reached in mid-July in both countries. The rate of increase in the Netherlands was quite remarkable for a viral epidemic. A significant number of cases per day continues, with a further increase during October.


Figure 6. Netherlands: Covid-19 new cases per day during 2021


This pattern in a less dramatic form is seen in most other countries in Europe – in France, Switzerland, Germany, Denmark, Spain, Ireland, Italy, Finland, Norway, Austria, Belgium, and others. 


Iceland has experienced the most dramatic peak of all during the summer of 2021. What was happening in this, one of the most vaccinated of countries? 


Figure 7. Iceland: Covid-19 new cases per day during 2021
from: Our World in Data


The steepness of the peak in Iceland during late July and August 2021 is perhaps more suggestive of a chemical attack on the population rather than a microbial epidemic. This extraordinary peak has not received any official comment, perhaps because it is completely out of keeping with the official narrative of the pandemic and the vaccination programme. A sudden peak in mid-summer is not we expect from a microbial epidemic or pandemic.


In late October 2021 we see the start of another peak, perhaps an early warning of a winter effect. The example in Figure 8 is Austria, which also experienced a summer increase. This late October increase is also seen in the UK, the Netherlands, Belgium, France, Poland, Norway, and Finland.


Figure 8. Austria: Covid-19 new cases per day during 2021


Tropical countries experienced nature in 2020, vaccines in 2021


We saw very low levels of Covid-19 in tropical and semi-tropical countries during 2020. We expected  2021 to show a similar low risk, but 2021 turned out to be very different.


Cambodia, for example


The first case in Cambodia was in January 2020, and by the end of the year there had been just 378 cases. By March 31st 2021 there had been 2,440 cases, and by October 17th 116,860 Covid-19 cases had been recorded.


Figure 9. Camdodia: Covid-19 new cases per day during 2020 and 2021
from: Our World in Data

There were no Covid-19 deaths in Cambodia during 2020. The first Covid-19 death was on March 11th 2021. Then there was a rapid increase in deaths, and by October 17th  2,670 Covid-19 deaths had been recorded. Why was 2021 so different from and so very much worse than 2020?


Figure 10. Camdodia: Covid-19 deaths per day during 2020 and 2021
from: Our World in Data

Was it just a coincidence that the vaccination programme in Cambodia started on February 10th 2021, immediately before the first death and the rapid increase in cases and deaths? The pattern was the same in the neighbouring countries of Laos and Vietnam, and also in the larger countries of Malaysia and Indonesia.


2020 and 2021


2020, as we have seen, was the year of nature, with no pre-hospital Covid-19 interventions other than lockdown and population control. The pandemic progressed in an anticipated way, with optimism that through subclinical infection during the summer months, nature would extend natural immunity against Covid-19, and that the pandemic would have a much reduced impact during 2021.


Since the time of Edward Jenner who introduced vaccination against smallpox, vaccines have been based on nature. An attenuated or a dead micro-organism (or part of it) would be injected into the body to produce a mild pseudo-infection so that immunity would be achieved. This natural approach has worked well for many years. 


But in 2021 we have experienced the new so-called vaccines, which are in truth experimental gene therapies, the brilliant products of the biotechnology laboratories. These “vaccines” had not been licensed and were used under Emergency Use Authorisation. But this did not inhibit the evangelism of governments and the enthusiasm of the people.


We expected that the vaccines would add to the immunity provided by nature, and that the pandemic would effectively disappear during 2021. But it has not worked out as planned. We have had more Covid-19 cases and deaths in 2021 than in 2020. In the UK we had approximately 2.5 million Covid-19 cases in 2020, but so far this year we have had more than 5.5 million cases. 


In the UK during the summer of 2021 we have experienced between 30 and 50 times more cases of Covid-19 per day (green line) compared to 2020 (blue line). We expect an increase during the autumn, but we expected fewer rather than more cases in 2021 than in 2020.


Figure 11. UK: Covid-19 new cases per day during 2020 and 2021

Please note that the case numbers in July 2021 were 30 times greater than just two months earlier, in May 2021. This is very mysterious, but as usual, the victims are blamed for their alleged misbehaviour. But is there a biological explanation for this great increase during the summer months?


Figure 12. UK: Covid-19 deaths per day during 2020 (blue) and 2021 (green)

We have seen the high numbers of deaths during the first three months of the pandemic in 2020, deaths mainly of the vulnerable including the very elderly, the very obese, and UK residents of Black African and South Asian ethnicity. But the daily deaths came down to single figures during August 2020.


Figure 12 shows that in the UK Covid-19 deaths decreased substantially during July and August 2020, the year of nature, as shown by the blue line. In 2021, as shown by the green line, the numbers of deaths each day were initially low but then they increased


On September 9th 2020 there were 3 Covid-19 deaths in the UK. On the same day in 2021 there were 185 Covid-19 deaths. Between July 1st and October 10th, there were 2,009 Covid-19 deaths in 2020, but 6,370 in 2021. This is both astonishing and disturbing. What is happening?


Why should 2021 have been so much worse than 2020? We expected that nature would bring about minimal Covid-19 cases and deaths during the summer of 2021, and that the numbers would have been even lower than in 2020 with the additional benefit of the vaccination programme. But we saw a massive increase in the number of cases and an increase in deaths. 


Something has gone seriously wrong.


Although extensive data are available from Worldometer and Our World in Data we do not question what we are doing. There is no open debate in the national press or broadcast media. We hear little from government agencies. We see no debate in medical journals and we hear no debate from medical organisations, for example the Royal College of Physicians of London. Although it has led medical knowledge and progress during the past 500 years, it has unquestioningly followed the government narrative during the pandemic. 


If the major difference between 2020 and 2021 is extensive vaccination. Can we really see any evidence of a favourable impact of the vaccination programme on the course of the pandemic? Is it conceivable that the vaccination programme has been detrimental?


UK Health Security Agency – an important clue


The UKHSA, in its Covid-19 Vaccine Surveillance Report Week 42, drew attention to an unexpected, and as yet unpublicised observation. It reported increases in Covid-19 case reports across all age-groups and regions of the UK. But the important observation was on page 23: 


(ii) waning of the N antibody response over time and 

(iii) recent observations from UK Health Security Agency (UKHSA) surveillance data that N antibody levels appear to be lower in individuals who acquire infection following 2 doses of vaccination. 

"N antibody" is antibody to nucleocapsid.


This official observation indicates that in double vaccinated individuals, the immunity antibody response is impaired. This would explain why the number of cases of Covid-19 has been increasing during the summer of 2021, and why Covid-19 cases and deaths are occuring in the double-vaccinated. The effect of a third vaccination remains to be seen.


What next?


During the week ending October 24th 2021, the UK has experienced 328,287 new cases of Covid-19, and 948 Covid-19 deaths. This is with 80% of the population older than 15 years being "fully" vaccinated. We need something more, and vitamin D is glaringly obvious but still denied. 


The term "fully vaccinated" is becoming obsolete: there is no such thing. With declining immunity following double vaccination, and uncertainty after a third, it looks as though vaccinations will continue perhaps indefinitely, at shorter and shorter intervals.


WHO policy in 2020 and 2021 has been “2 Vs”:  Vaccination and Ventilation, nothing in between. More and more vaccinations are being performed. People who test positive for Covid-19 receive no treatment until they arrive in hospital and on the ICU.


What will 2022 bring? We obviously need something else for prevention and treatment. Will the denial of Vitamin D continue? If so, why?


Pharmaceutical companies are busy producing new treatments for Covid-19, but the very successful clinical trials of Calcifediol and Calcitriol (the activated forms of Vitamin D) remain ignored. Despite effectiveness, safety and cheapness, all forms of Vitamin D remain unused within official public health measures and within our hospitals. We have experienced more than 139,000 Covid-19 deaths in the UK, and the denial of Vitamin D is more than regrettable.


Covid-19 cases and deaths are increasing as we enter our winter, the Vitamin D deficiency season. Are we going to correct widespread VItamin D deficiency?


Should those receiving their third vaccination be given a vitamin D bolus dose in advance to minimise suppression of immune response?