Friday 29 January 2021

Covid-19 & Vitamin D : How can we avoid looking stupid ?

 Covid-19 & Vitamin D : How can we avoid looking stupid ?



Scene 1:

A small meeting room in 10 Downing Street, London

Early January 2021

Four sitting around a table.

Boris Johnson, Prime minister of the UK






Good morning to you all and thanks for coming in at short notice. This is an extremely important meeting.

Sir Patrick Vallance, Chief Scientist of the UK






Prime minister, I have not been able to prepare for this meeting as I do not know the purpose of it.

Professor Chris Whitty, Chief Medical Officer of the UK






The same goes for me, Prime Minister.

Boris Johnson

Sorry about this chaps, but it is very hush-hush. I have mentioned it only to Matt Hancock.

Matt Hancock, Secretary of State for Health and Social Care 







That was only yesterday when we discussed briefly the problem but not the solution.

Boris Johnson

Matt and I have just realised that we are in great danger.

Professor Chris Whitty

Danger from what? The vaccination programme is going really well. We all thought that you had made a full recovery from your serious Covid-19 illness.

Boris Johnson

It is not danger from the virus this time. It is a much more important and serious danger than that. It is the serious danger of looking stupid. The point is that under the direction of NICE, our so-called National Committee for Care Excellence, we have spent almost a year telling people, including ourselves, that vitamin D has no role in immunity and is of no benefit in the present pandemic.

Matt Hancock

I have been saying this in public and in parliament on many occasions, but in December I realised that it is not true.

Sir Patrick Vallance

You mean to say that vitamin D is important after all?

Matt Hancock

Yes, it is most important. I received a lot of important information to this effect when I was talking to the now-backbencher David Davis MP in the bar. He is extremely well informed.

Sir Patrick Vallance

But I am the chief scientist. You are supposed to hear important information from me, not from an ordinary MP over a drink in the bar.

Boris Johnson

I also heard this from David Davis. And he a scientist by training. I watched his very well-informed speech in the House of Commons on the value of vitamin D. I am told that Jo Churchill, our health minister who had to reply to him, that she agreed with everything he said, but she had been told in advance that she had to read out some drivel that had been written for her, and she was not allowed to express her personal, and if might say so, well-informed opinion.

Sir Patrick Vallance

But David Davis is not the Chief Scientist, and he has not been knighted for services to science. The same goes for Jo Churchill. I am the Chief Scientist and I decide what is true and what is not true.

Professor Chris Whitty

And David Davis is not medically qualified. He is not a proper doctor like I am.

Matt Hancock

But he knows a great deal on the subject of vitamin D. I caught a glimpse of you, Patrick, on Robert Peston's evening television programme on ITV. Patrick had been interviewed and a viewer phoned in and asked him if we should all be taking vitamin D. You replied, Patrick, along the lines of "That is what the government advises", and said nothing more.

Sir Patrick Vallance

There was no more that I wanted to say. I was hoping that such a question would be filtered out. But I managed to avoid saying "vitamin D" or "immunity".

Matt Hancock

I am fed up with dodging the question and counting the big numbers of deaths, now more than 100,000, knowing that vitamin D would have prevented many of these deaths.

Sir Patrick Vallance

It is NICE that we turn to for advice on such as vitamin D.

Boris Johnson

But the point is that during 2020 NICE has been digging us into a hole of vitamin D denial, deeper every time it issues a report. The question I repeat, is how do we get out of this hole without looking like idiots.

Professor Chris Whitty

It would not be very nice to expose the total failure of NICE to assess the potential role of vitamin D in the present pandemic.

Sir Patrick Vallance

The problem has been that no-one in NICE appears to know anything about vitamin D or immunity, and certainly nothing about how they are linked together, or of the value in the present pandemic.

Matt Hancock

It seem to me, from what I have been told, and from what I read on social media, that a large number of credible people within the country do understand about vitamin D and immunity. However NICE is remote and no-one seem to be able to interact with NICE directly. David Davis tells me that NICE might be OK for checking on new medicines with the help of big pharmaceutical companies, but with vitamin D we are dealing with a widespread deficiency state of a vitamin / hormone, and that it is glaringly obvious that vitamin deficiencies and hormone deficiencies must always be corrected. NICE seems to the wrong organisation to assess a vitamin or hormone deficiency. It has never happened before.

Sir Patrick Vallance

I must admit that NICE does not have an executive function. It is a merely an advisory body. It is the UK Medicines and Healthcare products Regulatory Agency that decides on which medicine can and cannot be used. NICE has assumed a role more important than it has. With vaccines, MHRA has given the go-ahead for use, and NICE has had no role in the roll-out.

Boris Johnson

At least we have been able to keep vitamin D out of the headlines of the major newspapers, off the television screens, and off the radio airwaves. To avoid looking stupid it is vital that David Davis, clever and well-informed as he might be, is kept hidden. If he were to become prominent we really would look stupid, and the first rule is that this must not happen.

Professor Chris Whitty

We have also been able to minimise any mention of vitamin D in the medical journals, and public funding for vitamin D research has been refused. Also funding for vitamin D related research has been refused by  the Gates-Wellcome Covid-19 Accelerator programme.  There has been virtually no vitamin D research in this country, just small projects in Tameside, Birmingham and Newcastle. They have passed virtually unnoticed, and we must be thankful for that.

Matt Hancock

David Davis picked up the Newcastle study. In the Observer and the Guardian on-line there was  a very long article from a journalist whose name is I think Mattha Busby on the subject of vitamin D and Covid-19. It was a very good article, by far the best that I have read, and I believe it had 1.5 million views within a week.

Sir Patrick Vallance

But there was no follow-up in the print editions. All seemed to go quiet, thank goodness.

Boris Johnson

But the word is getting about that vitamin D would be very valuable if we were to use it. We must therefore be prepared that at some stage we will need to state that vitamin D is valuable and so people must take it. Denial cannot go on for ever. But how can we do it without looking ignorant or stupid.

Matt Hancock

I thought until recently that vitamin D was all about bones and avoiding rickets. But now I understand its function of activating VDR, which in turn activates a large number of our genes, perhaps 10%. This initiates the escalation of defensive immunity, and it also switches off the damaging cytokine storm. All this was apparently known before the pandemic started.

Sir Patrick Vallance

You are very well-informed, Matt. I assume this is the wisdom of David Davis. Perhaps you could give me a tutorial on the subject after this meeting.

Boris Johnson

The point is that if we had  approved the use of vitamin D early in the pandemic, many thousands of deaths might have been prevented. But we obviously cannot let this get into the public domain or there will be riots, or even legal claims of negligence against us. This would be even worse than looking stupid.

Professor Chris Whitty

What we must do is keep the media publicising our highly successful vaccination programme, and so keep vitamin D out of the public eye. This is what we have been doing very successfully. We have also been keeping any ill-effects from the vaccines away from the public. Patrick will be well-aware that we have also kept hidden recent experience of vaccines that have gone wrong.

Sir Patrick Vallance

Enough of that.  The present vaccination programme is of the greatest importance. It is good news that keeps bad news out of the headlines, and for us vitamin D would be very bad news.

Matt Hancock

But vaccinations are not going to influence daily deaths, or take pressure off our hospitals and ICUs.

Boris Johnson

I am told that the daily new cases and deaths will go down considerably in late April and May.

Matt Hancock

That is certainly true. It happened in 2020 and it will happen again in 2021. David Davis tells me that it is the effect of the summer, the greater intensity of the sun and the resumption of vitamin D production in the skin. It happens every year. It is nature.

Professor Chris Whitty

But we must not admit that nature is bringing about the cure while the government is locking down the economy, education, worship, family lives, and causing untold misery. We must be patient and when death rates do fall after Easter we can tell the people that the reason is the success is lockdown and our vaccination programme. We must thank the people for their sacrifice and thank the pharmaceutical companies for their brilliance.

Boris Johnson

That would be excellent, but now, at a time of 1,000 deaths per day and as hospitals are like in a war zone, we need something that acts much more quickly than vaccinations. Matt, what else did you learn from David Davis?

Matt Hancock

Thank you prime minister. He told me that vitamin D itself is excellent for the prevention of Covid-19 but when taking it by mouth it takes about a couple of weeks to become fully active in the blood-stream. It must go through a first slow activation stage in the liver. But there is a part-activated form called calcifediol that if taken by mouth is active within a couple of hours. A clinical trial in Córdoba in Spain showed spectacular results from the use of calcifediol in patients admitted to hospital with Covid-19 pneumonia, reducing ICU admissions by 96%. 

Boris Johnson

Gosh! That sounds good. Better than vaccines, What did NICE make of it?

Professor Chris Whitty

NICE had already stated at the beginning of the pandemic that vitamin D was of no proven value and should not be used. It had to comment on the study from Spain, but as the results went completely against its previous statements it had to down-play the results. It passed the task to a professor from I think Birmingham, and he was able to write a couple of sentences to suggest procedural problems with the trial, and thus discount it and just recommend waiting for further studies. 

Matt Hancock

NICE just kicked the can down the road. I was told by David Davis that a full  review of the randomised clinical trial from Spain was undertaken by a team at the Massachusetts Institute of Technology. No procedural error was found and it was concluded that the probability of the 96% efficacy being by chance was less than one in a million, and significant effect from confounding variables less than one in 600,000. It was certainly very detailed study, in striking contrast to the back-of-an-envelope assessment by NICE.

Boris Johnson

Cripes! This is very embarrassing. If it gets out and NICE looks stupid, as it appears to be, we will also look stupid, which we aren't.  What has been happening at NICE? Are the members all asleep?

Matt Hancock

Perhaps they have narcolepsy, but Patrick is an expert on that subject. Spain is certainly not asleep. Córdoba is in the southern region of Andalucía, and a public health initiative of vitamin D / calcifediol was initiated there in mid-November. There was a rapid decline of hospital admissions, ICU admissions, and deaths within six weeks. 

Boris Johnson

Well, we need to do that here. Are our  public health departments awake? Are they going to take action?

Sir Patrick Vallance

Prime Minister, we cannot come out and say that we must give vitamin D to all the population. If we do, as you said at the beginning, we will look stupid for not having said so earlier in the year.

Professor Chris Whitty

Just before Christmas NICE did something rather clever. In a report it stated that: "Although we find that there is not enough evidence to recommend the use of vitamin D in the prevention or treatment of Covid-19, we encourage people to follow government advice and take it". 

Boris Johnson

The difference between "recommend" and "encourage" is very subtle. I regard them as having the same meaning. This is a good example of double-speak by a clever word-smith.

Matt Hancock

I must confess that I broke away from NICE misinformation as I regarded it, and I made a statement that all elderly people must receive vitamin D.

Sir Patrick Vallance

NICE was not very pleased. Nor was Public Health England.

Boris Johnson

But can we not build up on Matt's message and get vitamin D out to the people?

Matt Hancock

I have a cunning idea. I mentioned that everyone knows that vitamin D is something to do with bones, and very few people, including the vast majority of doctors, know anything about immunity. What we must do is invent an epidemic of rickets in old people.

Professor Chris Whitty

Rickets is the result of vitamin D deficiency in children. When in adults it is called osteomalacia.

Matt Hancock

Ok. But no-one will have heard of whatever it is that you said. Let's just call it weak bones. We can tell all old people by letter that they are at great risk of weak bones and that they must take vitamin D. In this way we can roll out vitamin D without mentioning immunity or Covid-19.

Boris Johnson

Brilliant Matt, Well done. In this way we can appear to be a caring government and not look stupid.

And so it came to pass.


Late January 2021








"Each '1-A-Day' vitamin D supplant contains 10 micrograms (µg) of vitamin D. This is equivalent to 400 international units (IU) of vitamin D. This is the daily amount recommended for the general population by Government for general health and in particular to protect bone and muscle health."


Scene 2

The same room in 10 Downing Street

Boris Johnson

Good morning.

We have done it. We have given vitamin D to all old people without looking stupid and without acknowledging that vitamin D is valuable in defensive immunity and helpful against Covid-19. There has been no criticism of us, only praise. Success. We deserve champagne today rather than coffee. 

Sir Patrick Vallance

And also NICE can continue without looking stupid or negligent.

Professor Chris Whitty

But we need to do something about SACN, our scientific advisory committee for nutrition. I have been looking into it and its recommendations are hopelessly out of date.

Matt Hancock

David Davis tells me that the dose of vitamin D that we were forced by SACN to put into the DHSC document for elderly people gave a dose of 10 micrograms, 400 units. This is far lower than what is recommended by European and North American countries. The dose we recommend is basically locked into rickets prevention in the first half of the 20th century, and it is effectively carved in stone by SACN.

Boris Johnson

So what dose should we recommend?

Matt Hancock

The maximum dose stated by SACN to be safe is 4,000 units each day. At this time of national emergency that is the dose that I would recommend. It is the dose that I have been taking during the past six months.

Boris Johnson

And it is the dose that I have taken since I was in hospital.

Professor Chris Whitty

It is the dose that I take.

Sir Patrick Vallance

I also take 4,000 units a day, as do all my staff.

Matt Hancock

And so it appears that we are all drinking wine (not just Champagne) in the form of vitamin D while preaching water for the masses.

Boris Johnson

Can you explain to me why we are giving vitamin D only to the elderly?

Professor Chris Whitty

The elderly are known to be deficient in vitamin D because they do not go outdoors.

Matt Hancock

And they are at high risk of Covid-19 death because of poor immunity due to vitamin D deficiency.

Sir Patrick Vallance

I have been doing bit of homework, also talking to David Davis and looking at social media.

Boris Johnson

And so Patrick, what have you learned?

Sir Patrick Vallance

It appears that the skin of old people is dry and does not produce the oil that the sun converts into vitamin D, and so they need to take vitamin D all the year round. 

Boris Johnson

Does it not appear to be strange, that we have only just realised the problem of vitamin D deficiency in the elderly at this time of a Covid-19 pandemic, when it has always been a problem, but not recognised?

Professor Chris Whitty

It appears that this pandemic has brought out the great dangers of vitamin D deficiency that were previously unsuspected. We must bear this in mind in preparing for a future pandemic.

Boris Johnson

We must definitely inform SAGE,  our Sleeping Advisory Group for Emergencies, which failed to prepare us for Covid-19.

Matt Hancock

There is also the issue of dark-skinned people living in the UK, BAME people. Most are vitamin D deficient and as a result they have a very high risk of death from Covid-19.

Boris Johnson

We have had three reports that tell us that this high death rate is due to socio-economic disadvantage and racism. We are looking into this.

Matt Hancock

These reports have been most unfortunate and unhelpful. They all missed the biological explanation of serious vitamin D deficiency, as David Davis has explained to me. The reports all dismissed vitamin D, but the leaders of the BAME communities made no protest and seem to accept the social explanation with great enthusiasm. Now the BAME community leaders are demanding priority for vaccines, but there is no mention of vitamin D. They appear to know nothing about it.

Professor Chris Whitty

I remember that in March and April, 24 working doctors died from Covid-19 and 23 were of Black African or Asian ethnicity. They were obviously not socio-economically disadvantaged.

Boris Johnson

It sounds like vitamin D deficiency.

Professor Chris Whitty

Yes, Prime Minister. The deaths of these doctors came to an abrupt end, the last of the cluster being on May 3rd. I was told last week that on April 29th the imaginative national secretary of BAPIO, the British Association of Physicians of Indian Origin, sent emails to virtually all BAME doctors in the UK telling them to take vitamin D immediately, and a colleague now retired and living in Italy provided them with supplies. This action was amazingly effective and it obviously prevented many deaths. 

Boris Johnson

They sound to be real heroes. We could not have achieved that with us having to consult NICE and PHE and many other groups beforehand. The deaths of these doctors seems to have been forgotten about, but we could encourage dark-skinned people to take vitamin D.

Matt Hancock

I have been told that the deaths of 25 doctors were reported in the British Medical Journal. 12 were white with average age at death 92, and 13 were black African or Asian ethnicity with average age at death 62, thirty years younger. This is difficult to explain away, and again, they were not socio-economically disadvantaged. It must have been the result of vitamin D deficiency.

Boris Johnson

I remember being shown a newspaper headline during the summer. If I remember correctly it was a study in Oldham that indicated that ethnic Asian people were seriously ill from Covid-19 at an age thirty years younger than white people.

Matt Hancock

There is still the problem of 1,000 Covid-19 deaths per day. Giving old people vitamin D 400 units per day is not going to stop these deaths. Should we be giving the sick calcifediol as in Córdoba study?

Sir Patrick Vallance

I would recommend restraint. I am told that another controlled trial in Spain has been completed and is to be published shortly. I hear that the results, when published, will be even more spectacular than the Córdoba trial.

Boris Johnson

We must wait for this report to become available. If what you say is true, NICE will look really stupid and responsible for thousands of deaths.  We will need to distance ourselves from NICE.  NICE has misled us so much that we will let NICE take the blame.

That is all for today. We will leave things for now and go our separate ways. We must keep the problem in our minds and we will meet again as soon as the news from Spain is available.

We will also need to be certain that above all we will not look stupid.


The room empties

Scene 3.  To be arranged.




David Davis MP – the one who will not look stupid










Monday 18 January 2021

Covid-19 and Vitamin D : Miracle in Andalucía

Andalucía

Andalucía, Spain

Encouraged by the very positive result of the RCT of vitamin D as Calcifediol in the treatment of Covid-19 pneumonia, and evidence of benefit of vitamin D many reports, the public health authorities in Andalucía decided to take action. 

The Covid-19 hospital admission rates, ICU admission rates, and death rates had risen during the early winter, as expected following the summer suppression effect as seen in other European countries. The rates had appeared to have reached, or were close to, the winter peak and so this was the ideal time to initiate correction of widespread vitamin D deficiency as a preventative measure. This was not to be a clinical trial: the time for such had passed. A randomised trial would have involved much planning and bureaucracy, and most importantly it would have put a large control group of people at risk from being deprived of the expected benefits of vitamin D. Would people allocated not to receive vitamin D obey this restriction? 

The number of deaths each day had increased during October and November and a high number of deaths would be expected through the winter until the spring equinox, after which deaths per day would reduce as in 2020. In biological and solar respects we have just two seasons of the year, summer and winter, separated by the spring and autumn equinoxes. In the summer vitamin D is produced and domestic solar energy is produced, but not significantly in the winter.

Previous Blog posts have described the very successful randomised controlled trial of Calcifediol, the rapidly acting 25(OH)-vitamin D, that took place in Córdoba, in Andalucía, southern Spain. The result was a 96% efficacy in the reduction of need for ICU transfer. In that in the control group, 2 of the 13 transferred to the ICU died, a reduction of the number of transfers from 50% to 2% would inevitably have led to a reduction in the number of deaths by more than 96%. 

This and other aspects of the role of vitamin D deficiency in serious outcome from Covid-19 led in Andalucía to a scientific assessment and report. We have seen superficial and poor quality assessment in the UK by NICE, and a very detailed analysis by a team in the MIT, which indicated the clinical trial in Córdoba to be without significant procedural error and with a less than a million to one probability of the findings being by chance.

The scientific report was viewed by the regional government in Andalucía on November 8th. It was accepted that vitamin D has a major influence on Covid-19 infection and that by enhancing defensive immunity it makes a major contribution to minimising the damaging and fatal effects of Covid-19. The instruction was for doctors treating Covid-19 patients to prescribe vitamin D as calcifediol, and for it to be issued to elderly residents of care homes. Vitamin D would be actively encouraged in others.

During December a miracle occurred in Andalucía. The number of deaths per day dropped dramatically, against the experience of nature. Perhaps it was due to the favourable influence of God. On the other hand it might have been the result of the vitamin D initiative, which in an immunological way would convert the winter into summer.

The reduction of Covid-19 effects can be seen in the following figures, taken from the Andalucía website.

We can see in Figure 1 the rapid increase in hospital admissions at the onset of the pandemic in March 2020 and then the rapid decline in April. There was a very low number of hospital admissions during the summer months, under the influence of the sun and the production of vitamin D. With the end of the summer, the number of hospitals admissions increased again to 300 per day in November.

On November 8th the directive went out for vitamin D to be used for prevention and the remarkable decline in hospital admissions during December is clearly visible.



Figure 1. Andalucía: Hospital admissions each day

The pattern of admissions to intensive care units was of the same pattern, shown in Figure 2.



Figure 2. Andalucía: ICU admissions each day

And in Figure 3 we see the dramatic effect on deaths, falling from 60 per day to 3 per day.


Figure 3. Andalucía: Deaths each day

Figure 4, below, concentrates on the time after November 1st. The effect of the vitamin D initiative is clear.

Figure 4. Andalucía: Deaths each day, November 2020 to January 2021


Meanwhile, in the UK the number of deaths continued to increase to about 1,000 per day.

Figure 5. UK: Deaths each day, November 2020 to January 2021 (note scale)


The message is clear. If we want to bring this pandemic to an end we must optimise defensive immunity. To achieve this we must correct widespread vitamin D deficiency. Vitamin D 4,000 units daily is safe and will be appropriate for prevention in most people. If there is a sense of urgency, if a person is ill with Covid-19 respiratory disease, then it is necessary to follow the protocol used Andalucia and use Calcifediol.

Calcifediol

We know that vitamin D is produced by the action of UV on 7-dehydro-cholesterol that is produced in the skin. 


Vitamin D must then be part-activated to 25(OH)vitamin D, otherwise known as calcifediol. This is what we measure in the blood in routine tests. Calcifediol is the form of vitamin D that is the reserve in the blood, to be available for use whenever needed, and this has been essential during the Covid-19 pandemic.

The part-activation of vitamin D to calcifediol takes place in the liver and the process is slow. In nature this is perfectly satisfactory as it is providing a steady-state function. But at present, when the Covid-19 pandemic is exposing the pre-existent pandemic of vitamin D deficiency, it is not adequate to requirements.


The appearance of calcifediol in the blood after vitamin D is taken by mouth is slow.


Figure 5. Increase in blood level of calcifediol after oral vitamin D, various regimens

Using different dose regimes it can be seen in Figure 5 that it can take up to two weeks before a safe blood level >30ng/ml is achieved. This is fine if the vitamin D is given to a person who is well, in prevention of Covid-19, but a very ill person with Covid-19 pneumonia would be likely to require ICU admission or even  die within this time. 

But the group in Córdoba with great understanding of pharmacodynamics used vitamin D as calcifediol and Figure 6 illustrates why, and why it was so successful.


Figure 6. Blood levels of calcifediol after calcifediol by mouth or injection


Whether given by injection (ampoule) or by mouth (capsule) calcifediol achieves good levels within just a few hours rather than weeks. The effect is therefore virtually instantaneous, as the calcifediol will be taken up by the immunity cells, thereby activating defensive immune processes and switching off the damaging cytokine storm.

This was the inspirational logic of the Córdoba study group: patients with Covid-19 pneumonia required treatment that would be active immediately, not in two weeks time. Calcifediol was the way to achieve this, and so it was to be. The clinical trial had the most remarkable result, released on September 3rd,  that it appeared that to the rest of the world it seemed to be too good to be true. ICU admissions reduced from 50% to 2%, with no deaths.

The important thing about calcifediol is that it must be brought into activity immediately by conversion into 1,25(OH), otherwise known as calcitriol. Some conversion takes place in the kidney cells to provide the circulating hormone that controls the level of ionised calcium in the blood. More importantly at present, is the production of 1,25(OH)D that takes place in the immune cells.

Calcifediol and vitamin D equivalence

Calcifediol is measured in mass units, micrograms. In the Córdoba clinical trial, capsules of 266 micrograms were used, but this dose was expressed as 0.266 milligrams. More confusion, but the UK practice is to avoid decimal points as they cause confusion and the decimal pint can be missed. I have noted previously in respect of vitamin D there can be confusion between mcg and mg, and so it is safer to use units. The use of units goes back to the days of biological assay, before vitamin D could be "weighed".




I will try to explain the equivalence of vitamin D and calcifediol, to the best of my inadequate understanding. My reading is that of vitamin D taken by mouth, approximately 20% appears as calcifediol in the blood. I cannot determine what happens to the remaining 80%, but it is only calcifediol (and calcitriol) that are routinely measured in the blood. It might be that the efficiency of the liver is only 20%, but his would be surprisingly low in a biological enzyme system. The alternative is that 80% could be diverted into deposition in the body fat, ad there can be a lot of it. I suspect that either more research needs to be done or I need to do a lot more reading of basic science.

In practice 5mcg of vitamin D seems to be required to create 1mcg of calcifediol. 

5mcg vitamin D = 200 units gives 1mcg calcifediol


To create 250mcg calcifediol requires:

250 x 200 units of vitamin D = 50,000 units vitamin D.


I do not understand why the capsules of calcifediol are 266mcg rather than 250mcg. I will try to find out the answer, and I expect there is one. 
 
The patients in the Córdoba trial received the equivalent of 100,000 + 50,000 + 50,000 + 50,000 = 250,000 units vitamin D within the first two weeks.

In the Andalucía public health initiative, calcifediol 266 micrograms is given twice in the first month, equivalent to 100,000 units vitamin D, then once each subsequent month, equivalent to 50,000 units each month.

What happens next?

The rest of the world should have followed the Córdoba protocol but it did not do so. The UK NICE stated that the result of the study should not influence the treatment of Covid-19.  A second large trial was demanded, and one was arranged in Spain. By the end of 2020, and by when 45,000 deaths had occurred since the result of the Córdoba study, the result of the second clinical trial had not appeared. Deaths continue, up to 1,000 per day. ICUs are under great pressure.

The study has now been completed but the journal in which the results will be published has an embargo on the release of information. I am given to understand that the result is excellent, perhaps even better than the Córdoba study itself.

A positive result must be anticipated by European and other governments and although vaccines are expected to suppress Covid-19 in the future, vitamin D as calcifediol is required for those sick now, preventing many deaths and taking pressure off the hospitals. 

But where is the calcifediol going to come from? Are world supplies of vitamin D adequate to meet the needs of the population?

Or will denial of vitamin D continue? Will new information be kept away from the public eye?

The virtual end of the pandemic in Andalucía is still virtually unknown outside Andalucía.

Andalucia government

http://www.juntadeandalucia.es/presidencia/portavoz/salud/155979/ConsejeriaSaludFamilias/ConsejoGobierno/Covid/mayores/vitaminaD/calcifediol


http://www.juntadeandalucia.es/institutodeestadisticaycartografia/salud/COVID19.html


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