Friday, 19 March 2021

Covid-19 & Vitamin D : do not sit on the fence when there is blood on the floor

Covid-19 & Vitamin D

No sitting on the fence: there is blood on the floor!

2008. I just managed to get out of the way !

When the pandemic of Covid-19 appeared a year ago there was a great deal of evidence predicting that our known widespread deficiency of vitamin D would cause a serious problem. It would produce a problem of sub-optimal immunity, and thus a high risk of death from critical or fatal infection. And this is what happened. As expected the deaths occurred in excess in communities known to have a high prevalence of vitamin D deficiency: the ethnic Black African and Asian (BAME), the obese, and the elderly in particular. 

The early missed opportunity

There could have been community-based blood testing to detect individuals with vitamin D deficiency, but it did not happen and vitamin D testing was discouraged by public health bodies. Vitamin D could have been given to all, on the basis that in a single dose of 100,000 units it would have corrected deficiency of those deficient and would have done no harm to those not deficient. Blood testing within the following three months would identify the need to continue with a supplement. Alternatively a vitamin D supplement dose of 20,000 units each week or 3,000 units each day would have been appropriate and perfectly safe.

But official correction of vitamin D deficiency did not happen. We had to wait for more than 100,000 deaths before vaccines became available. 

We have had a large number of "scientists" who have dominated the political agenda. There have been mathematicians, statisticians, epidemiologists, virologists, nutritionalists, sociologists, the chief medical officer and the chief scientists, both of who have enjoyed an academic career. Some of them have mentioned vitamin D with a remarkable lack of enthusiasm, in complete contrast to their embrace of vaccines.

The dead hand of NICE

The reason for the denial of use of vitamin D has never been clear. The large amount of evidence from the forty years preceding the pandemic made little difference to official advice. Reference was always made to the reports by NICE, the National Institute for Health and Care Excellence. 

The reason why the correction of a vitamin deficiency had to be referred to NICE is difficult to understand, as it would be an automatic clinical duty to correct a vitamin or hormone deficiency, be it vitamin D, vitamin C, vitamin B12, the prescription of insulin or thyroxine and so on. But NICE has somehow been given the responsibility for the correction of vitamin D deficiency, and a series of its reports failed to approve the use of vitamin D, but always failing to acknowledge deficiency. 

NICE informed the nation of a lack of evidence and demanded randomised controlled clinical trials (RCTs). 

A report from NICE on June 29th told us that:

"There is no evidence to support taking vitamin D supplements to specifically prevent or treat Covid-19" 

This avoided any mention of the fact that research points to the majority of the population being deficient of vitamin D. If NICE is supposed to help doctors in their treatment of ill patients, it failed miserably to do so. The response has been very far from Excellent.

Once again more evidence, randomised controls were demanded. The result of the first RCT, from Córdoba, Spain, appeared on September 3rd. The response of NICE was that the (very positive) result should have no influence on the way in which doctors treat patients (with Covid-19 pneumonia). 

"The clinical management of patients with COVID-19 should not be changed based on the results of this study."

On December 18th NICE published a joint report with SACN (Scientific Advisory Group on Nutrition) and PHE (Public Health England) in which Sir Paul Chrisp (director of the centre for guidelines at NICE) stated:


"While there is insufficient evidence to recommend vitamin D for the prevention or treatment of Covid-19 at this time, we encourage people to follow government advice on taking the supplement thought the autumn and winter period."


The reason for this change of direction is that the Health Secretary Matt Hancock had stepped outside NICE advice. He had become aware of the importance of vitamin D in the prevention of Covid-19 and he issued a directive that all elderly people should be issued with a vitamin D supplement. NICE could not disagree with a minister and so it had to use double-speak, taking advantage of the many synonyms in the English language. To "recommend" and to "encourage" are verbs without an obvious difference in meaning.


NICE cannot be regarded as having the best interests of the sick and dying at heart.


NICE denies responsibility


The full NICE report that included the first RCT of vitamin D as 25(OH)D or calcifediol, its natural rapidly-acting form, appeared in December 2020. Although the earlier report carried its "recommendation" that doctors should not have their treatment of patients be influenced by this first RCT, the full report carried an interesting disclaimer:


"The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian."


NICE and other documents carried generally very negative reviews of vitamin D, and denied the role of vitamin D in defensive immunity, ignoring the accumulated evidence. It has been the same in other commentaries, at best balanced, always stating a need for more research, but when is there not a need for more research? Does science ever stand still? Is a balanced view of help to a doctor caring for the sick and dying?

There was undue publicity given to two barely comprehensible papers that were pre-published in January 2021. 



One was from Canada, the other was from Greece.They stated that there was no evidence of benefit from vitamin D. They were of very poor quality and added nothing, but headlines were dramatic.

The very positive result of the second controlled trial, from Barcelona, has received no official comment. It was "rejected" by Professor Adrian Martineau, a member of NICE. Still a demand for more RCTs that would inevitably necessitate more human sacrifice.

No evidence?

The common suggestion of "no evidence" is absurd. Let us assume that there had been a murder and that ten detectives were sent out to investigate. On the following day eight detective returned to HQ and reported that they had all found incriminating evidence that pointed to one man who appeared to be guilty of the crime. On the following day the other two detectives returned and stated that there was no evidence of the accused man being responsible for the crime. Would their finding of "no evidence", or rather their failure to find evidence, invalidate the evidence found by the others? 

Of course there is ample evidence to suggest that vitamin D would be of benefit in Covid-19, but most people seem to be unaware of it.

A view from an ivory tower

A recent editorial in the British Medical Journal on the subject of Covid-19 and vitamin D was written by two nutritionalists and a professor of primary care diabetes, the latter having previously written what I can only describe as a non-medical appraisal of the high Covid-19 death rate of BAME people without once mentioning vitamin D! Even though it was in the British Medical Journal, the editorial was of no practical value to practising doctors. There was no practical advice as to how to reduce the deaths from Covid-19 in any ethnic groups. 

"Existing evidence supports a compelling case for further research." Let's just kick the can down the road while more people die. 

The authors of this editorial, like perhaps all commentators on the subject of Covid-19 and vitamin D, did not have responsibility for patients admitted to hospital with Covid-19 pneumonia. Whether or not they themselves took vitamin D was not declared. They gave no advice as to whether such patients should be treated with calcifediol as in the Córdoba protocol, but they gave ample discouragement. 

Advisors to government but not to doctors

Government advisors on the Covid-19 pandemic live in offices, ivory towers. They do not live in the emergency areas of hospitals. They never see blood on the floor. They do not know what it is like to make life or death decisions. They do not understand the pressure to do the very best to help an individual patient. But they inhibit rather than help those front-line doctors who need support.


A report in December 2020 from an all-party committee of parliament also managed to find no place for vitamin D. The ignorance is wide-spread.


MD in Private Eye is not one to follow central directives, but his first and very brief mention of vitamin D during the pandemic informed us that "The jury is still out". He followed this by a plea to be given vitamin D should he develop Covid-19 (Eye 1452). If the jury is still out it indicates that evidence has been withheld or that the judge has failed to give direction. However MD showed some of the pragmatism that doctors require, but in advice to others he followed the official line: he clearly sat on the fence of indecision.




Clinical decisions

For a clinical doctor to make a decision to prescribe vitamin D / calcifediol for a patient with Covid-19 pneumonia is actually very straightforward and I am sure that non-one would argue with it. Surely a doctor would not regard herself or himself of being at risk of charges of negligence or other disciplinary charge should vitamin D be prescribed. But doctors are frightened of giving vitamin D. 

Decision-making is encapsulated in Pascal's Wager, that I have described previously.

To give vitamin D as calcifediol to a patient admitted to hospital with Covid-19 pneumonia would have a high probability (about 70%, but not certainty) of reducing the need for ICU transfer and death, and it would have a cost of about £10, with no side-effects. 
To deny the patient calcifediol would correspondingly fail to reduce the need for ICU transfer and failed to reduce the number of deaths.

What could be a more simple decision than this? Obviously vitamin D / calcifediol must be given, that is if the objective of the doctor is to minimise illness and reduce the chance of the death of a patient. Can anyone provide a reason why a patient critically ill with Covid-19 pneumonia should not be treated with calcifediol, or why anyone deficient in vitamin D not have the deficiency corrected?

Why is calcifediol not being given to patients with Covid-19 pneumonia in the UK? Because NICE says that it should not be given. Doctors and their managers are frightened of not obeying NICE. Can NICE justify it actions in denying vitamin D to those are dying?

Legal claims

It has just emerged that there is a now a group legal claim against the UK government as to why not more was done to protect the population, so as to keep the number of deaths well below 125,000. 



The legal claim is bound to uncover the fact that vitamin D and its active metabolite calcifediol (25(OH)D) had been withheld, when all the evidence pointed to it being very helpful and life-saving. 83,000 people have died since the result of the Córdoba study became available on September 3rd, and a significant number of these deaths were therefore avoidable. The question in a court of law would be, "Why was vitamin D not given?" The government will point out that it was only following the advice given by NICE. NICE will defend itself by pointing out its disclaimer, which I will repeat as it is vitally important in its defence. The disclaimer must have been written by lawyers.

"The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian."


Who will be held guilty?

This declaration clearly shifts the blame for the deaths of patients to hospital doctors, for following its repeated advice!

This is a disgrace.

The responses of doctors and their professional organisations, and the General Medical Council will be interesting.





 










16 comments:

  1. Thanks David. Wish your advise was taken seriously. Its a disgrace. 😌

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  2. Big Medicine and BigPharma do not want the population to learn about the prevention of all diseases and cure of most (from MS to asthma to psoraisis to Covid to COPD and even cancers etc etc) including autoimmune diseases and cancers by taking what they call high doses of Vitamin D3 (20,000 IUs a day is equivalent to what is made in the skin after 1/2 hour of summer sunbathing in northern US. It is not a high dose..but MDs will tell you it is toxic! ) Vitamin D3 is actually a hormone that controls 2700+ genes involved with revving up your immune and tissue remodeling systems.If everyone started taking 20,000 IUs of D3 per day (adjusted for weight-20k is for a man) it would put about 90% of the medical industry and Big Pharma OUT OF BUSINESS..90%!!! .Vitamin D3 is their worst enemy and many of them know it and are 100% corrupt! You can read about the lack of cancers and most other diseases in latitudes with strong sun here is a blog post>>>OVERWHELMING PROOF THAT VITAMIN D3 DEFICIENCY CAUSES MOST HUMAN DISEASES link>>
    https://jefftbowles.com/vitamin-d3-deficiency-causes-most-human-disease/

    Once you read that, you can find a way to my book that outlines the scandalous corrupt history of Big Medicine Big Pharma and Vitamin D3 going back to the 1920'!! It is an outrage and it is still going on with Harvard and many other "elite" institutions in the driver's seat-pumping out junk science and disinformation!
    Learn the history of the biggest criminal fraud perpetrated in the history of mankind! here US>> https://www.amazon.com/dp/B07ZBP8QZZ
    or here UK> https://www.amazon.co.uk/dp/B07ZBP8QZZ

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    1. David, another brilliant analysis. And I fear you are absolutely right about Big Pharma, Jeff. This is the tip of the iceberg of the biggest corporate scam in history. Let’s call it Billindagate, in honour of Nixon’s old friend Watergate. Only this time the criminal break-in is out in the open, and on the Future of Humanity.

      Of course those in high places know the dangers to Big Business posed by the abolition of global D-deficiency. And it is highly likely that the NIH and Gates-funded ‘gain of function’ research beloved of Anthony Fauci, and illegally subcontracted in 2015 via Peter Daszak of the Eco-Health Alliance, to Shi Zheng-Li in Wuhan, depends upon its exploitation. This poses a conundrum; Gates-Baric-Daszak-Shi deliberately created a new coronavirus Chimera in the lab ‘just to see what would happen if some such natural virus ever emerged’. Shi gives it the RaTG3 bat coronavirus backbone; a pangolin coronavirus spike protein; some HIV sequences that facilitate its reverse transcription; and most dangerous of all a 12-base sequence between Spike S1 and S2 that codes for the arginine-rich receptor for the intracellular proteolytic enzyme Furin. (see Chapter 5 in Tritto, Cina Covid-19: la chimera che ha cambiato il mondo).

      And guess what? You now have a virus that ONLY the vitamin D-dependent innate immune system can fight. This, in October 2019 somehow escapes from the level 4 'High Security' lab in Wuhan (which happens also to house the PLA’s Biodefence home team!) At my prep school we had a schoolboy excuse for such phenomena -‘Sorry, Sir, it was me but I only did it accidentally on purpose’.

      Hence the obscene rush to produce new vaccines and suppress the obvious, and indeed the only solution for a nasty virus new to man. Global correction of D-deficiency. Which may also prove necessary to safely fight some or all of the vaccines. We are surely about to witness the full potential of corporate fan-shit-hitting, so please step back, and give a NICE loud cheer for the Big Winner! Ladies and gentlemen please give a rousing welcome to Billindagate!

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    2. You've said just what I planned to say. BigPharma has made huge profits & wants to continue to do so on ppl who have not taken measures to ensure their own healthy longevity via highly nutritious diets & supplementation of numerous items (including Vit D esp) that have been shown to reduce & even eliminate typical disorders that accompany chronological aging.
      Dr Grimes has presented the info well for those who do not already know or do not make use of that info for their own good health.

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  3. Thank you, though I can hardly bear to read this post.

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    Replies
    1. Thanks Bébinn, Your few words say so much. Best wishes, David

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  4. Government advisors in most countries on the not only on Covid-19 pandemic but also other medical disorders live in offices or ivory towers, or laboratories, with neither having pertinent knowledge on the clinical and preventative disease subject and never had relevant practical experience. Neither do they provide direct patient care in hospitals nor have experience making life-or-death decisions in medical situations.

    Besides, they do not understand the pressure in doing best for patients under pressure as indicated above. Instead, they continue to hinder front-line healthcare workers' work and mislead the legislature with faulty, armchair counterproductive, and misleading advice. One can witness the similarity of the above to other areas of administration.

    There is ample evidence to support vitamin D benefits in the prevention and during the early stages of those with Covid-19. Two recent medRxiv non-peer-reviewed preprints indicated By Dr, Grimes, [https://doi.org/10.1101/2020.09.08.20190975 and https://doi.org/10.1101/2021.03.04.21252885;] provided no correlations of vitamin D status with COVID-19 outcomes. However, notably both studies had significant methodological issues, inherent biases, and study design errors.

    Disgraceful Committees, such as NICE and SCAN [also in the USA (e.g., NIH and CDC) and in other countries] must be abolished for misleading politicians and the public alike, and thus harming citizens, and make ALL members of these two committees accountable (similar to a fiduciarily responsibilities of a board of directors of organizations) for their failure to protect lives and the public.

    Administrators and doctors forget those guideline recommendations are never intended to be mandatory (including IOM, Task Forces, and other suggestions). These should not prevent nor override healthcare professionals' responsibility to make appropriate individual and societal decisions to benefit patients, in consultation with their patients and guardians. They have the right (including the use of therapeutics) to do the best for a given patients.

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  5. Another excellent article. Worrying that NICE are sitting on the fence.

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    1. Thanks for this comment. I wondered if the initial photograph might be a bit insensitive, but i wanted to bring out how challenging things can be dealing with emergencies in hospitals. You will appreciate that I am so angry that NICE can deny doctors a safe and effective contribution to patient care when NICE is in a comfortable office and the members go to bed at night. I appreciate your encouragement.
      Incidentally, I was standing where the blood landed and I had to jump backwards very quickly. I also have a photograph of the dutiful and considerate nurse cleaning up the mess afterwards. It was bleeding oesophageal varices, and the patient survived, at least in the short term.

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    1. Many thanks for your comment, and best wishes

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  9. David I can't thank you enough for the education I'm receiving through your website, articles and blogs. I'm dumbfounded as to why the Government aren't taking this information seriously...then again, with the huge Pharma companies and wealthy billionaires driving the agenda, I shouldn't be surprised.
    I will certainly do all that I can to help drive your message forward in any way possible, and as small a way as it might be.
    Keep up the good work and KTTT

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    Replies
    1. Thanks John. I really appreciate your encouragement. Trying to bring the importance of vitamin D to general attention is like trying to make holes in water.

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