Friday, 26 August 2022

Covid-19 & Vitamin D: UK unhelpful clinical trial

London – Greenwich and Canary Wharf

It has been established very well during the Covid-19 pandemic that a low blood levels of Vitamin D recorded in advance of illness (Santander, Heidelberg, Israel ) is the most significant but potentially reversible risk indicator of critical disease and death. Vitamin D deficiency is also the common factor within the major at-risk groups, the obese, the elderly, and those of South Asian and Black African ethnicity who li
ve in the UK and other northern European countries. 

It has been established that Vitamin D in its "raw" form when given to the critically ill in Intensive Care Units (ICU) is not effective (Brazil), the simple reason being that as we know, it takes up to two weeks for the Vitamin D to be converted in the liver into its hydroxylated pre-active form, 25(OH)D, also known as Calcifediol. When Calcifediol is given by mouth it takes just two hours to achieve good blood levels. It is Calcifediol, 25(OH)D that we measure in the blood as Vitamin D.

Randomised controlled trials (Cordoba and Barcelona) have shown that when Calcifediol is given to patients admitted to hospital on account of severe Covid-19, it is remarkably successful in reducing the risk of escalation to ventilatory care and death. Why it has not been used widely in the UK and elsewhere is a mystery.

Correction of vitamin D deficiency

It would be a sensible public health initiative to correct Vitamin D deficiency within the population, especially in those at particular risk. A "safe" level of Vitamin D in the blood should be achieved, ideally before admission to hospital. Vitamin D is cheap, readily available, and safe when given in physiological doses checked by blood levels. 

It is clear that a low blood level of vitamin D (=Vitamin D deficiency) can be a serious disadvantage, and restoration to an ideal blood level of 40ng/ml (100nmol/L) would be sensible. But how to achieve this is the challenge. 

The physiological way to obtain Vitamin D is by exposure of the skin to the sun, at times when at close to sea level the sun is more than 45 degrees above the horizon, judged by the length of the shadow being less that the height. This could be recommended but an excessive single exposure leading to burn is to be avoided.

It has been demonstrated that not only people with ideal blood levels of Vitamin D have a reduced risk of critical or fatal Covid-19, but also people who are taking vitamin D supplements at the time of hospital admission on account of Covid-19 (Tameside, UK). 

The biology of the pivotal role of Vitamin D, in its fully activated form 1,25(OH)D, in the escalation of natural defensive immunity has been established during the past forty years.

With the onset of a serious pandemic due to a new respiratory virus, it would seem to be sensible to act on a knowledge of medical science supported by early reports of the dangers of low blood levels of Vitamin D. Correcting Vitamin D deficiency would have been of great potential benefit, with no danger. I have drawn attention to the report of just a single case of vitamin D toxicity occurring during the pandemic.

Randomised controlled trial – RCT – from UK

Official advice concerning the use of Vitamin D during the pandemic was very negative, ridiculously so given the circumstances and 200,000 Covid-19 deaths in the UK. The pandemic emergency resulted in vaccines being issued on the basis of Emergency Use Authorisation (EUA), meaning that only short term and rudimentary RCTs in healthy people had been completed. 

When it came to vaccinations in pregnancy there were no RCTs, which can be regarded as negligent. Safety was to be judged on the basis of "post–marketing surveillance". And this is the important thing: the main purpose of RCTs is to establish safety, following the thalidomide tragedy of the 1960s. When taking medicines, effectiveness is less importance than safety. A medicine might not do good, but it must not do harm – primum non nocere.

Whereas the "vaccines" against Covid-19 are a new RNA technology with safety being far from clear, Vitamin D is a natural substance that has been in use for a century. The standard dose range is known, with appropriate blood levels. The exceptionally rare side-effect of Vitamin D intoxication (hypervitaminosis D) is always the result of major dose error and is both easily recognised and completely reversible. The need for RCTs of Vitamin D was much less pressing than for vaccines.

The challenge of prospective randomised trials of vitamin D, or anything else, is that if low-risk individuals are to be studied, very large numbers must be recruited if the endpoint of critical illness or death is to be reached in significant numbers. Administration costs are inevitably very high, and follow-up times will be long. It imight be sensible to concentrate on a smaller number of individuals who are at high risk of serious or fatal Covid-19. Hence the success of the RCTs from Spain, small numbers showing a big effect with statistical significance.

I have also shown in previous Blog posts the wisdom of Sir Austin Bradford Hill, whose criteria of pragmatic "proof" (it is never absolute) identifies an RCT as being only one component. For ethical and operational reasons an RCT might not be possible, or be of only limited value. There is also the wisdom of Blaise Pascal, who realised that decision-making is also pragmatic, a trade-off between likely benefit and possible adverse outcome.


United Kingdom - the COVIDENCE UK study

Early in the pandemic in the UK, a large community-based clinical trial of Vitamin D in the prevention of Covid-19 was proposed by Professor Adrian Martineau. Funding of the study became an immediate problem as a large administrative staff would be essential and there would be no pharmaceutical company support. However the study was undertaken and the result became available in early 2022.

6200 adults were incorporated into the trial, with a number of exclusion criteria including current Vitamin D supplementation. 2958 of these were randomised to receive Vitamin D.

2690 (86.8%) of those to receive VItamin D had blood Vitamin D levels less than 30ng/ml, 75nmol/ml. This shows the extent of clinically significant Vitamin D deficiency. They had suboptimal blood levels as identified in the observational studies described in Heidelberg, Israel, and other places. 

1334 were given a lower dose of vitamin D supplement, 800 units per day, and 1356 were given a higher dose, 3200 units per day.

The controls did not have blood testing and they were informed that they were not to receive a Vitamin D supplement. This is important as, with the Heidelberg and Israel studies, the identification of Vitamin D deficiency before the study would have created the ethical dilemma if they were not to have the deficiency corrected.

There was no placebo given to the control group. This weakened the trial and in the knowledge that they were not to receive Vitamin D that was being tested, the controls would be likely to take a Vitamin D suplement not given to them. In fact 49.9% of them did so on at least one occasion.

The trial commenced in December 2020, with six month follow-up of individuals. The vaccination process was under way at that time and 89.1% of the subjects received one or more doses of a Covid-19 vaccination during the study period. This would obviously complicate the interpretation of the results.

The baseline Vitamin D levels can be seen in Figure 1. Both units in current use are shown, nmol/L and ng/ml. We can see no significance difference between the two treatment groups at the baseline. We see again the high prevalence of low sub-optimal blood levels of Vitamin D.

Figure 1. Baseline blood levels of Vitamin D


In Figure 2 we can see the blood levels of Vitamin D at the end of the study. The ideal blood levels can be judged to be greater than 75nmol/L, 30ng/ml, and preferable to be 100nmol/L, 40ng/ml. We can see that the former level is achieved by taking 800units per day, and the higher level by taking 3,200units per day.

In previous posts I have generally advised a supplement of 3,000units per day (the dose that I take, but as 20,000units once each week) but I have also emphasised the importance of checking blood levels so as to monitor the appropriate dose of the supplement. I have drawn parallels with monitoring the treatment of other hormone deficiencies, namely thyroxine and TSH levels in hypothyroidism, and glucose in diabetes.


Figure 2. End of study blood levels of Vitamin D

It is interesting to note that mean blood level of Vitamin D in the "No offer" group at the end of the study was 66.6nmol/L, 26.6ng/ml. As mentioned above the baseline blood Vitamin D levels in the "No offer" group, the intended controls, were not measured. There is no reason why they should not have been the same as in the treatment groups, which is about 41nmol/L, 16.5ng/ml. The fact that at the end of the study the mean blood level was 66.6nmol/L, 26.6ng/ml, indicates that many of those in the "No offer" were taking Vitamin D supplement of their own initiative, as some admitted. The increase would be 66.5%.

Clinical outcome was of course reported in the results of the study. We can see in Figure 3 that there were no significant differences in the cases of Covid-19 in the three groups, 2.97% in the high dose group, 3.63% in the low dose group, and 2.64% in the "No offer" group. There was similarly no significant difference in hospital admission rate. Ventilation was necessary in only one in each group, and there were no deaths.

Figure 3. Covid-19 infections related to Vitamin D supplement


Figure 4 shows us that there were very few acute respiratory infections, with no significant differences between the groups. The infection rate was highest in the Vitamin D high dose group.

Figure 4. Acute respiratory infection related to Vitamin D supplement


Conclusions

The main conclusion of the study as mentioned in the paper is that a public health policy of Test and Treat Vitamin D Deficiency is a practical proposition. To quote from the paper:

"Ultimately, however, this trial was designed to investigate the effectiveness of a pragmatic 'test–and–treat' approach to boosting population vitamin D status, rather than  biological efficacy of vitamin D to prevent ARIs [acute respiratory infections], and our findings should be interpreted accordingly."

It is not possible to form a conclusion concerning the effectiveness or otherwise of Vitamin D supplementation, but it appears that in prevention among asymptomatic people, a dose of 3,200units is perhaps of no advantage over a lower dose of 800units each day. However the absence of Covid-19 and respiratory deaths in all groups indicates that the study was underpowered (too small) to assess effect on deaths. To do so it would have been necessary recruit at least ten times the number of subjects.

This was a field study and the supplement dose was not adjusted to meet the needs of individual people. It was "one size fits all", but there might be an advantage of personalised approach with intermediate blood testing.

Of greatest importance in assessing Vitamin D efficacy is that the study was compromised by the "control" group being uncontrolled. It would have been scientifically more robust if they had been given a placebo, but that was not the case. This might have been for ethical rather than operational reasons, and similarly no base-line Vitamin D testing for the "control" group. However for a "test-and-treat" evaluation, the management of controls was not important and indeed the presence of controls was not really necessary.

In practice, those randomised to be controls were informed that they were not to receive a Vitamin D supplement, termed "no offer". It would appear that they did not want to miss out on what would be a very safe and potentially great advantage in the face of the pandemic, and many accepted Pascal's Wager, that is they took Vitamin D in unknown amounts, but sufficient to increase the mean blood level of Vitamin D by 66.5%. 

The other confounding factor was the distribution of vaccines at the same time of the study. This was among all groups but it could confuse and diminish any assessment of clinical outcome.

Of 6,000 people taking Vitamin D supplement (including a significant but unknown number of "controls"), only three required ventilatory care for Covid-19 and there were no deaths. This in itself tells us the value of taking a Vitamin D supplement to correct deficiency.

Tracing for and testing of vitamin D deficiency was achieved in this study. 

Assessment of correction of Vitamin D deficiency was inconclusive.

There are of course several other studies, and a study from Mexico will be the subject of the next Blog post.






Monday, 11 July 2022

Covid-19 & Vitamin D: A Single Case of Vitamin D "intoxication" but much misunderstanding

During the past two years much has been made of the possible but exceptionally rare dangers of Vitamin D, assertions by those who have succeeded in suppressing an official use of Vitamin D which would optimise natural defensive immunity against Covid-19. This is the opposite of media silence concerning documented dangers from the new Covid-19 vaccines (which I believe might be prevented by correcting Vitamin D deficiency).

There have been in the past occasional case reports of "hypervitaminosis D", which is an excessive blood level of Vitamin D with undesirable but easily reversible metabolic consequences. A single case of hypervitaminosis D has been documented in the UK during early July 2022. It was treated both simply and effectively. The BMJ Case Report was followed by widespread reporting in the press, far more than the incident demanded. Unintentionally the press spread disinformation due to misunderstanding, as we will see below. The initial report was in the British Medical Journal, warning doctors about possibly more cases in the future.

 

British Medical Journal, July 2022

The report was cascaded by several UK newspapers to alert the public. Since i published this Blog post yesterday (July 11th) I have been informed that it has also been reported in Germany and Australia. 

All the newspaper reports over-simplified the medical paper and missed the most important points.



Sky News



The Times


Daily Mirror



Evening Standard

Topics


Hypervitaminosis D

An excess of Vitamin D can lead to an increase of the blood level of calcium, which is mobilised from the bones. In turn, the high blood level of calcium (hypercalcaemia) has metabolic effects on the kidneys that increase the volume of urine production (polyuria), leading to dehydration. This is exacerbated by the other effect of vomiting. Correction of the problem is simple, by intravenous saline. 

Hypervitaminosis D is extremely rare and it has not been reported in various recent Vitamin D trials. The point is that hypervitaminosis D is always the result of errors of dose, and there is a ready explanation for this. When it occurs Vitamin D has usually been given together with calcium supplements.

Identification of VItamin D

When Vitamin D was first identified and isolated in the early 20th century, the amount of it for metabolic use was so small that it could not be "weighed". Measurement was by biological assay, and expressed as International Units (iu), an agreed international standard. One unit of Vitamin D was defined as the daily requirement of an immature ten gram (10g) mouse, the amount required to ensure its bone development without rickets.

Everyone was happy with this and Vitamin D for human use was expressed in units (strictly "iu"). 400 iu was considered to be the daily amount to prevent rickets in children, and recent consideration has been for about ten times this for optimising immunity in the human adult. The daily need can be scaled up from one unit for the 10g mouse to 6,000iu for the 60kg human, but half this would be satisfactory.

1922 – the identification of Insulin

Insulin was identified and isolated in 1922, at about the same time as Vitamin D. Similarly insulin was present in such tiny amounts that could not be weighed and so the daily need and dose were expressed as international units of biological action. The use of biological units continues to this day without any clumsy attempts to change to mass units, weights, even though the mass of insulin can be measured.

It is now known that one unit of insulin weighs 0.0347 mg, which equals 34.7 micrograms. One unit of Vitamin D weighs 0.000025 mg or  0.025 micrograms (see below). Insulin has a much greater mass than VItamin D beacuse it is a large very complex protein molecule, whereas Vitamin D is a simple oil.

It was identified that the body produces on average during each day about one unit of Insulin per hour. 24 units of Insulin per day was the initial stating dose, divided into two or three injections (8+8+8 or 16+8 units) to coincide with major meals. Insulin resistance means that increasing doses are necessary to achieve normal blood glucose levels in some people.

Imagine the confusion if people with diabetes were to be told to take 0.2776 milligrams or 277.6 micrograms of Insulin (8 units) three times a day! Chaos would be inevitable, especially as the dose must be modified to suit the individual. Diabetes specialists are sensible and keep to the units that everyone understands

Measurement of Vitamin D

One unit of Vitamin D can now be measured as 25 billionths of a gram, 0.000000025 grams, or 0.025 micrograms. This is obviously infinitessimally small, too small to see. Vitamin D can now be measured in mass units rather than biological assay units, but this has created its own problems.

As with Insulin, everyone has been happy with internationally agreed biological units, iu, of Vitamin D. The arrival of mass units (based on weight) has caused confusion and it is this that can lead to the problem of hypervitaminosis D.

The move to mass units

Whereas most doctors and the general population think of Vitamin D in terms of units, the important UK Standing Advisory Committee on Nutrition (SACN) uses mass units. Hence confusion. The same would have happened in other countries.

400 units of Vitamin D is accepted as being the minimum daily dose of Vitamin D to prevent rickets in a child. 400 units is 10 micrograms, also expressed as mcg or μg. 

Metric units

People are accustomed to using the metric unit gramme, or gram, and are aware that a milligram (mg) is a small proportion of this, but few are aware that milligram is actually one thousandth of a gram.

The microgram does not appear in the lives of most people. It is a unit of measurement effectively confined to scientific disciplines, and the scientific knowledge of the great majority of the population is abysmally low. Few people can even guess that a microgram is one thousandth of a milligram, a millionth of a gram. Such a tiny amount is beyond general comprehension. The minimum daily requirement of Vitamin D is 10 millionths of a gram (10 μg)  and the requirement for optimal immunity is 100 millionths of a gram (100 μg). Here lies the opportunity for confusion and danger.

The abbreviations mcg or μg are also unknown to most non-scientific people. Unfortunately mg can be assumed and has been expressed in the press. This immediately leads to a dose excess by a factor of one thousand.

The development of confusion

If a person takes Vitamin D 4,000 units each day, all will be well, simple and easily understood. 4,000 is a large number, but remember the 10 gram mouse.

But if we transcribe this to 100 mcg or μg there is opportunity for confusion and error. It is possible that in error 100mg will be taken, which is 4,000,000 units, a thousand-fold increase.

This is the way in which severe hypervitaminosis D can occur. Fortunately it is easy treated.

The sensible way forward is regard Vitamin D in the way that we sensibly regard Insulin: keep to well-understood international units, and forget what in practice is the pseudo-science of using tiny mass units in public life.

Advice from the Newspapers

Sky News


Sky News misinterpreted the units. Sky News reported that the subject of the case report was taking 50,000mg of vitamin D each day, which was obviously absurd. 50,000mg is 50g, the size and weight of a large egg.  but the reporter had no knowledge of units of measurement

50,000 mg is 50,000,000 micrograms, 50 million! With a Vitamin D conversion factor of 40 it would be 2,000,000,000 units, 2 billion units! How the press can misinform.


The patient, described in the British Medical Journal (BMJ)

Although maintaining anonymity, the BMJ gives information about the circumstances of the Vitamin D excess. 

"The middle-aged male patient had a variety of health issues, including tuberculosis, an inner ear tumour (left vestibular Schwannoma) that had resulted in deafness in that ear, a build-up of fluid in the brain (hydrocephalus), bacterial meningitis, and chronic sinusitis."

The description continues:

"He had been taking high doses of more than 20 over the counter supplements every day containing vitamin D 150,000 iu (daily requirement 10 mcg or 400 iu); vitamin K2 100 mg daily (daily requirement 100–300 μg); vitamin C; vitamin B9 (folate) 1,000 mg (daily requirement 400 μg); vitamin B2 (riboflavin); vitamin B6; omega-3 2,000 mg twice daily (daily requirement 200–500 mg); plus several other vitamin, mineral, nutrient and probiotic supplements."

 What we can see is vast uncontrolled polypharmacy self-administered by someone with no understanding of what he was doing. It is very sad but we are in an era of "healthism" in which taking supplements is almost routine. Those people selling the supplements should exert some control over excess consumption, and this should have been the most important message of the case report. 

In a medical world supplements, replacement therapies, are given on the basis of need. Type 1 diabetes is a condition of insulin deficiency, and insulin replacement therapy is given under controlled conditions, with careful monitoring of blood levels of glucose and HbA1c. 

Clinical and public health medicine should have a firmer grip on Vitamin D, so that supplements are given following blood level testing, with follow-up to ensure appropriate dose. Medicine is negligent in not achieving this, with public health and health service managers even more negligent in discouraging it.

Incidentally, the BMJ Case Report is not perfect. It uses both mcg   and μg as abbreviations for micrograms. My preference is the abbreviation "mcg" as this is simple to type. To type "μg" requires looking up symbols. Using Greek letters without necessity is an example of pseudo-science.

The Case Report uses IU as a cumbersome and not always intelligible abbreviation for international units. Once again we should take the lead from Insulin and use the simple abbrevation "unit" which is what everyone has used during the past hundred years.

It mentions in respect of VItamin D a "daily requirement 10 mcg or 400 iu". This is the dose that is necessary to avoid rickets, but it is increasingly recognised that about ten times that dose is necessary to optimise immunity.

When I read "Hypervitaminosis D, as the condition is formerly known...." I was rather surprised as I did not know of a more recent term. I now realise that this is a typo, and that "formerly" should have been "formally", a similar word with a very different meaning.

Blood levels of Vitamin D

The blood level of VItamin D is not generally measured, and indeed clinical doctors in the UK are discouraged from requesting it. After ingestion or production in the skin, Vitamin D is transported to the liver. It is then hydroxylated to 25(OH)D, which is the circulating reservoir available for immediate use. It is Vitamin D as 25(OH)D that is measured in the blood as a routine. 25(OH)D is also known as Calcidiol or Calcifediol. 

It is not appropriate or possible to use international units in measuring blood levels of Vitamin D. It is only since the measurement by mass units that the blood levels have been able to be expressed.

Blood levels have been initially expressed by the mass unit of nanogram

The same problem again: only people with a scientific background might understand this unit. One nanogram is a thousandth of a microgram, and so one nanogram is a thousandth of a millionth of a gram. Perhaps the general population does not need to be troubled by this.

There is a movement towards using SI units (International System of Units), involving molar measurements. And so 40ng/ml (40 nanograms per millilitre) is equivalent to 100nmol/L (100 nanomols per litre), a conversion factor of 2.5.

1,25(OH)D

It is also possible to measure the blood level of circulating fully-activated Vitamin D, 1,25(OH)D. Most 1,25(OH)D (Calcitriol) is produced in the cells of immunity in response to infection, but a small amount is produced in kidney cells to circulate and act on bone and maintain an accurate blood level of ionised calcium. 1,25(OH)D is present in the blood in only very tiny amounts, measured in picograms per millilitre. A picogram is a thousandth of a nanogram, in other words a million millionths of a gram. In practical terms this need not concern us, but it demonstrates the tiny amounts of hormones that are necessary for bodily health.

Complexity can lead to error

I hope that the numbers displayed have not been overwhleming. The complexity outlined is in the use of varying terms of measurement, not of the need for and benefits from VItamin D.

I would strongly recommend the continuing use of International Units, or just "units" that we have all been accustomed to during the past century. As it works perfectly well and without confusion with Insulin, let Vitamin D be the same.

I would also recommend that doctors in clinical and public health take more responsibility for Vitamin D, identifying deficiency by blood testing, prescribing or advising appropriate dose, and using blood levels to monitor the dose of the supplement.

It is also important that pharmacists and others who are selling Vitamin D directly to the public take responsibility in advising against excessive dose and uncontrolled polypharmacy in general. 

Many strengths of Vitamin D capsules are available. Perhaps the highest strength should be 20,000 units, with emphasis that it is a convenient and effective dose to be taken only once a week. This is what I take.




On the rear of this packet, the manufacturer clearly states that this is a once per week dose, and that doctors and pharmacists must confirm this.






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Wednesday, 22 June 2022

Covid-19 & Vitamin D : Lack of benefit of vaccines in Canada


Figure 1. The inevitable effect of vaccinations on blood levels of Vitamin D.  
The green line illustrates someone who has a good blood level of Vitamin D.
The blue line represents some who initially has a low blood level of Vitamin D.
Without Vitamin D supplement, vaccinations will damage Vitamin D mediated immunity.
(see previous Blog post for further details)


In this Blog post there are many Figures and a lot of numbers. The important points are in the text, which I hope can be read easily. The details in the Figures are for reference so as to demonstrate that the data are real.


My previous Blog post looked at data from the Public Health Agency Canada, PLAC. I identified that during the week April 10 to April 17 2022, there were 277 Covid-19 deaths. This is calculated by the total cumulative number on April 17 (16,002) minus the total cumulative number recorded on April 10 (15,775). Of the 277 deaths, 276 had received at least one vaccination and only one had not been vaccinated.

This might appear to be too extreme. Could it really be true? I was doubtful but when I analysed the data the numbers were real and they were published in official documents. Was this week somehow exceptional? What about other weeks?

The problem is that each weekly report by the PHAC is an update of the previous week, starting in December 2020. At that time all of the Covid-19 deaths were obviously in the unvaccinated, and during most of 2021 the majority would have been unvaccinated. It would be only at the end of 2021 that first people would be triple vaccinated, that is "fully vaccinated (x2) plus additional (booster)". But the historic data are not of relevance at present, as it is "now" that is important to us.

We can subtract last week's cumulative data from this week's (always a larger number), but I am unable to identify data from previous weeks as previous data is contunally over-written. However by taking screen-shots each week it is possible to look at each week prospectively.

I described additional data from May 1st, two weeks data being identified by subtraction of April 17th and then averaged into two separate weeks. I can now display the data reports from May 8th, May 15th, and May 22nd a total of six weeks. 


Recent updates of Covid-19 deaths in Canada

From the official PHA Canada reports I can display Table 2 of the two most recent updates.

Data from May 8th

Figure 2. Data from May 8th 2022


Data from May 15th

Figure 3. Data from May 15th 2022


Data from May 22nd 

Figure 4. Data from May 22nd 2022


It is necessary to extract useful information from the data, for the six weeks that it is possible to analyse so far.


Covid-19 deaths during each week

Week ending April 10 

This is the baseline week and so all we can see is cumulative data starting in December 14th 2020. Note that "vaccination <21days" implies that the vaccination has not had adeqaute time to induce immune protection.

The important data for April 10th is extracted in Figure 5.

Figure 5. Data extract from April 10th 2022



The fact that during the time from December 14th 2020 to April 10th 2022 60.29% of those who died from Covid-19 were not vaccinated does not lead to a useful conclusion. The proportion of the population vaccinated was increasing steadily, not a steady state. It does not tell us about "now", but is frequently advertised by those who are promoting vaccination without being in possession of up-to-date facts.

The PHAC provides details of the vaccination profile of the nation, shown in Figure 6. 

Figure 6. Vaccination data up to May 22nd 2022

It is obvious that in the early weeks of the pandemic the numbers vaccinated was low, but at present 85% have received at least one vaccination and 82% were double ("fully") vaccinated. 49% had been double vaccinated plus booster.

The tables presented subsequent to April 10th will display just weekly additions, concentrating on "now".


Week April 10 to April 17

Figure 7. Data extract from weeks ending April 10 – 17 2022



This was illustrated in my previous Blog post.

An important detail is the rate of increase of Covid-19 deaths related to vaccinatiion status. We can see that the increase had been greatest in those double (2.2%) and triple (8.7%) vaccinated.These are increases based on the data from April 10th (denominator).

We can also see that 226 of the 227 deaths (99.6%) during this week were in people who had been vaccinated, only one unvaccinated. This might be the result of 99.6% of the population of Canada having been vaccinated, but this is not the case (Figure 6) and we will look at it in more detail later, after we have looked at other weeks. Will this remarkable proportion continue into the subsequent weeks?

Week April 17 to April 24

 

Figure 7. Data extract from week ending April 24 2022


The answer is that the extreme result of the previous week was not repeated. However two thirds of the deaths were among the vaccinated, and one third unvaccinated. It appears that the rate of increase was the greatest among the triple vaccinated. 

To assess the increase in each week it is better to concentrate on the precise numbers. We can see simply that 293 of those who died had not been vaccinated, whereas 556 had been vaccinated. This is 34.6% not vaccinated and 65.4% vaccinated.

It is important to note that 40% had been triple vaccinated.

Week April 24 to May 1

Figure 8. Data extract from week ending May 1st 2022

The data from this week are effectively the same as the previous week. PHAC published a two-week update and I have divided the data equally into two separate weeks.

Week May 1 to May 8

Figure 9. Data extract from week ending May 8th 2022


The number of Covid-19 deaths has been lower this week at 218. We can see the numbers for each vaccination status, noting that 30.3% of those who died with Covid-19 were unvaccinated and 69.7& were vaccinated, almost all double or triple vaccinated.

Week May 8 to May 15

Figure 10. Data extract from week ending May 15th 2022

During this week there were 412 deaths, 10.9% in the unvaccinated, 89.1% in the vaccinated, the great majority being triple vaccinated.

Week May 15 to May 22

Figure 11. Data extract from week ending May 22nd 2022

During this week, the sixth of the series, there were 459 deaths, 16.3% in the unvaccinated, 83.7% in the vaccinated, the great majority being triple vaccinated.


Most Covid-19 deaths are in the vaccinated

During this time period we have seen in Canada a consistent pattern of most Covid-19 deaths occuring in the vaccinated, especially in the triple vaccinated. This is of course the opposite of the official narrative, but unlike the official narrative it is based on up-to-date facts.

There is a problem. The deaths are numbers of people but we are not told of their ages. Is the age distribution the same in each of the vaccinations groups? We do not have the data. There is a possibility that the high death rate in the triple vaccinated might be influenced by them being older, but we cannot assume this to be the case. We must accept the data available, expecting refinement as the data are refined.

Composite data during six weeks

We can extract numbers from the tables shown above, firstly to show some variation in the number of Covid-19 deaths each week, Figure 12. The mean average is 361, which is 52 per day.

Figure 12. Covid-19 deaths weekly, Canada 2022


Figure 13 shows the proportion during six recent weeks of those dying who had received at least one vaccination. The average mean is 78%, corresspondingly 22% have been unvaccinated. This is not what we are told.

Figure 13. Percentage of Covid-19 deaths in the vaccinated


We can also see the variation of the number of Covid-19 deaths based on the number of vaccinations received.

Figure 14. Number of Covid-19 deaths in Canada by vaccinations status
April 10th to May 22nd



Most of those dying have been vaccinated, especially triple vaccinated. But....

Interpretation requires Caution

It is necessary to remember the extent of vaccination within the population of Canada, seen in Figure 6. Details are shown in Figure 15.

Figure 15. Vaccination status of the population

This is very important. The basic data presented above in Figure 14 has no real meaning unless it is standardised for the number of people in the vaccination group. We can achieve this by dividing the number of deaths in each group by the percentage of the population in each group. This is looking at ratios between the four categories of vaccination status. The results can be seen in Figure 16.

Figure 16. Corrected effect of vaccines in Canada


This can also be expressed graphically, Figure 17.

Figure 17. Effect of vaccines in Canada, April 10th to May 22nd 2022
adjusted for proportion of population vaccinated.

We can see that in data corrected for prevalence of vaccination, the Covid-19 deaths are higher in the unvaccinated group compared to the three vaccinated groups. 

There appears to be mortality benefit from one or two vaccinations, but the benefit is lost in those with three vaccinations.

Conclusions

My understanding of this is that each vaccination creates an intense immune stimulation, its very purpose. However it is known that immune activation comsumes the essential Vitamin D, a molecule of which can be used only once and then it is irreversibly de-activated. It follows, but is as yet untested or unpublished, that successive vaccinations will consume Vitamin D and deficiency will result. Reduction of immunity will follow, including response to further vaccinations.

Vaccinations require Vitamin D, and so perhaps all we need is correction of widespread VItamin D deficiency to optimise natural immunity. This would reverse the apparent ineffectiveness of triple vaccination.

Vaccinations must be considered to be at least disappointing in their effectiveness. We have no controlled trials on which to judge effectiveness and safety, but observational data, such as from Canada, are disturbing. In many countries Covid-19 cases and deaths are higher at present than they were in 2021, Figure 18. 

Figure 18. UK Covid-19 cases on June 21st and 22nd
2020, 2021, 2022


Some countries have seen the emergence of significant Covid-19 numbers only since the third vaccinations were introduced, for example in Australia, Figure 19.

Figure 19. Australia, Covid-19 cases each day


But we are dealing only with Covid-19 cases and deaths. When we look at total deaths, and cases and deaths from other specific diseases, the picture becomes increasingly disturbing. 

Post-script: week of May 22nd to May 29th.

The data from Canada for the week May 22 to May 29 has just become available. The summary table and the full table are shown below, but I have not incorporated them into previous summary figures.

Figure 20, Covid-19 deaths in Canada occurring during the week May 22 to 29 

Figure 20 shows the numbers of deaths for each vaccination group, and the percentages. We can see that during this week 95.3% of Covid-19 deaths were in the vaccinated and only 4.7% were in the vaccinated. 

Once again we must remember that 85% of the population had received at least one vaccination and only 15% were unvaccinated. We can adjust for this as before to indicate death numbers as relative rather than less helpful "raw" numbers. These are the raw numbers divided by the proportion of vaccinations status, as in Figure 15. We see the result in Figure 21.

Figure 21. Adjusted relative numbers of Covid-19 deaths during the week.

Once again we can see the failure of vaccination, especially multiple vaccinations, to protect against Covid-19 deaths.

This might have been prevented by correction of Vitamin D deficiency during the pandemic. It is not too late for public health initiatives to enhance natural immunity by using Vitamin D, especially as numbers of Covid-19 cases and deaths remain stubornly high.


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