Lorenz Borsche (LB) / Dr. Bernd Glauner (BG)
(This article also appeared on Telepolis.)
The lockdown worked and the potentially explosive propagation rate Reff was reduced from 1.3 to 0.7 (left). Vitamin D deficiency causes a 10 times higher death rate according to recent studies (right). Read here why there will continue to be a limited lockdown – and what we should do instead.
In this article, my job was mainly the data and graphics processing of the corona numbers, but I am actually a biochemist and have been involved in vitamin research for many years. Before you judge too hastily regarding vitamin D, you should know that science has long failed to recognise its function as an important regulator of gene expression. When I was a student at university, people were still taught that vitamin D is responsible for the stability of bones, and that's it.
This has changed completely over the last 20 years. In the meantime, hundreds of publications have made it clear that vitamin D is not a vitamin at all in the literal sense, but a hormone that controls the regulation of at least 1000 genes. Most of them have to do with the human immune system. What is more, vitamin D does not simply have a stimulating function, but ensures the balance of many metabolic processes necessary for the immune system. An important function is also, for example, the prevention of autoimmune diseases. It is now known that MS is the result of a defective vitamin D receptor protein. In contrast to that, the function of vitamin D in bone metabolism has somewhat taken a backseat nowadays.
Regardless of corona, it has been known and published for many years that vitamin D deficiency promotes the development of pneumonia – or scientifically correct ARDS (Acute Respiratory Distress Symptom) - as a result of viral infections. In addition, vitamin D stimulates the body's own synthesis of antiviral substances which specifically block the spike protein necessary for the docking mechanism of covid-19 to the receptor protein ACE2. All of this is well-researched, published information that clearly shows us that vitamin D deficiency patients are in a very unfavourable situation with regard to the risk of pneumonia.
In today's society, a large part of the population suffers from a massive vitamin D deficiency - especially in winter. Statistics often assume that blood values of 20ng/ml are sufficient for vitamin D function. This is wrong! These limits date back to the time when vitamin D was only studied for its effect on bone metabolism. The fact is - and studies in many European countries show this - that depending on the country, 20-40% of people do not reach this value even in summer. One reason for this is the recommendations for vitamin D substitution. It has been published for years that the official recommendations of 400-800 units of vitamin D per day are based on a calculation error by a factor of 10, for which the responsible scientist has even apologized. Unfortunately, this has still not been included in the official recommendations, as they should be in the range of 5000 units per day. Necessary for a stable immune system are blood values of 40-60ng/ml. But most people don't have these values.
This means that technically, we are not currently dealing with a corona pandemic, but with a vitamin D deficiency pandemic. Obviously nobody wants to admit that. And when I hear that a drug can reduce mortality from 11% to 8%. it is is something to wonder at compared to the new studies which show that up to 90% of deaths could be avoided.
So the ultimate question is: Do we want to save lives or not?
My co-author Lorenz Borsche has been trying for a few weeks to find partners in the medical field in Germany who, with his financial support, can determine the vitamin D level in Covid-19 patients. Unfortunately, this is not done routinely by us – not even at a general practitioner's – despite the fact that even the RKI repeatedly announces that our population suffers from a vitamin D deficiency.
Obviously, you have to go all the way to Indonesia to find doctors who do such examinations. The result is exactly what one must expect based on the scientific background described above. At vitamin D concentrations below 20 ng/ml a very large number of patients succumb to the pneumonia triggered by Covid-19, whereas at vitamin D concentrations >30 ng/ml the majority of patients survive and do so with a very good correlation, statistically speaking.
In view of the obviousness of the available information, it would now be time to conduct such a study in Germany as well, in order to verify the available results. After all, many thousands of human lives are at stake and we have one of the best health systems in the world, with highly trained doctors who have all taken the Hippocratic oath. Lorenz has virtually run his feet off, begged and pleaded and offered private, financial support in order to achieve that at least a few hundred vitamin D tests are carried out on Covid-19 patients - but to no avail. How can that be? Vitamin D is obviously one of the unspoken taboos in the world of our medical practitioners.
Lorenz has a different natural disposition than me, writes differently and sometimes embellishes a bit. But I can understand him very well. How is it possible that physicians in poor countries carry out such studies on their own initiative without sponsorship, but in a rich country like Germany you can't find anyone who is willing to do so, not even for donations to finance them? I can understand very well that one would like to shout out loud in view of the massive walls one runs up against again and again regarding vitamin D, especially in view of all the misfortune that the corona pandemic brings with it (see chapter "Tried everything?). I for one am on his side.
Dr. Bernd Glauner, Tübingen, 5.5.2020
LB: Bernd wrote to me about my articles in TP. It soon turned out that he had had the same positive experience with vitamin D for which we both see sufficient scientific plausibility, and both believe that with good vitamin D levels many late corona victims could still live today.
And we both found the confusion of numbers in the press on the subject of Corona terrible: more clarification was needed. I couldn't match his expertise in biochemistry and vitamin research, nor his eminent talent for mathematical analysis of data problems. But I was able to contribute impetus, connections, visual ideas and strategies.
From the graphics and their interpretation rises as a result what we both suspected anyway: The lockdown was necessary, unfortunately. And at the same time a problem, because you can clearly see that it would have to last until a final vaccine is available, even if it is mitigated à la Sweden. But that could be January 2021. With all the serious social and economic consequences. Neither of us can really believe that much-discussed drugs such as Remdesivir will save us, and reports of the side effects are too unpleasant.
We also agree on the evidence from the studies listed below on vitamin D and C-19, including a study involving 780 participants. This may be a factor of 12 smaller than a placebo-controlled double-blind study with 10,000 participants. But it is certainly significant because it shows that infections in groups with deficient vitamin D levels end in death 10 times more often, whereas the statin study to which I allude had shown a difference of just 1.2% in mortality over the years. A minimal difference that was not even statistically significant.
We also agree on the problem, which clearly arises from the curves to be shown at the beginning: Herd immunity is years away. R must remain below or at 1 as long as there is no vaccine. If our figures, especially the R curve, deviate from those of the RKI (allegedly R<1 already on March 23rd), then this may be due to the fact that they are calculated in a purely restrospective way without the need to use predictive models. Prophecies are not our profession and it is easy to be wise after the event :-)
Vitamin D supplementation, i.e. the immunological upgrading of the population to a healthy level that is exemplarily shown by nature to Masai, Hadza and our closest cousins, the chimpanzees, which would allow us to let the SARS-CoV-2 virus spread and to survive the infection together like a wave of flu, so that we can finally get rid of the masks and go back to the restaurant, cinema or stadium, seems to us both to be the only conceivable solution. Which also costs much less money than any other measure. And a fraction of what the lockdown has cost and will cost us - in money and in human lives.
Lorenz Borsche, Heidelberg, 5.5.2020
Often pictures help to understand facts better, maybe even to discover them, which can then be examined mathematically in detail. For the data evaluation of the corona numbers with which we are being confused on a daily basis, I met Dr. Bernd Glauner, an experienced biochemist, developer of medical devices and programmer - incidentally, because of my first vitamin D article on Telepolis - who also knows the world of biotechnology and pharmaceutical research from the inside out from his professional experience. And of course the mathematics required for this.
When I looked at the graphical representation of country data on worldometers.info (select a single country, scroll down, look at the bar graphs), I noticed that infection cases and deaths fluctuated so drastically up and down, but showed similar patterns, and with some days offset seemed to develop in parallel. The peak here matches the peak there, if you go back about 12 days? And the following valley and peak, all offset by about 12 days? Would that allow a prognosis? So the infections of today will give us that many new deaths in 12 days?
The Peak in infections around 26/27 March would then be the peak in deaths on 8/9 April? The one on April 17th matched the one around April 28th?
We have examined this, I with pictures, Bernd Glauner with incorruptible mathematics. In a collaborative effort that was fueled by debate. At first my graphs didn't fit his mathematics or vice versa, but in the end both fit together very well. We took the data from the Morgenpost Monitor, where you can fortunately turn back the pages.
We are plagued on Worldometers.info, the daily dose of madness, right at the start with rather confusing curves: the curve of new illnesses rises and rises and rises, and you have to know that it can never fall in this way, that it would only be over if it were horizontal, because it can never fall if you set it up in such a way that you start from zero and always count up.
If the same were to be done for road deaths, this curve would also only rise continuously since 1870/71. Perhaps flatter from year to year, but always rising. You have to have a very sharp eye to be able to see that the number of new infections (bottom left) is actually falling. And if you now think that logarithmically (middle) it looks better somehow, you will of course wonder. No, it does not, it’s just different:
And this (right) is what the rather incomprehensible "information" looks like, which all magazines like to reprint, here with three curves, all of which have to climb until the Greek calends, if we don't stop saddling up every day (FOCUS on 5.5.2020)
And now? Now let’s see if there is something better, something that is easier for us to make use of. Something from which we can perhaps learn how to go on? Is there a threat of another lockdown after a relaxation? That depends eminently on the question of what effect it has, has had. Can you see that? Bernd? Baton change now! :-)
Data is the new currency of our digital age. Well, if you are able to interpret them. Regarding the Corona pandemic, we are currently suffocating in a flood of data. Every day new highs in case numbers and deaths. Death rates that vary between 0.5% and 20% depending on the country and parameters that are difficult to understand, such as the basic reproduction number Ro (R_zero) and Reff (R_effective). In addition, these data are stirred up daily in a cacophony of opinions that makes interpretation virtually impossible for most people.
Which brings us back to the data. Worldometer provides an excellent corona site. The data is very well maintained, but not necessarily clearly presented. You can see the increases in the number of cases and of course they are increasing daily - even still in China. Apart from the fact that this may frighten many people, there is not much to read from it. The bar charts of the daily increase in the number of infected and dead people are more interesting. We noticed for the first time that there is a clear offset of several days in the curves between the number of newly infected and the number of dead. This is actually logical, as time inevitably passes between testing, admission to intensive care and death. But why does this vary from country to country? Of course you can only see this when you superimpose the curves and unfortunately this is not possible within Worldometer.
I am a "datophile" scientist with a long-standing love for spreadsheets and programming. But where do you get the data from to import it into Excel? The coronavirus monitor of the Berliner Morgenpost is suitable for this. You can import the data of most countries into Excel by copy/paste on a daily basis. No sooner said than done, a little work, but then I had the data.
Next, I created a program with Visual Basic to sort the data of the countries together and then checked what the Germany chart of the daily infected and dead looked like (left). Hmmm, you don't see much, you have to zoom up the death rate curve a little bit, i.e. multiply the numbers, because only a fraction of the infected people die, so that you can compare them visually (right).
Looks better, but the readings are already fluctuating quite a bit. This is partly due to the fact that there is a slight delay in reporting every weekend. This means that the values should be smoothed with a 7-day average (bottom, left).
What do you see now? The curves are similar, but it is quite clear that they are offset by several days. The tines in the red curve are explained by the much smaller number of cases, absolutely smaller fluctuations are also multiplied. Now you could of course optically shift back and forth until it fits. But this can be done more professionally if the data series for an offset of up to 18 days are copied together fully automatically and then statistically evaluated how the daily changes in the number of cases and the death rates fit together best.
Bingo, with 12 days offset, the rise of the curves is compatible with each other! (top right)
And then finally program the Reff value in addition. That sounds easier than it is in practice. In contrast to the basic reproduction number Ro, which is the effective reproduction number that comes into play when part of the population is already immune. It is calculated as the quotient of the number of newly infected persons on the current day divided by the number of newly infected persons 4 days before. 4 days is on average the time it takes for an infected person to infect another person. You can read more about this in the box below.
How can you use the curves? First of all, the label on the Y-axis shows the factor by which the death curve had to be zoomed up so that it is at about the same level as the infected person's curve. This is a measure of our death rate. For Germany, the factor is 24.2, which means our death rate is 100/24.2 = 4.13%. Furthermore you can see in the Germany diagram that the curves do not fit together so well in the further course. The death rates are obviously increasing relatively more than the number of infected persons.
Why is that? We know the cause from the news. This stands for what I consider to be the incredible carelessness with which we have dealt with our nursing homes and care centers. Actually, everyone knew that elderly and disadvantaged people are at above-average risk, but most of those responsible have done nothing! At the beginning of the outbreak, it was mainly young people (e.g. people returning from skiing holidays) who were affected and who had a low mortality rate. Later, more and more older people with high mortality rates came in addition.
Now it becomes interesting when you create the same graphic for other countries. Let's take Spain and Italy as the worst affected countries in Europe.
That looks quite different from the situation in Germany. The offset between the curve of the infected and the curve of the dead is only 3 or 4 days here (see marking in the legend).
What does that mean? Figuratively, we see the effects of an inadequate, overburdened health system here. People are mostly tested only when they come into the clinic or even when they end up in intensive care. Some tests are probably even done posthumously. Thus, only a few days pass between testing and death. With the 12 days offset - and a comparison with many other countries shows this - we are doing pretty well in Germany!
Otherwise, you can see at a glance from the curves if there is no end of the pandemic in sight in a certain country. As an example here are the diagrams for Russia and India. With these the Reef value also still clearly above 1.
And here again, it is clear that health systems are not necessarily well positioned with a daily offset of 4 or 6 days.
That leaves Sweden, our special case.
Meanwhile in Sweden the Reff-value has also decreased to about 1. But you can see at a glance that the number of cases is not decreasing as nicely as in Germany. This is the price for not having a lockdown. The death rate seems to be relatively high with 100/5.0 = 20%, but you have to know that in Sweden only hospital patients are tested. This is about 20% of the infected, so for comparison purposes one can rather assume a death rate of 4%, similar to our own.
Sweden has accepted a high risk, but does not have to bear the consequences of a complete lockdown. Moreover, although the death rates per million inhabitants are a factor of 3 higher than here and in Denmark and six times higher than in Norway and Finland, they are only about half as high as in Spain, Italy, France and the UK.
We can pretty much safely assume that the number of infections and deaths will rise again after the opening in Germany. By how much we’ll have to wait and see. In the long run, it will become apparent which approach will ultimately be better ethically, economically and socially.
In Sweden, as elsewhere, 1/365th of about 1/80-82nd of the population dies every day, simply because their life is over. 9.9 million/82/365 = 330. 60 deaths (2660/45) per day are said to have been added by Corona since mid-March. However, this should be seen as excess mortality, over 18% is more than just a severe flu epidemic, and the flu is still to blame sometimes. And this is exactly what the Euromomo-Z-score shows, calendar week 10/2018 is likely to have been the flu wave with the "wrong" vaccine, with a Z-score of 5.3 (i.e. 5.3 standard deviations), in mid-April of 2020 already the three times higher rate, 14.5 standard deviations from the baseline to the new peak value:
Incidentally, you can also see from the steepness of the rise that the sheer infectivity must be much higher than with influenza. This is not an optical illusion either, because the right curve is so much higher, C-19 actually rose from 0 to 14.5 within 3 weeks, with the flu in 2018 it was at least 4, maybe 5 weeks to only 5.3.
This, then, is the disadvantage of a high lag in the death curve: the lethality, which is roughly estimated from the daily data, becomes worse when looking backwards. What is absolutely puzzling, however, is the course of Sweden's curves: While the blue infection curve takes some leaps between mid-April, but does not want to show a clear trend, the (shifted) red curve of deaths drops significantly, actually always a hopeful sign. But such a deviation between blue and red does not occur anywhere else.
Either the Swedes have secretly decided to test not only hospitalized people but also those who develop only mild symptoms and have to be quarantined but not hospitalized. Or the data is rubbish. We would wish them the former, but for the latter we are in the dark and will never know whether or not the state epidemiologist Tegnell was wrong in his voluntary course.
And you can also see that Sweden's Reff is larger than in Germany. That looks minimal, but it has consequences. You can now see very clearly what they are on the Germany curve, and the lockdown opponents have to wonder:
The R-curve, coming from a good 3, falls until 13 March, then rises again briefly, only to fall very sharply from 15 March onwards - as repeatedly stated by all lockdown critics. The ban on major events as well as the self-discipline of the population show their effect, R drops below 1.4. But threatens to rise again slightly on 24/25 March, the good-intentions-effect diminishes. The lockdown then brings Reff from 1.3 on 26 March to just 0.7 on 6 April. If you think that this is nothing at all, take a look at the two pictures, created with the nice toy from a ZEIT article:
And as soon as R rises a little again, Ms Merkel's worry lines get deeper. You have to understand, she is a physicist, and Fukushima has made it very clear to her what an exponential event is: unstoppable.
The physicist Jochen Ebel has compared corona with nuclear fission in an email:
A decaying U235 atom has an R0 of 2-3 (neutrons approximately analogous to new infections). Due to the "hygiene" in natural uranium, most infections are caught by U238, so that R is clearly below 1. Through technical measures (e.g. brake rods), an R of 1 is achieved in the nuclear power plant and with the continuous new infections (=neutrons) the nuclear power plant will function stably for years. But if something goes wrong (unintentionally Harrisburg, Chernobyl, Fukushima, intentional nuclear bomb) then R becomes greater than 1 and an explosion occurs.
And I would add: the "infection" processes during nuclear fission happen in the nanosecond range, where even an R=1.1 triggers a neutron avalanche within seconds. In the case of corona, it is 4 days on average from generation to generation, but still R must not rise above 1 in the long term if we want to avoid great suffering.
What does not reveal itself to me is the warning of the second wave. There is no biological or mathematical reason why a second wave should be worse than the first. But of course an increase of R over 1 over several days or weeks will almost certainly trigger a lockdown again.
What is unpleasant is that it is possible to calculate how much time would have to pass until at least 2/3 of the population would have had C-19 and would (hopefully) be immune, given the current level of infections and R=1, i.e. neither increasing nor decreasing numbers of infections: Too much. Even with a very high dark figure of 5, this would take years. A solution looks different.
On 2 May a PDF reached me from Indonesia. Prabowo Raharusuna and his colleagues had examined 780 Covid-19 patients. For vitamin D. Sponsored by? No one. Author conflicts? None. The result: depressingly clear:
After correction for age, sex and previous illnesses, the risk of death is 10 times higher for people with vitamin D deficiency. For insufficient D status still 7 times higher compared to sufficient, good D level.
In order to make the evaluation transparent and easy to interpret even for non-scientists, Sadiah Priambada, the statistician in the team, prepared the data in such a way that the three comparison groups with vitamin D level groups of <20, 20-30 and 30+ ng/ml can be assessed on the basis of an equal age average and an equal number of cases. This more easily readable evaluation leads to practically the same results as the original data as a whole.
We could not standardize the comorbidity (previous diseases), too few cases would have remained. So we must not compare the percentages of the dead and attribute everything to vitamin D, that would give a result that would be too high, here about 30:1. Every simplification has its limits. Whether pre-existing comorbidities are possibly also a consequence of decades of vitamin D deficiency will have to be proven in future studies.
(The original data can not only be found in the study linked above, we have also provided a comparison with detailed explanations of the data reduction and comments by Sadiah Priambada here as a PDF file).
However, the Indonesians use the international guidelines of the WHO: 20 ng/ml is already considered deficient, 20-30 is insufficient, only more than 30 ng/ml is considered normal. In Germany, outdated, clearly lower values apply: more than 20 ng/ml is already "normal", 10-20 a little bit insufficient, and only below 10 ng/ml a deficiency worthy of treatment is established. However, this is not treated, because it is not measured, and costs 30 Euros, which the health insurance company is reluctant to pay and only does pay with lengthy explanations from the doctor. Simply measuring, where would that end us?
Over 80% of healthy German seniors have normal values, i.e. more than 20 ng/ml. Sick seniors (geriatric patients), however, have 80% insufficient, half even deficient values (see article "Does vitamin D protect against Covid-19?"). From the data of the RKI it can be calculated that 25% of all Germans must have even less than 6 ng/ml in the winter quarter (Dec/Feb). Prabowo Raharusuna, with whom I have made contact in the meantime, could only shake his head. And he immediately pointed me to a small, fine study of his friend in the Philippines, Mark M. Alipio (also without any "funding", i.e. no conflicts of interest, with more than 200 test persons). The results are damn impressive here, too:
Alipio writes about it:
Also, for each standard deviation increase in serum 25(OH)D, the odds of having a mild clinical outcome rather than a severe outcome were approximately 7.94 times (OR=0.126, p<0.001) while interestingly, the odds of having a mild clinical outcome rather than a critical outcome were approximately more than 19.61 times (OR=0.051, p<0.001).
And another one:
Mean serum 25(OH)D level was 23.8 ng/ml. Serum 25(OH)D level of cases with mild outcome was 31.2 ng/ml, 27.4 ng/ml for ordinary, 21.2 ng/ml for severe, and 17.1 ng/ml for critical.
I would like to remind you that in Germany we all have an average of only 18.8 ng/ml over the year, while almost half of the elderly people with pre-existing comorbidities have less than 10 ng/ml, in winter less than 6 ng/ml. If they catch C-19s, then... And there is also the assumption that most people with more than 30 ng/ml would survive a C-19 infection undamaged.
With the 45 ng/ml provided by Mother Nature (Massai/Hadza, see the linked article) possibly almost everyone would. Because, as the table above shows, only 4.3% who had a mild course actually had less than 30 ng/ml D(25), but 95.8% who had a very severe, critical course. That’s supposed to be a coincidence?
And no, the D-level did not change in 95% of the patients during the course of the study. In case anyone wonders why the Filipino patients investigated also did not have more than 24 ng/ml D(25) on average, and thus not much more than we do, with much more sunshine? Exactly for this reason, it is so hot there that they prefer to avoid the sun, as Prabowo told me: "...because the heat from the sun is scorching here in our place. The X factor would just be COVID patients are admitted in a closed area and sun's effect would really not convert the biologically active form of vitamin D in the skin."
Sounds like the situation in nursing homes, except that there is too little sunshine here instead of too much, and the seniors stay inside because it is cold. But of course, I don't want to hide this, he also wrote: "Most people infected are dying because of comorbidity and partly because of the effect of smoking. Heavy smokers as I observed are highly prone to mortality." But "heavy" in Southeast Asia means something different than here.
And Prabowo Raharusuna drew my attention to another study from England, which is now also mentioned here in the press:
The role of Vitamin D in the prevention of Coronavirus Disease 2019 infection and mortality
The researchers around Petre Cristian Ilie tested the number of Covid-19 deaths per 1 million inhabitants against the D-level in 20 European countries:
The mean level of vitamin D (average 56mmol/L, STDEV 10.61) in each country was strongly associated with the number of cases/1M (mean 295.95, STDEV 298.73 p=0.004, respectively with the mortality/1M (mean 5.96, STDEV 15.13, p < 0.00001).
Wait a minute, the high numbers are in Spain and Italy, aren't they? The low ones are in Scandinavia? The researchers explain the statistically significant result with the higher D-level of the Nordic countries:
The Seneca study showed a mean serum vitamin D of 26 nmol/L in Spain, 28 nmol/L in Italy and 45 nmol/L in the Nordic countries, in older people . In Switzerland, mean vitamin D levels are 23(nmol/L) in nursing homes […].
In short: "Older people" have 10 ng/ml in Spain, 11 ng/ml in Italy, but in "Nordic countries" they have 18 ng/ml. In Switzerland the figure is also only 9 ng/ml in nursing homes.
Why do the northerners have the better D-level? Although the sun... ? Maybe they are more "outdoor", but maybe it's the fish - after all, the best-selling baby porridge jars are the ones with fish taste, Claus Hipp once mentioned in a TV documentary as a funny difference in popular taste. And fatty sea fish contains a lot of vitamin D.
So who’s to say that there is no study on the question of whether high supplementation of vitamin D can still help when the emergency has already occurred, i.e. in patients who need to be ventilated. The USA conducted a suitable study in 2016:
High dose vitamin D administration in ventilated intensive care unit patients: A pilot double blind randomized controlled trial (Jenny E. Han et. al.)
Results: A total of 31 subjects were enrolled with 13 (43%) being vitamin D deficient at entry (25(OH)D levels<20 ng/mL). The 250,000 IU and 500,000 IU vitamin D3 regimens each resulted in a significant in-crease in mean plasma 25(OH)D concentrations from baseline to day 7; values rose to 45.7±19.6 ng/ mL and 55.2±14.4ng/mL, respectively, compared to essentially no change in the placebo group (21±11.2ng/ mL), p<0.001. There was a significant decrease in hospital length of stay over time in the 250,000 IU and the 500,000 IU vitamin D3group, compared to the placebo group (25±14 and 18±11 days com-pared to 36±19 days, respectively; p=0.03).
In short: The placebo group had >20 ng/ml, the others were "raised" to 45 and 55 ng/ml respectively with 250,000 and 500,000 I.U. vitamin D injections. While the length of stay of the placebo group in the ICU was 36 days, the 250,000 group had an average of 25 days and the 500,000 group had an average of 18 days. This is a smooth halving. Who’s to say that vitamin D is only good for prevention, but it can't help in acute cases.
And finally a small study on ventilated patients from Iran 2018:
Effect of High-Dose Vitamin D on Duration of Mechanical Ventilation in
ICU Patients (MirMohammad Miri et al. )
Intervention was carried out intramuscularly with 300,000 IU of vitamin D. Instead of 28 days only 18 days mechanical ventilation, instead of 29 only 19 on ICU, instead of 61% deaths only 36%.
For me rather irritating news, however, came from Prabowo Raharusuna, when he linked me this study from the Scientific American:
Glucose metabolism plays a key role in the cytokine storm seen in influenza, and the link could have potential implications for novel coronavirus infections
A question immediately occurred to me, Prabowo answered it:
> urgent question: Do ICU patients get treated with glucosis intravenously??? Could be deadly if the study is right :-(
Yes they are given IV of glucose for energy source as per hospital protocol and physician’s request. This might explain partly why patients with diabetes mellitus are more likely to die compared to patients without. However, I noticed that the tested virus in the study is influenza A virus which although has some similar genetic makeup with SARS-COV-2, could not really be applied to COVID patients. In some patients however, excessive or uncontrolled levels of cytokines are released which then activate more immune cells, resulting in hyperinflammation. More studies shall be needed to verify the results of the study.
> urgent question: Are intensive care patients treated intravenously with glucose ??? Could be fatal :-(
Yes, you will receive IV glucose as an energy source according to hospital protocol and medical request. This could partly explain why patients with diabetes mellitus die more often compared to patients without diabetes mellitus. However, I noticed that the virus tested in the study is the influenza A virus, which has a similar genotype to SARS-COV-2, but cannot really be applied to COVID patients. However, in some patients, excessive or uncontrolled cytokine levels are released, which then activate more immune cells, leading to hyperinflammation. Further studies are needed to verify the results of the study.
It is well known that you have no appetite when you have the flu. Maybe nature is trying to say something with this and would rather have less blood sugar levels? If elevated blood sugar levels, which are often associated with the two co-morbidities diabetes-II and obesity (in New York allegedly the leading co-morbidity), contribute to the cytokine storm, then this not only explains the high mortality of these two groups, but glucose doses in intensive care units – the medical “gold standard” – would perhaps also be counterproductive?
Moreover, what if it turns out that high blood pressure, which we consider to be the No. 1 co-morbidity reason, is in reality just a parallel occurring side effect of a blood glucose level that is too high for this or that reason, so that there would be a multivariate non-causal correlation between the two, leading to the wrong conclusion, namely that it is the *high* blood pressure, whereas it is actually the blood *glucose* level which is ztoo high? Which is also increased with glucose and thus aggravates the cytokine storm?
The NZZ was already speculating in 2016 under the title "Starve a fever - feed a cold":
Mice with a bacterial infection die when they receive sugar infusions. This could affect the care of sepsis patients.
If this also applies to influenza A patients, as the study above shows, does it also apply to corona? In Indonesia this message has apparently not arrived yet, maybe one of the TP readers knows if Covid-19-Intensive patients are also "sugared" by default in our country?
Anyone who asks is a fool for five minutes. If you don't ask,
you're a fool forever. (Chinese proverb)
So, to sum up: If all people, especially the seniors, had a D-level significantly above 30 ng/ml, above 40 ng/ml would be even better, then we would not have to fear C-19. At 45 ng/ml, as found in primitive peoples near the equator (and that must be good for something, because wild chimpanzees have it too), we should hope to lose practically no one else because of C-19, unless the previous illness was so severe that it would have been a matter of days or weeks anyway. So it is similar to the 2018 flu epidemic.
What makes me think so: From the Indonesian study with 780 participants it follows that the risk of death would be only 1/10 if everyone had more than 30 ng/ml. From the Philippine study it follows that with a bad D-level, one has an 8 times higher risk to have a "critical" course. So that is the same. From the Iranian "ventilator study" follows a reduction of mortality by half under artificial respiration if vitamin D is supplemented intramuscularly with 300,000 IU, the American study sees a reduction of the stay in the intensive care unit from 36 to 18 days at 500,000 IU. Same, same. But different! ;-)
Only every tenth person is still in intensive care, half of which can be saved with high-dose D. Maybe even more, if the glucose administration actually turns out to be counterproductive when there is a risk of sepsis, and if it were adjusted. A lethality rate of 2-4% currently assumed would result in 0.1-0.2%, a figure that even a severe flu would reach (2018: 25,000 deaths among perhaps 15-20 million infected persons).
Apart from this, it is highly plausible that the so-called "pre-diseased people" would also benefit significantly from a better D-level, indeed the entire population as a whole.
Moreover, the above studies suggest that a corresponding high-dose intervention would be indicated at the time of hospitalization, not at the time of transfer to the ICU. Which could save even more lives and turn severe courses into mild ones.
And how much does it cost? For a healthy level of ~50-60 ng/ml at 70 kg body weight I take drops with 5.000 I.U. D3 + 200 mcg K2 dissolved in oil, which cost me 7 cents a day. This could be "prescribed" for everyone, if you weigh only 50 kg, you take them only 5 times a week, so on weekdays, if you weigh 90 kg, you take two on Saturday and Sunday. At the beginning everybody takes two to three times the amount for two to three weeks, so that the levels go up quickly. The C-19 patients in the hospitals are immediately brought to health with the above mentioned 500.000 I.E. syringes, ditto the nursing staff, the other non-infected patients similar to the population.
And in 4-6 weeks, we'll call off the lockdown completely, unlock the country again, let the Bundesliga play, open theatres and cinemas, go to festivals and restaurants without face masks again, and let Covid-19 search and find its herd immunity. And look forward to the fact that next year we will all be much healthier than today. Anyone who sees a problem in this has to explain to me why we try toxic stuff like hydrochloroquine and wait for expensive remdesivir when we already have vitamin D and all the evidence that it can really help is so clear. And why we should burn 100 billion in a month-long lockdown when 7 cents a day and per head would do the trick?
But if it all seems so simple, why does it seem to be completely unknown?
In FOCUS I had read that according to a Chinese study with slightly less than 200 Covid-19 intensive care patients, more than one in four, 28%, had died. And all 54 had suffered sepsis, commonly known as blood poisoning, a typical consequence of pneumonia, but of course also of other serious infections.
Then, while googling sepsis and vitamin D, I found a study from Iran that had examined how patients were doing who landed at ICU after surgical intervention. And the clever researchers determined the vitamin D levels and sorted the patients according to them. The result was: 14 times more cases of sepsis in the group with the lowest level than in the group with the highest.
And from my second health book, still unpublished because of Corona, I had a statistic from the BfR, the German Federal Office for Risk Assessment, in my head: 80% of seniors with "pre-existing comorbidities" had a vitamin D deficiency, according to Iranian standards probably even more like 90%. And at least half even had a severe deficiency. Meanwhile, the healthy seniors were, for the most part, reasonably well supplied, according to German standards.
1+1+1 is 3. The C-19 deaths are mainly old to very old people with pre-existing comorbidities, i.e. the group that has a severe vitamin D deficiency, mostly in our country but probably everywhere, especially in winter. C-19 victims die of or with sepsis, say the Chinese. Sepsis is 14 times more common among those who have a vitamin D deficiency, say the Iranians. I think the conclusion can be drawn by everyone. So what to do? Very simple: measure the D level in C-19-positive test persons, note the course of the disease, 20 days later the statistics are ready.
With that I set off, to the SPIEGEL about an editor who knows me from PISA times, to the Morgenpost with its great monitor, to Tom, Dick and Harry, have bothered business magnates with it, whom I still know from earlier, have written to the Schwabing chief physician Wendtner, of course also to the virologist Drosten via website. I wrote to the head of a very large clinic, who quietly supplements his own cancer patients with vitamin D, which means he should be open to it, and by that time had already cleared beds for C-19 patients, sent the mail with statistics (BfR, China, Iran) through a mutual friend, together with the offer to pay for 120 D-tests personally, if they were only done. To the Drosten team via the parents (chance encounter on the street) of one of his right hands. Mrs. Will and Mrs. Illner via their audience question address. Mrs. Martini from NDR, who podcasted Mr. Drosten daily and actually asked him the vitamin D question just before.
Reactions? None at all. Oh, I forgot: the completely unknown Iranian study appeared in a SPIEGEL article a week after my mail, slightly incoherent, because the article was about vitamins and corona, not about sepsis after surgery. But still. But then declared unimportant, unclear, ineffective with the most spurious arguments.
Then I thought about money. I wanted to sacrifice my nest egg, because with a real lockdown it wouldn't last long either. The idea: a full-page advertisement, an open letter to Wendtner, Drosten et al. So I asked a large press house that is involved in Corona. Yes, they would send me an offer for two major daily newspapers, quickly. To be fair, I sent the proposed text right after it. The next day the refusal, the managing directors of the two newspapers had unfortunately declined. How? Making money in the Corona crisis refused? Where today every conspiracy theorist can give his two cents on YouTube and get millions of clicks?
Maybe there's another way, perhaps do the study myself? Through a German-Italian doctor at Lake Garda, I tried to organize contact to the community of Vò, where all the inhabitants had been tested, the 89 infected people are known and also the course of their illness. The subsequent D-tests would not have cost 3,000 Euros, which I would have donated. Ground to a halt because of Italian bureaucracy.
Maybe in Germany? Called the mayor in Tirschenreuth, very nice, sociable man. Unfortunately not responsible for the district hospital, but he gives me the name and number of the district administrator and the recommendation to call there. Of course I can only reach the secretariat. 5,000 Euro offer was presented – and I was listened to surprisingly patiently. "We'll call back". I am still waiting for the call back today – oh no, not for weeks now.
In between, I had the Corona website built with everything I knew about the topic. And then a little redemption: Telepolis accepts an article on the topic and I am allowed to present everything I know in it, including a side blow to the SPIEGEL. And then there's a follow-up. And a second article which, because of a trifle in the title, apparently develops high clickbait quality and breaks the commentary record. Such an article doesn't write itself standing on your head either, you've been sitting there for a few hours, hmmm, rather days...
Have I tried everything? Other than a demonstration of self-immolation: Yes, as far as I can tell. I would also have voluntarily let myself be infected, but an anecdotal individual attempt, who would that help? I'm no Robert Koch and we don't have 30 years.
All the people I have asked (and I have asked them all) have not come up with anything better. My quiet hope was and is: Telepolis is read by many journalists who write mainstream but inform themselves "offbroadway", just not to miss anything. Will that be enough? I don't know, but that's all I can do. Except, together with Bernd, to write this article and hope that it will be read somewhere where it would be really relevant, in the Charité, in Schwabing, in Düsseldorf, where Mr. Laschet is waiting so eagerly to be able to open up the country again.
So what do you do, convince others? Search for studies, find them, write them down and hope that someone is interested. Which, as described above, has so far been an almost impossible endeavor.
Why is that?
I have been asking myself this question for a long time, Bernd Glauner has been asking himself, Prabowo Raharusuna in Indonesia has been asking himself,, Mark M. Alipio in the Philippines, who have provided us with these convincing studies, of their own accord, without any public or private funding or support. Just like El James Glicio in New Delhi, retired general practitioner and author of the very fresh, relatively small study "Vitamin D Level of Mild and Severe Elderly Cases of COVID-19", who comes up with identical results:
„Majority (84.6%) of COVID-19 critical patients had Vitamin D insufficiency and 100% of critical patients less than 75 years old had Vitamin D insufficiency.“
El James Glicio "decomposed" the data for us once again into the internationally used D-level grouping (<20: deficiency, 20-30: insufficient, >30 sufficient/good). Visualized it looks like this:
One can see very clearly that the severe cases are predominantly vitamin D deficient, while in the mild cases the good D level is many times higher than the bad.
I have therefore asked Bernd to take a closer look at the scientific knowledge about the effect of vitamin D on viral infections. Here is what he can tell us about it:
(BG) Actually, we Germans are a very science-loving people and our medicine is based not only on clinical examinations but also very much on scientific knowledge. Our country has produced many Nobel Prize winners in the medical field, most notably Emil von Behring, Robert Koch and Paul Ehrlich. In view of the ignorance of our medical experts, one could now get the idea that there are no scientific facts or findings on the effect of vitamin D in viral infections and especially in the development of pneumonia (ARDS) that would make an influence of vitamin D on covid-19 infections conceivable.
The exact opposite is the case!
Our scientists have extensively investigated how and where vitamin D intervenes in the relevant metabolic pathways. Without going into too much detail, the so-called renin/angiotensin system (RAS) is of particular importance. The misregulation of this system in vitamin D deficiency contributes significantly to the development of ARDS and the triggering of a cytokine storm. Dr. Renu Mahtani, an American physician of Indian descent, has compiled a very nice summary on this topic with quotations from the most important publications. She proves very impressively that - as already mentioned in the introduction - we are not actually dealing with a Covid-19 pandemic, but with a vitamin D deficiency pandemic, and a sufficient supply of vitamin D is sufficient to keep Covid-19 largely in check.
Here is a very convincing presentation (in English).
(LB) Then where does this "disinterest" of our medical doctors come from, which sometimes even seems to take on active forms? How is it that our state epidemiologist can freely admit that he has no idea about vitamins? And nobody, really nobody, thinks that this is strange?
If I weren't so much standing with both feet on the ground, so completely resistant to conspiracy theories, I would draw certain conclusions from the fact that a scientific-objective educational video, such as the one by Renu Mahtani, was temporarily blocked by YouTube on the grounds of violating community guidelines. I do not. But the question is always allowed, even obligatory: Cui bono?
At the beginning I wanted to help Lorenz with a little mathematics to get the flood of data on Covid-19 under control. But once you have the graphs in front of your eyes, the question immediately arises whether these scenarios are unchangeable natural law or man-made. I think we were able to show that Germany and many other countries have prevented many Covid-19 infections and thus many deaths by their measures.
But how many more people could have been saved if the information on vitamin D presented here had been consistently implemented? And could we perhaps even have avoided the lockdown with all its consequences for our economy and social interaction? We have great hope that this article will help to ensure that vitamin D will have the place it deserves in the treatment of Covid-19 infections in the future and that we can at least prevent the "second wave" that is already on everyone's lips.
Heidelberg/Tübingen, Lorenz Borsche, Dr. Bernd Glauner, 6.5.2020