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Patterns of Covid-19 Mortality and Vitamin D: An Indonesian Study (papers.ssrn.com)
52 points by l_davis 2240 days ago
5 comments

>> the vitamin D hammer and influenza

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4463890/

> A colleague of mine and I have introduced vitamin D at doses that have achieved greater than 100 nmol/L in most of our patients for the past number of years, and we now see very few patients in our clinics with the flu or influenza like illness. In those patients who do have influenza, we have treated them with the vitamin D hammer, as coined by my colleague. This is a 1-time 50 000 IU dose of vitamin D3 or 10 000 IU 3 times daily for 2 to 3 days. The results are dramatic, with complete resolution of symptoms in 48 to 72 hours. One-time doses of vitamin D at this level have been used safely and have never been shown to be toxic.8 We urgently need a study of this intervention.

> complete resolution of symptoms in 48 to 72 hours

Not to be glib, but isn't that about normal for the flu? The reason there's so many folk remedies is that you'll generally recover after a couple of days and attribute it to whatever you did in those days.

For average folks, sure. This study is for 'nursing home residents'.
Always a good idea to get some sun, so do get out more! Crucially, Vitamin D gained via sunlight is significantly more effective for Vitamin D-related health improvements than supplements.

...which kinda points to the problem here: Vitamin D aka getting sunlight aka living an active life is almost impossible to control for.

Consider Bill Gates as an example for a healthy and active 65-year old man who seems to be spending a lot of time outside, considering their perennial tan. It would be perfectly believable for someone like that to have asthma, or well-controlled diabetes, or have had a bout with cancer 15 years ago without any of that having much of an impact on their daily lives.

Now consider an overweight, opiate-dependent patient of the same age, driving their mobility scooter through wall-mart and otherwise not leaving their couch much.

These two people are in the same category here except for Vitamin D levels.

It's also strange that the numbers do not seem to be representative of the larger patient population. Death rates, especially, are far higher. This isn't necessarily a problem, but it could be. One reason might be the limited availability of patients with data on Vitamin D levels. If so, the immediate suspicion is that testing depends on disease severity. Worst case, Vitamin D testing was previously done for some subgroup of patients: for example, levels might be routinely measured for lung cancer patients but not diabetics.

Finally, I'm somewhat suspicious of discretising the measurements into three classes. This obviously throws away part of the data for no immediately obvious reason. And intuitively, the difference between the two classes with Vitamin D deficits seems somewhat low?

> Crucially, Vitamin D gained via sunlight is significantly more effective

Do you have any citations for that?

I can't back that statement up but sunlight has a suite of other non-vitD-synthesis effects too: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5086738/
That's a very interesting paper! It has long been my belief that sunshine is good for you, and so long as you avoid an outright suburn, basically the more the better. Even with respect to cancer alone, from what I've seen in the literature over recent decades it seems undeniable that the reduced risk from various common cancers like prostate and breast cancer far outweighs the possible increased danger from skin cancer since melanoma is comparatatively rare and carcinoma not very dangerous; but mostly this is ascribed to Vitamin D and then taken as a recommendation for Vitamin D supplementation rather than increasing sun exposure. The sun, the primary source of life's energy on earth, remains mostly vilified by medical science.
An earlier study [i] concluded "Vitamin D insufficiency is highly prevalent in severe COVID-19 patients."

[i] https://www.medrxiv.org/content/10.1101/2020.04.24.20075838v...

I've seen several studies finding similar patterns. I also notice the general media has said nothing about this Vitamin D link.

Also interesting to note that African Americans have been hit very hard by covid. This is also a group that is well documented as having higher rates of Vitamin D deficiency. Generally people with darker skin living in higher latitudes have greater D deficiency rates.

Hum, Portugal, Japan, South Korea and China (with a really low deathrate for their population), all eat lots of fish... many african countries and australia have both lots of sun and depend on fish also for their diet.

Spain, eat lots of fish also... but maybe food served on hospital and home retirement was not so equilibrated and many of those people were on other medications that could break the intake before.

Is a promising idea

> Also interesting to note that African Americans have been hit very hard by covid.

Covid-19 will hit members of the community at different times.

A report the other day was taking about White Rural Republicans are currently being hit.

At the end it'll kill people at different rates, in 3 years time we will know when it's spread evenly.

I'm not saying throw it out for black people in cold environments. But there are many other more obvious reasons why at this point in time they have different results and this distracts from the idea D deficiency is important to me.

Fox News, 4 weeks ago: https://www.foxnews.com/opinion/former-cdc-chief-tom-frieden...

Let the downvotes begin!

I've spent a lot of time there.

Yes, the smoking culture is similar to the West in the 70's.

But more important, it's a very hot and humid country, so urban people do not go outside to walk more than a block, and if they do, it's with long sleeves, hijab, etc.

So they're not getting Vitamin D from sunlight in the larger cities.