Coronavirus

[Investor20]

Looks like Herd immunity is the only way to go, without a vaccine.

 

On this, I don't disagree.

 

I disagree that Herd immunity is the only way even without Vaccine.

 

There are many ways to mitigate the virus transmission and its effects that are not being pursued. They include ventilation, drugs like HCQ+Zinc, Ivermectin, other small pharma drugs even with successful RCTs and Vitamin D.  However, I want to focus on Vitamin D in this post.

 

https://chrismasterjohnphd.com/covid-19/finally-confirmed-vitamin-d-nearly-abolishes-icu-risk-in-covid-19

Finally Confirmed! Vitamin D Nearly Abolishes ICU Risk in COVID-19

 

The above article is referring to a RCT done using Vitamin D metabolite from liver, Calcifediol (the form that they test in blood for Vitamin D levels).  I understand they used this as it takes several days for Vitamin D to be converted into Calcifediol by liver and hence this form was used in hospital patients for treatment.

 

The results were amazing. 

 

"To account for all of these differences, they adjusted for them statistically. In the adjusted model, vitamin D still reduced the odds of ICU admission by 97%, with the 95% confidence interval ranging from a 75% to a 99.7% reduction in the odds."

 

We can presume a reduced ICU admission by 97% also would result in similar reduction in deaths.

 

As the article points out this is not first time such a result was observed:

 

"These results are consistent with the first observational study on vitamin D, which found that 96% of severe and critical cases occurred at 25(OH)D under 30 ng/mL, whereas 97.5% of mild cases had 25(OH)D above 30 ng/mL."

 

There are also studies showing substantial decrease of infection with Vitamin D.  A recent Univ. of Chicago study showed:

 

https://www.upi.com/Health_News/2020/09/03/Vitamin-D-deficiency-raises-COVID-19-infection-risk-by-77-study-finds/7001599139929/

Vitamin D deficiency raises COVID-19 infection risk by 77%, study finds

 

Why is this so? 

    There are lot of articles talking about T-Cell based crossimmunity from other Coronaviruses for Covid-19.  However there is research showing adequate Vitamin D levels are critical for T Cell immunity to function.  Its referred as a on & off switch. With Vitamin D deficiency, the T Cell immunity will simply shut off.  Here is one reference:

 

https://www.sciencedaily.com/releases/2010/03/100307215534.htm

Scientists have found that vitamin D is crucial to activating our immune defenses and that without sufficient intake of the vitamin - the killer cells of the immune system -- T cells -- will not be able to react to and fight off serious infections in the body. The research team found that T cells first search for vitamin D in order to activate and if they cannot find enough of it will not complete the activation process.

 

Note: Emphasis in bold added

[mattee2264]

Looks like Herd immunity is the only way to go, without a vaccine.

 

Also disagree. Herd immunity requires the majority of the population to be infected which would be a terrible health outcome when there is a good chance by middle of next year an effective vaccine will be wildly available.

 

There is an obvious middle ground of social distancing and mask wearing where social distancing is not possible. And after the hard lockdown was eased it was the perfect opportunity to try it out. But it hasn't been given a proper chance because there has been very little attempt to enforce these measures and compliance has been piss poor. In the UK for example people have swarmed to overcrowded beaches, fill the streets outside bars with drinks in hand, attend mass rallies, and walk side by side with their friends. Perhaps as a result cases have gone from <1,000 a day in the middle of the summer to over 3,000 this week. Of course there is more testing so the results aren't directly comparable. But there is no doubt that cases are rising again and it is gonna be a long winter.

 

The government is already starting to impose new restrictions and if cases continue to rise the restrictions will get more and more onerous until we are back in full lockdown. And in Europe the same scenario will play out. I am not so familiar with the US politics and the US government seems comfortable with a much higher infection rate but I am sure there is still a threshold at which point their hand will be forced especially if other countries in the world are starting to lock down their economies.

[StubbleJumper]

Looks like Herd immunity is the only way to go, without a vaccine.

 

Also disagree. Herd immunity requires the majority of the population to be infected which would be a terrible health outcome when there is a good chance by middle of next year an effective vaccine will be wildly available.

 

There is an obvious middle ground of social distancing and mask wearing where social distancing is not possible. And after the hard lockdown was eased it was the perfect opportunity to try it out. But it hasn't been given a proper chance because there has been very little attempt to enforce these measures and compliance has been piss poor. In the UK for example people have swarmed to overcrowded beaches, fill the streets outside bars with drinks in hand, attend mass rallies, and walk side by side with their friends. Perhaps as a result cases have gone from <1,000 a day in the middle of the summer to over 3,000 this week. Of course there is more testing so the results aren't directly comparable. But there is no doubt that cases are rising again and it is gonna be a long winter.

 

The government is already starting to impose new restrictions and if cases continue to rise the restrictions will get more and more onerous until we are back in full lockdown. And in Europe the same scenario will play out. I am not so familiar with the US politics and the US government seems comfortable with a much higher infection rate but I am sure there is still a threshold at which point their hand will be forced especially if other countries in the world are starting to lock down their economies.

 

 

The question is: In the United States, which will come first, herd immunity by virtue of a vaccine, or herd immunity by virtue of the virus having already run its course?  We are now roughly six months into this pandemic in the US and there have been 6.5 million officially diagnosed cases, but those are only the officially diagnosed.  How many cases have there truly been?  Maybe 60 million?  Perhaps as many as 90 million?  Maybe fewer than 60m or 90m? 

 

If you believe that herd immunity occurs once ~60% of the population is resistant, you would need roughly 200 million people in the US who are resistant.  So are we one-third of the way there right now?  Half way there?  Less?

 

If the vaccine doesn't show up on the scene before the middle of next year, as you suggested, it is entirely possible by that time that new cases will be tailing-off as the US asymptotically approaches herd immunity due to the spread over the previous 12 or 15 months.

 

 

SJ

[John Hjorth]

Thank you for your last post, and thereby reminding me, Investor20,

 

Here up in northern Europe [Denmark], we're now gradually entering what I call "the dark season" [which I simply hate!].

 

I've now put purchase of Vitamin D on my TO-DO list for Monday. [i don't know if the Lady of the House and I are in a state of Vitamin D deficiency or not - No need to challenge the fate.]

 

Disclosure : I've had two post signatures over the years here on CoBF. The first one, until I switched to the incumbent a few years ago, was : "Don't worry about getting old - It doesn't last that long." [Needless to say, that I'm happy for the switch back then today! [ ; - D]].

[Cigarbutt]

@Muscleman

This continues to be an interesting perspective. A few things:

The Swedish 'authorities', from the start, took some decisions. From official reports and from discussions with actual people on the ground, it was clear that reaching herd immunity was not the goal although it could be a side effect of their strategy subject to a path based on sustainability. They (people and the leaders) were shaken by the actual turn of events (severity). One can admire them for the way the social contract on this was 'negotiated' (based on fairness, transparency etc).

Immunity in Sweden is highly heterogeneous with significant variations between different regions and the capital. Even in the capital, immunity levels are quite variable as many sub-groups and some ethnicities were more highly 'involved' than others. It's hard to use a binary concept of herd immunity when there is such variable levels of acquired immunity.

The graph below is from an article published 2 days ago, whose angle is "they were right all along". i think you're good at "reading graphs" and i have a technical and a fundamental question.

1-When looking at countries but Spain, isn't it possible to expect a resurgence in most countries including Sweden but with Sweden's curve being delayed and lessened because of the the way they dealt with the problem?

2-If herd immunity is the variable to look at and if Sweden achieved it, considering that the area under the curve for these graphs is a reasonable indicator of the pain that needs to be endured for herd immunity to occur, how do you explain Spain (and soon France)?

 

@Investor20

Thanks for the post as this is an area that interests me. It would be great to have new and more specific data. Do you know about snake oil? It's a long story (which i will abstain from telling but you can look it up easily) but basically it started with a good idea in China which was imported to the US and the idea was denatured to such a degree during the Spanish Flu that it acquired a new meaning. Apologies for the apparent 'attack' on what you bring to this topic but trust and respect for science needs to be rebuilt and sometimes things happen at the margin. The facts that some stuff is inexpensive and that, at least, there is some rationale behind it, in no way lessen the potential risk for conceptual credibility for the entire enterprise.

 

@StubbleJumper

If your idea is directionally correct, a side effect would be an ability to compute (with some adjustments) the number of deaths required to acquire herd immunity. It would be nice for We, The People to know about this.

https://ourworldindata.org/grapher/daily-covid-deaths-per-million-7-day-average?year=latest&time=2020-02-28..latest&country=ITA~USA~GBR~KOR~CAN~DEU~SWE

 

[John Hjorth]

Israel is an interesting case right now as they have to backpedal and go back to various lockdown measures. It's a delicate balance.

Herd immunity is likely not a significant issue here and at this point as they were able to contain the virus earlier. The key aspect appears to be related to stringency measures applied compared to others. Early on they ranked higher on the stringency index and, for the last few weeks, have ranked quite a bit lower on the index, relatively.

The spread now is more into the younger cohorts, the "vulnerables" are probably better protected and medical care has improved (more because of a better combination of timely treatments than new treatments) and the death curve is less ominous but it's a delicate balance.

The dynamics around this virus have a lot in common with fires in the wild.

 

Cigarbutt,

 

Ref. this quoted post of yours, and the chart in your last post [where Denmark is charted, too], right now [started at 15:00 hours local time] there is a Police Press Conference on the Danish News Channel called TV2 News.

 

The whole ting reminds me about a doctor [i think he was american], stating some time ago, that he was fighting on two flanks :

 

1. The virus

2. The ignorance and the reckless stupidity of the population [, generally speaking].

 

- - - o 0 o - - -

 

Personally, I've lost all faith & hope in a definitive solution to this situation without a vaccine [, though I still hope I'm wrong].

[StubbleJumper]

@Muscleman

This continues to be an interesting perspective. A few things:

The Swedish 'authorities', from the start, took some decisions. From official reports and from discussions with actual people on the ground, it was clear that reaching herd immunity was not the goal although it could be a side effect of their strategy subject to a path based on sustainability. They (people and the leaders) were shaken by the actual turn of events (severity). One can admire them for the way the social contract on this was 'negotiated' (based on fairness, transparency etc).

Immunity in Sweden is highly heterogeneous with significant variations between different regions and the capital. Even in the capital, immunity levels are quite variable as many sub-groups and some ethnicities were more highly 'involved' than others. It's hard to use a binary concept of herd immunity when there is such variable levels of acquired immunity.

The graph below is from an article published 2 days ago, whose angle is "they were right all along". i think you're good at "reading graphs" and i have a technical and a fundamental question.

 

1-When looking at countries but Spain, isn't it possible to expect a resurgence in most countries including Sweden but with Sweden's curve being delayed and lessened because of the the way they dealt with the problem?

2-If herd immunity is the variable to look at and if Sweden achieved it, considering that the area under the curve for these graphs is a reasonable indicator of the pain that needs to be endured for herd immunity to occur, how do you explain Spain (and soon France)?

 

@Investor20

Thanks for the post as this is an area that interests me. It would be great to have new and more specific data. Do you know about snake oil? It's a long story (which i will abstain from telling but you can look it up easily) but basically it started with a good idea in China which was imported to the US and the idea was denatured to such a degree during the Spanish Flu that it acquired a new meaning. Apologies for the apparent 'attack' on what you bring to this topic but trust and respect for science needs to be rebuilt and sometimes things happen at the margin. The facts that some stuff is inexpensive and that, at least, there is some rationale behind it, in no way lessen the potential risk for conceptual credibility for the entire enterprise.

 

@StubbleJumper

If your idea is directionally correct, a side effect would be an ability to compute (with some adjustments) the number of deaths required to acquire herd immunity. It would be nice for We, The People to know about this.

https://ourworldindata.org/grapher/daily-covid-deaths-per-million-7-day-average?year=latest&time=2020-02-28..latest&country=ITA~USA~GBR~KOR~CAN~DEU~SWE

 

 

Yep, if you are so inclined, it's a pretty basic exercise to estimate the potential number of deaths in the US that would be associated with the virus running its course.  If you believe that herd immunity kicks in when ~200m have already had the virus (ie, ~60% of 330m population), and if you believe that the IFR is ~0.4%, you'd be looking at perhaps 800k covid deaths in the US over the 18 month epidemic.  As a check of that arithmetic, the US is currently at ~193k deaths right now, which mainly reflects cases diagnosed up to about 3 or 4 weeks ago (ie, over the past 28 days there are about 1m officially diagnosed cases and probably about 20k more deaths in the pipeline for those ~1m infections that already exist today).

 

The numbers are large, but none of that is particularly new.  Larger numbers have been trotted out from various models over the past six months, but public policy in the US has evolved in its own particular way irrespective of the potential magnitude.

 

 

SJ

[StubbleJumper]

 

1-When looking at countries but Spain, isn't it possible to expect a resurgence in most countries including Sweden but with Sweden's curve being delayed and lessened because of the the way they dealt with the problem?

2-If herd immunity is the variable to look at and if Sweden achieved it, considering that the area under the curve for these graphs is a reasonable indicator of the pain that needs to be endured for herd immunity to occur, how do you explain Spain (and soon France)?

 

 

Cirgarbutt,

 

I would suggest that the area under the curves might not be measuring the same thing for each country.  As we know, the area under the curve measures only a fraction of the "true area" because officially diagnosed cases are a small fraction of the actual number of cases (many are asymptomatic or have very mild symptoms).  What is actually being measured by the Swedish curve?  It's a measure of diagnosed cases in a country that seems to view covid as inevitable and mild for most demographics.  Given that attitude in Sweden, is it likely that many people bother to get tested?  The worldometer data would seem to lend a little support to that view as Sweden has 124k tests per million population, while Spain is at 214k tests per million.  If testing is one of the drivers of the number diagnosed outcomes per million, all other things being equal, you would expect the area under Spain's curve to be greater than the area under Sweden's curve.

 

None of that, however, it meant to suggest that there is not a great deal more pain awaiting both countries.

 

 

SJ

[muscleman]

@Muscleman

This continues to be an interesting perspective. A few things:

The Swedish 'authorities', from the start, took some decisions. From official reports and from discussions with actual people on the ground, it was clear that reaching herd immunity was not the goal although it could be a side effect of their strategy subject to a path based on sustainability. They (people and the leaders) were shaken by the actual turn of events (severity). One can admire them for the way the social contract on this was 'negotiated' (based on fairness, transparency etc).

Immunity in Sweden is highly heterogeneous with significant variations between different regions and the capital. Even in the capital, immunity levels are quite variable as many sub-groups and some ethnicities were more highly 'involved' than others. It's hard to use a binary concept of herd immunity when there is such variable levels of acquired immunity.

The graph below is from an article published 2 days ago, whose angle is "they were right all along". i think you're good at "reading graphs" and i have a technical and a fundamental question.

1-When looking at countries but Spain, isn't it possible to expect a resurgence in most countries including Sweden but with Sweden's curve being delayed and lessened because of the the way they dealt with the problem?

2-If herd immunity is the variable to look at and if Sweden achieved it, considering that the area under the curve for these graphs is a reasonable indicator of the pain that needs to be endured for herd immunity to occur, how do you explain Spain (and soon France)?

 

@Investor20

Thanks for the post as this is an area that interests me. It would be great to have new and more specific data. Do you know about snake oil? It's a long story (which i will abstain from telling but you can look it up easily) but basically it started with a good idea in China which was imported to the US and the idea was denatured to such a degree during the Spanish Flu that it acquired a new meaning. Apologies for the apparent 'attack' on what you bring to this topic but trust and respect for science needs to be rebuilt and sometimes things happen at the margin. The facts that some stuff is inexpensive and that, at least, there is some rationale behind it, in no way lessen the potential risk for conceptual credibility for the entire enterprise.

 

@StubbleJumper

If your idea is directionally correct, a side effect would be an ability to compute (with some adjustments) the number of deaths required to acquire herd immunity. It would be nice for We, The People to know about this.

https://ourworldindata.org/grapher/daily-covid-deaths-per-million-7-day-average?year=latest&time=2020-02-28..latest&country=ITA~USA~GBR~KOR~CAN~DEU~SWE

 

There is a saying that traders trade for a living and analysts analyze for a living.  :)

In the world of investing, we need 10 variables to reach a decisive conclusion but we only have 2. What do you do? Either wait for longer or make an educated guess and act.

 

Going back to your questions, I would assume different countries have different standards for who can get tested. It is pretty easy in the US, especially in Seattle. I just fill out a form online and someone delivers a test kit to my front door by 2 pm, and I test myself and put it back at the front door by 3 pm, and someone picks it up that same day.

But some other countries can be very difficult to get it tested. I have no way to know if Spain has the exact same standard to get tested as Sweden. You have less cases if you have a high bar for testing.

But all I know is this. If you keep the country open, and not many people are wearing masks, and the cases trend down, I smell herd immunity and I act on it. You can keep waiting and waiting until you get comfortable to act on it but likely that's the time when everyone is comfortable and acts on it and likely that's the market top. You have to be able to act ahead of other people.

 

[Cigarbutt]

...

There is a saying that traders trade for a living and analysts analyze for a living.  :)

In the world of investing, we need 10 variables to reach a decisive conclusion but we only have 2. What do you do? Either wait for longer or make an educated guess and act.

Going back to your questions, I would assume different countries have different standards for who can get tested. It is pretty easy in the US, especially in Seattle. I just fill out a form online and someone delivers a test kit to my front door by 2 pm, and I test myself and put it back at the front door by 3 pm, and someone picks it up that same day.

But some other countries can be very difficult to get it tested. I have no way to know if Spain has the exact same standard to get tested as Sweden. You have less cases if you have a high bar for testing.

But all I know is this. If you keep the country open, and not many people are wearing masks, and the cases trend down, I smell herd immunity and I act on it. You can keep waiting and waiting until you get comfortable to act on it but likely that's the time when everyone is comfortable and acts on it and likely that's the market top. You have to be able to act ahead of other people.

From a humble perspective, it's hard to 'see' or 'smell' a short term connection between reaching some kind of herd immunity and market 'movements'. Maybe you can? This thread is more about trying to understand the world. Because of your superior perspective, we are in the unfortunate position that i may benefit from yours without you benefiting form mine. :)

We all have to make decisions based on limited information. How to go about it is the question.

[Investor20]

@Investor20

Thanks for the post as this is an area that interests me. It would be great to have new and more specific data. Do you know about snake oil? It's a long story (which i will abstain from telling but you can look it up easily) but basically it started with a good idea in China which was imported to the US and the idea was denatured to such a degree during the Spanish Flu that it acquired a new meaning. Apologies for the apparent 'attack' on what you bring to this topic but trust and respect for science needs to be rebuilt and sometimes things happen at the margin. The facts that some stuff is inexpensive and that, at least, there is some rationale behind it, in no way lessen the potential risk for conceptual credibility for the entire enterprise.

 

 

https://www.businessinsider.com.au/fauci-takes-recommends-vitamin-d-and-c-supplements-immunity-boost-2020-9

Dr. Fauci says he takes vitamin D and C supplements and that they can lessen 'your susceptibility to infection'

 

“If you’re deficient in vitamin D, that does have an impact on your susceptibility to infection. I would not mind recommending, and I do it myself, taking vitamin D supplements,” he said. “The other vitamin that people take is vitamin C because it’s a good antioxidant, so if people want to take a gram or so of vitamin C, that would be fine.”

[Cigarbutt]

@Investor20

Thanks for the post as this is an area that interests me. It would be great to have new and more specific data. Do you know about snake oil? It's a long story (which i will abstain from telling but you can look it up easily) but basically it started with a good idea in China which was imported to the US and the idea was denatured to such a degree during the Spanish Flu that it acquired a new meaning. Apologies for the apparent 'attack' on what you bring to this topic but trust and respect for science needs to be rebuilt and sometimes things happen at the margin. The facts that some stuff is inexpensive and that, at least, there is some rationale behind it, in no way lessen the potential risk for conceptual credibility for the entire enterprise.

https://www.businessinsider.com.au/fauci-takes-recommends-vitamin-d-and-c-supplements-immunity-boost-2020-9

Dr. Fauci says he takes vitamin D and C supplements and that they can lessen 'your susceptibility to infection'

“If you’re deficient in vitamin D, that does have an impact on your susceptibility to infection. I would not mind recommending, and I do it myself, taking vitamin D supplements,” he said. “The other vitamin that people take is vitamin C because it’s a good antioxidant, so if people want to take a gram or so of vitamin C, that would be fine.”

On a personal level, i continue to be exposed to the real risk of destroying the therapeutic alliance when dealing with poorly substantiated beliefs. This unappreciated risk may be one of the reasons why many people turn to 'alternative' solutions (with outcomes ranging from mild to tragic consequences) and tend to develop disdain for 'experts'. i assume this "tension" can be pushed to another level on an anonymous thread that includes discussions about decision-making processes at the individual and collective levels.

As far as this thread and sub-topic are concerned, the official 'recommendation' is reasonable but, in itself, does not change the weight of evidence.

i've been following the science on this and you may be interested in the following:

https://myorthoevidence.com/Blog/Show/76

 

Again, one has to be flexible and open-minded, especially if the option is available and low-cost but one also has to consider second-order effects. With the Covid outbreak, the amount of research with low, zero or even negative value has exploded and the threshold for publications has been dramatically reduced, even in recognized publications. The cost of this is very high. The evidence that you have brought here so far on this topic has been VERY poor. Also, most of the sources of information on this and related topics are very often one click away from statements that the 'substance' is good for everything under any circumstances and two-clicks away from a 'product' that can be purchased online. The cost of this is also very high.

 

Having said all that, keep the info coming. Personal opinions are OK but weight will be allocated according to solid fundamental data, designs etc.

----) Back to regular programming

 

[muscleman]

...

There is a saying that traders trade for a living and analysts analyze for a living.  :)

In the world of investing, we need 10 variables to reach a decisive conclusion but we only have 2. What do you do? Either wait for longer or make an educated guess and act.

Going back to your questions, I would assume different countries have different standards for who can get tested. It is pretty easy in the US, especially in Seattle. I just fill out a form online and someone delivers a test kit to my front door by 2 pm, and I test myself and put it back at the front door by 3 pm, and someone picks it up that same day.

But some other countries can be very difficult to get it tested. I have no way to know if Spain has the exact same standard to get tested as Sweden. You have less cases if you have a high bar for testing.

But all I know is this. If you keep the country open, and not many people are wearing masks, and the cases trend down, I smell herd immunity and I act on it. You can keep waiting and waiting until you get comfortable to act on it but likely that's the time when everyone is comfortable and acts on it and likely that's the market top. You have to be able to act ahead of other people.

From a humble perspective, it's hard to 'see' or 'smell' a short term connection between reaching some kind of herd immunity and market 'movements'. Maybe you can? This thread is more about trying to understand the world. Because of your superior perspective, we are in the unfortunate position that i may benefit from yours without you benefiting form mine. :)

We all have to make decisions based on limited information. How to go about it is the question.

 

That's actually not true. Whenever I see my opinion being widely agreed upon, I become very concerned about it because there is likely no more value to act on that conclusion.

[Spekulatius]

@Investor20

Thanks for the post as this is an area that interests me. It would be great to have new and more specific data. Do you know about snake oil? It's a long story (which i will abstain from telling but you can look it up easily) but basically it started with a good idea in China which was imported to the US and the idea was denatured to such a degree during the Spanish Flu that it acquired a new meaning. Apologies for the apparent 'attack' on what you bring to this topic but trust and respect for science needs to be rebuilt and sometimes things happen at the margin. The facts that some stuff is inexpensive and that, at least, there is some rationale behind it, in no way lessen the potential risk for conceptual credibility for the entire enterprise.

 

 

https://www.businessinsider.com.au/fauci-takes-recommends-vitamin-d-and-c-supplements-immunity-boost-2020-9

Dr. Fauci says he takes vitamin D and C supplements and that they can lessen 'your susceptibility to infection'

 

“If you’re deficient in vitamin D, that does have an impact on your susceptibility to infection. I would not mind recommending, and I do it myself, taking vitamin D supplements,” he said. “The other vitamin that people take is vitamin C because it’s a good antioxidant, so if people want to take a gram or so of vitamin C, that would be fine.”

 

I do take Vitamin C and D supplements. I have been doing this pre-Covid (Vitamin D, since diagnosed with Vitamin D deficiency a couple of years ago), but In no way do I assume it is a super drug they will reduce my chance of hospital admission by 95%.

In fact, I think additional Vitamin D intake likely does nothing unless you have been diagnosed with low levels of Vitamin D. There is even a debate if taking Vitamin D does anything at all if you are not deficient. spending some time outdoors in the sun is likely better, but then there is winter time.

 

I expect a marginal impact in my case and think the risk reward is favorable. It might not be favorable if you have issues with your liver and high doses might even be toxic over time.

 

 

[tng]

It's also not clear if low Vitamin D is just a marker some other deficiency. Supplementing with vitamin D may be different than being able to naturally have high vitamin D. It's probably a good idea to supplement with Vitamin D if you are low because it's well studied and safe, but it might not be the miracle supplement if you are doing other things wrong.

[Investor20]

It's also not clear if low Vitamin D is just a marker some other deficiency. Supplementing with vitamin D may be different than being able to naturally have high vitamin D. It's probably a good idea to supplement with Vitamin D if you are low because it's well studied and safe, but it might not be the miracle supplement if you are doing other things wrong.

 

tng.  That study in Spain is a randomized clinical trial between 25OH Vit D vs standard of care (RCT, supposedly the only gold standard of clinical research)

 

https://www.sciencedirect.com/science/article/pii/S0960076020302764

Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: A pilot randomized clinical study”

 

Design: Parallel pilot randomized open label, double-masked clinical trial.

 

Participants: 76 consecutive patients hospitalized with COVID-19 infection, clinical picture of acute respiratory infection, confirmed by a radiographic pattern of viral pneumonia and by a positive SARS-CoV-2 PCR with CURB65 severity scale (recommending hospital admission in case of total score > 1).

 

Even though they did not provide the incoming patients blood Vitamin D levels there are now many studies showing more serious patients have disproportionately Vitamin D deficiency. Below is one such study:

 

https://www.medpagetoday.com/meetingcoverage/asbmr/88586

At the time of hospital admission, 25(OH)D levels were lower in the severely symptomatic group, at 18.2 ng/mL, than in the mildly symptomatic group, at 30.3 ng/mL, and in controls, at 25.4 ng/mL (P<0.0001 for both comparisons).

 

So both from Causal relationship (more severe patients had lower Vitamin D) and now the Spanish showed one can give 25OH Vitamin D (Calcifediol) upon hospitalization with already pneumonia in radiological patterns and reduced the ICU admission by 95% compared to standard of care in a randomized clinical trial.

 

Once we have randomized clinical trial with such result, supported by other causual relationships, I am not sure why many of you are questioning this? Should they repeat the clinical trial with more patients to confirm?  Yes, absolutely. But it is also difficult to conduct such a study now.  Who will volunteer not to take Vitamin D with such result already available?

 

 

[Investor20]

That Vitamin D protects in respiratory infections is not a new information.  My post above is for Covid 19.  However there were lot of randomized clinical trials done for respiratory infections in general.  Below is a reivew of such studies - published before Covid19 (December 2016).

 

https://www.bmj.com/content/356/bmj.i6583

 

Systematic review and meta-analysis of individual participant data (IPD) from randomised controlled trials.

 

Among those receiving daily or weekly vitamin D, protective effects were stronger in those with baseline 25-hydroxyvitamin D levels <25 nmol/L (adjusted odds ratio 0.30, 0.17 to 0.53) than in those with baseline 25-hydroxyvitamin D levels ≥25 nmol/L (adjusted odds ratio 0.75, 0.60 to 0.95; P for interaction=0.006).

 

Vitamin D did not influence the proportion of participants experiencing at least one serious adverse event (adjusted odds ratio 0.98, 0.80 to 1.20, P=0.83). The body of evidence contributing to these analyses was assessed as being of high quality.

 

Conclusions

Vitamin D supplementation was safe and it protected against acute respiratory tract infection overall. Patients who were very vitamin D deficient and those not receiving bolus doses experienced the most benefit.

.........................

 

I understand Odds ratio 1.0 means no effect.  Odds ratio of 0.3 in patients  with baseline 25-hydroxyvitamin D levels <25 nmol/L by administration of Vitamin D3, means 70% people got protected from respiratory disease.

 

Note: Emphasis in bold added. Not medical advise. Consult your physician

[Cigarbutt]

It's also not clear if low Vitamin D is just a marker some other deficiency. Supplementing with vitamin D may be different than being able to naturally have high vitamin D. It's probably a good idea to supplement with Vitamin D if you are low because it's well studied and safe, but it might not be the miracle supplement if you are doing other things wrong.

...

https://www.medpagetoday.com/meetingcoverage/asbmr/88586

At the time of hospital admission, 25(OH)D levels were lower in the severely symptomatic group, at 18.2 ng/mL, than in the mildly symptomatic group, at 30.3 ng/mL, and in controls, at 25.4 ng/mL (P<0.0001 for both comparisons).

 

So both from Causal relationship (more severe patients had lower Vitamin D) and now the Spanish showed one can give 25OH Vitamin D (Calcifediol) upon hospitalization with already pneumonia in radiological patterns and reduced the ICU admission by 95% compared to standard of care in a randomized clinical trial.

 

Once we have randomized clinical trial with such result, supported by other causual relationships, I am not sure why many of you are questioning this? Should they repeat the clinical trial with more patients to confirm?  Yes, absolutely. But it is also difficult to conduct such a study now.  Who will volunteer not to take Vitamin D with such result already available?

@Investor20

Apologies for the resistance. The 'problem' i have with the approach is not the basic data shared, it's the way authors of studies jump to conclusions and the way you seem to jump on the bandwagon. :)

The data is worth looking at and perhaps to think about but the jumping-rational-steps approach possibly linked to certain beliefs is what leads vaccines to markets without appropriate evaluations and what leads to:

 

-----

The Milan study done by Dr. Gennari includes a very questionable way to establish the three groups (one hospitalized, one working or living in care centers and one being tested for vit D levels in a completely different context). The fact that the real issue of correlated risks is mentioned but not integrated in the thought process before jumping to conclusions is simply mind-boggling. Even if there is some kind of correlation, let's say you formulate the results as an odds ratio versus exposure, if "exposure" to vitamin D deficiency results in a worse outcome, how can you rule out that factors such as race (as a separate independent risk factor) , lower socioeconomic status or other presently risk factors unaccounted for do not 'explain' the difference.

Look at this as a piece of info that may help to integrate the value of vit. D levels into the larger picture:

https://www.apmresearchlab.org/covid/deaths-by-race

What i'm saying is not that vit" D levels are irrelevant, i'm saying that one should start with (or at least consider) the other elephants in the room.

-----

On herd immunity, the following is interesting:

https://marginalrevolution.com/marginalrevolution/2020/09/the-fragility-of-herd-immunity.html

Many comments raise relevant points but i would say that the author gets the bipartisan gist of it.

[Investor20]

How to insert an image inside a post?  I am trying to post Vit D blood levels vs death rate plot for Covid 19.  Thanks

[Cigarbutt]

How to insert an image inside a post?  I am trying to post Vit D blood levels vs death rate plot for Covid 19.  Thanks

Maybe you're pulling my leg but just in case you're serious.

First, a picture is worth a thousand words but i owe you an (scientific) explanation for the partisan picture: Taking into account the pathophysiology of the virus, its mode of transmission and multiplication as well as socio-sanitary data from the area where the rally occurred, it's likely that many will become sick, some will be hospitalized +/- requiring ventilatory support and a few may have signed their own death warrant.

For the method to insert an image (please accompany with a scientific explanation, especially for the causation part), you can use (click on) the bottom-left item on your screen above the smiling emoji and obtain: [ img ] [ /img ], then insert your url link with a proper image format so that it becomes: [ img ] http://www.blablabla.png [ /img ].

i also learned earlier this year (from an exchange between posters of whom at least two are vit.D fans) how to change the size of the picture to improve the 'fit'. For example:

 

http://tylervigen.com/correlation_project/correlation_images/per-capita-consumption-of-cheese-us_number-of-people-who-died-by-becoming-tangled-in-their-bedsheets.png

http://tylervigen.com/correlation_project/correlation_images/per-capita-consumption-of-cheese-us_number-of-people-who-died-by-becoming-tangled-in-their-bedsheets.png

 

So, by using: [ img ] [ /img ] and changing it to: [ img width=# ] [ /img ], # being something like 200 to 900, you can adjust size.

BTW, the correlation coefficient for the above data is a solid 0.95 so i've petitioned my local jurisdiction to limit cheese consumption even if it may have an adverse effect on vit. D levels at the population level.

In a show of good faith, i will accept a recommendation to take vit.D during the next winter if you submit a specific product (i need help). Please not the product that contains fermented and rancid cod oil.

Hope this helps but i'm starting to wonder.

[StubbleJumper]

The classic graph is the one that demonstrates clearly that climate change has been caused by the disappearance of pirates:

 

 

 

 

 

Obviously, to combat climate change, we need the Crown to issue a few more "letters of marque."

 

 

 

SJ

[Investor20]

How to insert an image inside a post?  I am trying to post Vit D blood levels vs death rate plot for Covid 19.  Thanks

Maybe you're pulling my leg but just in case you're serious.

First, a picture is worth a thousand words but i owe you an (scientific) explanation for the partisan picture: Taking into account the pathophysiology of the virus, its mode of transmission and multiplication as well as socio-sanitary data from the area where the rally occurred, it's likely that many will become sick, some will be hospitalized +/- requiring ventilatory support and a few may have signed their own death warrant.

For the method to insert an image (please accompany with a scientific explanation, especially for the causation part), you can use (click on) the bottom-left item on your screen above the smiling emoji and obtain: [ img ] [ /img ], then insert your url link with a proper image format so that it becomes: [ img ] http://www.blablabla.png [ /img ].

i also learned earlier this year (from an exchange between posters of whom at least two are vit.D fans) how to change the size of the picture to improve the 'fit'. For example:

 

http://tylervigen.com/correlation_project/correlation_images/per-capita-consumption-of-cheese-us_number-of-people-who-died-by-becoming-tangled-in-their-bedsheets.png

http://tylervigen.com/correlation_project/correlation_images/per-capita-consumption-of-cheese-us_number-of-people-who-died-by-becoming-tangled-in-their-bedsheets.png

 

So, by using: [ img ] [ /img ] and changing it to: [ img width=# ] [ /img ], # being something like 200 to 900, you can adjust size.

BTW, the correlation coefficient for the above data is a solid 0.95 so i've petitioned my local jurisdiction to limit cheese consumption even if it may have an adverse effect on vit. D levels at the population level.

In a show of good faith, i will accept a recommendation to take vit.D during the next winter if you submit a specific product (i need help). Please not the product that contains fermented and rancid cod oil.

Hope this helps but i'm starting to wonder.

 

No, I am not pulling any body leg.  I wanted to post a graph from a pdf article, not from a website. I can extract the plot itself as an image.  Is there a way to post that inside the article instead of as an attachment? Thanks for the information to post from website but that is not what I am looking for.

 

The primary article on Calcifediol and also the meta-analysis about Vitamin D for respiratory infections are both randomised clinical trials.  They are not causual.

 

In addition there is lot of causal data.  Why are you StubbleJumper and Cigarbutt so hungup on causal studies part of my post ignoring the randomised clinical trials which are interventional trials?

[StubbleJumper]

How to insert an image inside a post?  I am trying to post Vit D blood levels vs death rate plot for Covid 19.  Thanks

Maybe you're pulling my leg but just in case you're serious.

First, a picture is worth a thousand words but i owe you an (scientific) explanation for the partisan picture: Taking into account the pathophysiology of the virus, its mode of transmission and multiplication as well as socio-sanitary data from the area where the rally occurred, it's likely that many will become sick, some will be hospitalized +/- requiring ventilatory support and a few may have signed their own death warrant.

For the method to insert an image (please accompany with a scientific explanation, especially for the causation part), you can use (click on) the bottom-left item on your screen above the smiling emoji and obtain: [ img ] [ /img ], then insert your url link with a proper image format so that it becomes: [ img ] http://www.blablabla.png [ /img ].

i also learned earlier this year (from an exchange between posters of whom at least two are vit.D fans) how to change the size of the picture to improve the 'fit'. For example:

 

 

 

So, by using: [ img ] [ /img ] and changing it to: [ img width=# ] [ /img ], # being something like 200 to 900, you can adjust size.

BTW, the correlation coefficient for the above data is a solid 0.95 so i've petitioned my local jurisdiction to limit cheese consumption even if it may have an adverse effect on vit. D levels at the population level.

In a show of good faith, i will accept a recommendation to take vit.D during the next winter if you submit a specific product (i need help). Please not the product that contains fermented and rancid cod oil.

Hope this helps but i'm starting to wonder.

 

No, I am not pulling any body leg.  I wanted to post a graph from a pdf article, not from a website. I can extract the plot itself as an image.  Is there a way to post that inside the article instead of as an attachment? Thanks for the information to post from website but that is not what I am looking for.

 

The primary article on Calcifediol and also the meta-analysis about Vitamin D for respiratory infections are both randomised clinical trials.  They are not causual.

 

In addition there is lot of causal data.  Why are you StubbleJumper and Cigarbutt so hungup on causal studies part of my post ignoring the randomised clinical trials which are interventional trials?

 

 

No, I'm not making fun of the studies you quoted, but rather the general tendency to confuse correlation with causation. 

 

On the specific subject of vitamin D, I would say that it was one of Dr. Dalal's most important contributions to this site last April.  For a brief period, he abandoned his aggressively partisan approach to covid to instead provide practical advice about what individuals could do to manage their own risk.  Vitamin D was one of his key recommendations, and frankly, as we approach the equinox, it stands prominently in my mind as a measure that should be adopted.  It is quite clearly a "heads I win, tails I don't lose" proposition because for $10 you can purchase 200 caplets to take you until the next equinox, and in Canada's winter, at worst you'll be a little less deficient than usual in Vitamin D and you'll be out $10.  At best, it could do something for you that is of considerable value.  So, Pascal's Wager?

 

 

SJ

[Cigarbutt]

In the meantime, if present trends continue, it appears that, by the time the vaccines come, only a minority of people will want them. Only 51% of adults would get it today.

 

 

Why?

Many reasons including trust, politicization of issues, confused messages etc

Based on what SJ mentioned last July (in relation to the younger cohorts): "You can appeal to people's sense of solidarity and goodwill to their fellow man all you want, but in the end, people will make a decision based on their own individual risk and benefit." So maybe many are using an inverse Pascal's wager to decide: what I have got to lose (rare side effect) versus no significant gain with the vaccine from an immunity standpoint. There is little to gain from a vaccination program where such a high percentage of the group is taking an individual perspective on this. i wonder if we should just decide on our own what is good for all of us. At noon today, i participated in a webinar from public health and the 'expert' said that this was one of the biggest challenges that they had to deal with during the community spread.

[beerbaron]

Let me bet, other developed countries will get vaccinated at 90%+ rate and be done with it faster than the US. I can't understand the distrusts of the US citizen toward scientists and institutions. Scientific theory, and infrastructure improvement made it so that within 200 years most of us live better than kings on many metrics.

 

Maybe that is just how the CEO of USA conveys it's message, IMO it feels rushed and improvised and that make the population nervous. They feel something is off, or the message is blurred... because as I recall a few years ago the CEO of USA was a bit of a vaccine skeptical. Funny how someone words has a impact on the populace actions much later one.

 

For some reasons, some people fight innovations that have been proven again and again... and again. If the trials have been done in proper form I'll get me, my parents and my family vaccinated without questions. Why would anybody do otherwise? Don't we want to walk in a store breeding freely and see the smile of our neighbors when they feel great? It's in our best interest... just prove to all of us that the diligence has been done and that it's not some kind of banana republic scheme to win our votes.

 

BeerBaron