A surprising 97% of adults in India are vitamin D insufficient, <30ng/ml, the Endocrine Soc min. For elders: 98%<30 & 91%<20 (clinical deficiency). See https://t.co/JNQmO4UdPT How many fewer would be dying in India if basic deficiency/insufficiency had been remedied?

@L_HANK @StuartJRitchie A fundamental question Covid19 raises: how bad does a pandemic have to get before normal (slow) medical approval process w/ high evidence bar switches to more like disaster med (use anything if expected benefit outweighs harm) & can there be a middle ground / gradual transition.

As it is March Vit D levels will rise for people on the northern hemisphere of the world. This doesn't mean all people will get sufficient or optimal vitamin D levels, but levels will rise. Bc more UVB and exposed skin. Images: https://t.co/SlGoQUtF01 https://t.co/UIMnuFhGaI

I am having some doubts about the commercial partnership in this item, however I do hope @DrOz will reach a lot of people with this video:

#VitaminD advice to combat #COVID19 fits with my experience in LTC geriatric patients. 30 elderly patients in my hospital in Ireland had Covid-19 infection, ZERO deaths and no ICU cases. All were on vitamin D 800 iu or more.

To me this fragment sums up the whole discussion. One professor saying we should act on preventing vitamin D deficiencies. The other professor saying it isn't proven yet, despite many signs, giving the shallow argument that people might not comply to other measures anymore.

https://t.co/yAEufLHHy9

NL, my country, is in lockdown since December 15. Today on the news: plans that schools (age 12-18) can open from March 1st for 1,5 day a week. Can you imagine? Young kids at home for such a long period. Such invasive measures and Vitamin D never really considered, despite signs.

Trials testing dose and frequency are important. Frequency is important because other randomized controlled trials have shown that weekly & daily vitamin D doses were protective against respiratory infections but not monthly doses (ie. a single dose). 2/7 https://t.co/rpD72lacR7

All in all, I don't see this as a dismission of the idea to get vitamin D levels up to sufficient, just in case. There is no time to wait. It's safe, cheap and might help.

This is from the article itself in which the authors explain the limitations of the study

One can't expect that a single dose of vitamin D will help patients that already got severe covid, in such a way that they need hospitalizion. It's more interesting when a large group is followed outside of hospital during a longer period of time,that take D and those that don't

So this research doesn't dismiss that vitamin D can be helpful. And considering other RCTs with different research designs are on the way, it's too soon to conclude that vitamin D isn't helpful. Still many questions need to be answered and still many signs that Vit D contributes

Although the @JAMA_current research dismisses the hypothesis that one large shot of vitamin D is helpful for hospitalized covid patients, it does NOT dismiss the hypothesis that a low vitamin D level can cause a more severe course of a covid infection.

Therefore and among other reasons it has taken long for RCTs to appear. Last week also a preprint ( https://t.co/ggaHWaulOz) was released in which a large effect of vitamin D was observed when used in hospital. However this is still in preprint, meaning it's not yet accepted.

RCTs, Randomized controlled trials, are considered to be the most decisive evidence judging an effect of treatment or therapy. However, these are very difficult to set up. One of the reasons for this are ethical grounds, you cannot give one group no treatment, to distinct one

Yesterday @JAMA_current published a research article for a RCT, which dismissed the hypothesis that one large Vitamin D shot is helpful when given to covid-19 that need hospitalization. I would like to discuss this. A thread.

This is a very important study on vitamin D and Covid-19. Its findings are incredibly clear. An 80% reduction in need for ICU and a 60% reduction in deaths, simply by giving a very cheap and very safe therapy - calcifediol, or activated vitamin D.

Link to preprint for The Lancet:

Scotland hospital treating Covid patients with vitamin D amid highly promising data from Newcastle hospitals, the Mail reports today. The five hospitals in the Imperial college healthcare trust in London have also been ensuring people are not deficient in the sunshine hormone