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Rapid response to:


Preventing a covid-19 pandemic

BMJ 2020; 368 doi: (Published 28 February 2020) Cite this as: BMJ 2020;368:m810

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Rapid Response:

Re: Preventing a covid-19 pandemic

Dear Editor

Prevention and Cure of Covid 19? – A Discussion about Vitamin D Deficiency.
Fiona Smith 7th April 2020

Let’s be clear about this please, I’m not a doctor… But, with years of experience of being a loving mother and registered manager in charge of care for thousands of our older generation, I have had to live with the constant spur of an enquiring mind, especially in relation to procuring best care and support for the people I had responsibility for…

Having recently taken early retirement, my partner and I spent much of February 2020 travelling the Far East; we lived and breathed the emergence of Covid 19 through news and internet. Hand washing and mask wearing was a daily, minute by minute duty. But, on our travels through the heat and sunlight of Cambodia, Lao and Thailand, not only did we learn from locals that the Chinese were their most frequent visitors, but it was also evident they have close economic ties – widespread Chinese, housing and road construction work was heavily in progress; if Covid 19 was going to come knocking on any door, these three Countries would likely be the first to experience a pandemic. But, no pandemic appeared then, or even now. So, WHY?

Sunlight brings the benefit of vitamin D through its interaction and chemical synthesis with our epidermis – the benefits of which go far beyond the production of vitamin D. But, ‘cutting to the chase’, we theorised back then in February, that optimum levels of vitamin D, not only make you feel great, but medical studies (Martineau 2017) suggest it can help prevent respiratory tract infections; we also wondered whether optimum levels of vitamin D could make symptoms of Covid 19, asymptomatic or just extremely mild?

It is known that the death rate from Covid 19 is higher in men than women. It is also known that obesity, diabetes, high blood pressure and old age make your chances of survival more difficult too. It is my opinion that vitamin D deficiency is likely to be the reason, firstly that those with obesity, diabetes and the elderly have suffered more severe conditions related to Covid 19, but that others who don’t have known underlying conditions have suffered such terrible fates too, and these are my reasons:

1. Vitamin D deficiency is prevalent in people with high blood pressure, diabetes and obesity
2. Vitamin D deficiency is prevalent in the winter months due to lack of therapeutic levels of sunshine.
3. The overuse of sunscreens has reduced vitamin D absorption in summer months.
4. Women generally have higher vitamin D levels than men because oestrogen encourages the uptake of this vitamin into the body.
5. Older people don’t absorb vitamin D as effectively as younger people, and are often severely deficient. Generally older people who regularly sunbathe, not only live longer, but are much healthier, suffer less obesity and blood pressure problems and are less likely to suffer bone fractures – I have made this observation from 15 years of caring for the elderly.

I therefore suggest the following measures be taken:
1. Every new suspected case of Covid 19 be tested for vitamin D deficiency, and treated bringing vitamin D status to optimum levels. This would require several measured therapeutic doses of vitamin D, or several doses of full body UVB exposure.
2. Government advice be updated to encourage the UK population to take sensible levels of sunshine therapy and/or vitamin D supplementation at higher levels (4000iu – the upper level recommendation on the NHS website). People who live in flats should be allowed a permit to sunbathe in public areas.
3. Therapeutic vitamin D supplementation be provided to frontline staff and the most vulnerable.
4. Medical trials be actioned immediately, with results available within weeks regarding the value of therapeutic levels of vitamin D supplementation.

Competing interests: No competing interests

08 April 2020
Fiona Smith