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Covid-19 and ethnic minorities: an urgent agenda for overdue action

BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m2503 (Published 23 June 2020) Cite this as: BMJ 2020;369:m2503

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Measure serum Vitamin D3 serum levels now!

Dear Editor

Measure serum Vitamin D3 serum levels now!

Emeritus Professor Peter Cobbold believes that The National Institute for Health and Care Excellence (NICE) has already failed us all miserably by not conducting UK studies months ago which included measuring blood levels of Vitamin D3 (25(OH) D3 or cholecalciferol). [1] Randomised control trials (RCTs), and no other science input, have led NICE to decide that >25nmol/L 25(OH)D3 is not deficient whereas evolution of D3 signalling over 500 million years has refined our innate and adaptive immunity and endowed us with a physiological level of 100 to 150 nmol/L.

He believes that NICE is addicted to RCTs and needs to stop treating Vitamin D3 as if it were a xenobiotic. Instead, a report is needed about how Vitamin D3 relates to immune defences. The dramatic results of the observational studies from Indonesia, Philippines, Belgium, Louisiana, India, all point to a dramatic reduction in COVID severity or death at when D3 levels are >75nmol/L. Professor Cobbold is distressed to see British biological expertise being out-paced by developing countries and he thinks that NICE's dilatory intransigence is the culprit. The fact that African and Asians are less responsive to 25(OH)D3 than Caucasians, compounds the impact of their known lower 25(OH)D3 levels.

We need to know our vitamin D3 levels now. Not all of us will have another five years to wait not taking Vitamin D in a trial.

1 Cobbold PH. NICE blinkered by RCTs. https://www.bmj.com/content/369/bmj.m2475/rr

Competing interests: No competing interests

02 July 2020
Ellen CG Grant
Physician and medical gynaecologist
Retired
Kingston-upon-Thames. UK