Intended for healthcare professionals

Rapid response to:

Editor's Choice

Covid-19: We need to understand the risks to tackle them

BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m3790 (Published 01 October 2020) Cite this as: BMJ 2020;371:m3790

Read our latest coverage of the coronavirus outbreak

Rapid Response:

Re: Covid-19: We need to understand the cause to tackle the risks.

Dear Editor

First things first: cause precedes effects. Understand the cause and the risks become understood.

SARS-CoV-2 is obviously a cause but there is also major contributor in our physiology: most of the human population is seriously deficient in the secosteroid hormone D3. Forget about dexamethasone: we are not deficient in any drug and D3 covers its actions. Ignore convoluted arguments such as Spiegelhalter's and the 4C score, many co-morbidities are traceable to D3 deficiency. Paul Garner might try measuring his 25(OH)D3, it is likely on the floor: severe infections "use up" 25(OH)D3.

There is now an abundance of evidence that a serum 25(OH)D below 75 nmol/L is a risk for severity of COVID and for testing positive. Mechanistic data abound for actions of D3 on innate and adaptive immunity. We know that low 25(OH)D increases expression of the ACE-2 receptor for SARS-CoV-2, the major difference between the pandemic virus and others. The use of oral bolus of 25(OH)D2 by the Cordoba hospital to reduce severity of COVID 25-fold makes dex look antediluvian. Meta-analyses such as Martineau's aggregated data of RCTs almost all using D3 doses decided upon by experts in bone D3 with no reference to the known physiological serum level. When Schwalfenberg doses his patients to 100 nmol/L he found 5 years ago a huge reduction in winter colds and flu. Moreover the use of a "D3 hammer" (one off 50,000 IU) stopped infections progressing.

A scientist would look at his results and think "That's odd", and repeat with a large trial. Instead medicine still quotes appallingly bad RCTs into D3. And turns away: mistakes dont come bigger. It is now blatantly obvious that to get on top of this virus that what we need to do is simple: supplement all to around 100 nmol/L 25(OH)D3, use the D3 hammer to check any infection that arises, and use the Cordoba protocol in pts hospitalised with COVID-19. Two papers are all you need to read:

https://www.cfp.ca/content/61/6/507.long
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7456194/

D3 has been fighting viruses and other microbes for 500 million years, medicine is not going to better it. SARS-CoV-2 has exploited our near global D3-deficiency. First correct that cause and the risks evaporate.

Competing interests: No competing interests

02 October 2020
Peter H Cobbold
Emeritus Professor, Cell Biology
University of Liverpool, UK
North Wales.