CORONAVIRUS

[Motorsport Mickey]

Whilst ...if we continue to use analogy and visionary imagination,...

With regard to Coronavirus the human race are in the position of having jumped off the top of St Mark's already and are hurtling towards the ground. Rapidly approaching and gently descending is a freely released parachute made up of increased Vit D3 daily consumption (let's say 4000iu per day as recommended by the US).  If we snatch the parachute and attach to ourselves it will have the affect of enhancing our immune systems (proven) and with various other health benefits (proven) it may even be found that the increased efficiency of our immune systems may ameliorate any Coronavirus affects if caught allowing a gentle landing whilst science perseveres with experimenting for a cure. We would experience  only a very small chance that the Vit D3 parachute may not be strong enough and tear allowing damage to be actioned upon ourselves. 

In the meantime NICE and PHE still offer the parachute which opens upon impact !

Mick Richards

[Peter Cobbold]

2 hours ago, iain said:

Nice do not dispute that VitD3 Deficiency  is poor for health. PHE have reinforced this with “lockdown and made it abundant clear that high risk self isolators should take 400iu per day. Is this enough..perhaps not but it’s better than nothing and remember it’s in addition to dietary intact and one would hope some exposure to sunlight.

I found the parachute analogy a little daft. Parachutes went though a huge development process, design, testing, refining, more testing QC and finally precision packing and more QC before release for use.............sound familiar ......thought so.

Or alternatively as RogerH "might" say....I have an idea........"I'll sew some straps to a sheet of silk  and a trouser  belt, you put it on and we'll fly my plane up to 10000 feet and you jump out..................it might just work 

Iain
 

The problem is 400 IUpd will not get us above 50 nmol/L which as Indonesia. Philippines etc show is a level that risks severe COVID or death. Incidental sunlight varies enormously between individuals and slip-slap-slop has ensured most are heliophobes. Unlike handwashing the PHE advice is not being advertised.

Peter

[Misfit]

D3 improves you immunity. What’s the situation when you have an over active immune system eg arthritis rheumatoid Psoriatic and taking methotrexate to control the inflammation and effects it causes? 

[Bleednipple]

Evidence, schmevidence.

[sorry, just to be clear, I was responding to John's post about renaissance parachutes!]

Edited May 20, 2020 by Bleednipple

[Peter Cobbold]

1 hour ago, Derek Hurford said:

D3 improves you immunity. What’s the situation when you have an over active immune system eg arthritis rheumatoid Psoriatic and taking methotrexate to control the inflammation and effects it causes? 

Derek,  There are several faces to immunity.  D3 promotes innate immunity that is the first line of defence agaisnt microbes. Adaptive immunity then recognises foreign debris from the invaders and makes antibodies. Immune surveillance recognsies rogue cancer cells. Autoimmunity is when things go wrong and normal cells are attacked as if foreign.  The lympocytes (T and B cells)  are metabolically suppressed by methotrexate. The adaptive immune system is damped down by D3, so a deficicny is not good. This is a vast oversimpification: the immune system is horribly complex.

One of the very first uses of acitve D3   1,25(OH)D3 was in psoriasis. It is applied topically. However I came across a paper in whcih the lead author uses huge doses of D3 supplement to control his psoriasis (50,000 IU pd) - too high for me though, I am risk averse. I found that at 2000 IU pd ( 100 nmol/L for me) my facial psoriatic lesions no longer need betnovate. No arthritis so cant comment on  that. My attitude to D3 is, because of its wide ranging effects in dozens of diseases, is to set my blood level of 25(OH)D3  at physiological 100 to 150 nmol/L  and not try to improve upon 500 million years of evolution by going higher. But for most of my decades I was much lower, too low, with the consequence of an inflamed brain now.

There is  a new angle to immunity that you might explore with GP or specialist. Immune resolution. I take omega3 fatty acids daily and a low dose aspirin 75mg,twice a week **. Together they generate "resolvins" that resolve inflammation by stimulating macrophages to eat up cell debris that might otherwise keep inflammation recurring.  Thhe key researcher is Serhan at Harvard.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4855303/

https://www.jci.org/articles/view/97943

- yes  dauntingly complex,  but your immunology specialist will know, your GP might not. 

Peter

** Resolvins in Parkison's https://www.mdpi.com/1422-0067/20/17/4256#abstractc

Edited May 20, 2020 by Peter Cobbold

[john.r.davies]

2 hours ago, Bleednipple said:

Evidence, schmevidence.

[sorry, just to be clear, I was responding to John's post about renaissance parachutes!]

OK, already!    It was along time ago!

[barkerwilliams]

Interesting read from perhaps a different perspective.

https://thecritic.co.uk/were-all-in-the-big-numbers-now/

Alan

[Bleednipple]

46 minutes ago, barkerwilliams said:

Interesting read from perhaps a different perspective.

https://thecritic.co.uk/were-all-in-the-big-numbers-now/

Alan

Excellent article and I hope it proves correct - ie that C19 has 'baked in' limits to growth and that community transmission is now extremely low. I was certainly struck by reports today that London had zero new confirmed cases today - probably s statistical artefact but certainly only running now about a couple of dozen cases per day and falling.

Nigel

[iain]

An interesting take, but fundamentally flawed in  many ways.

1. How can you compare spread of a normal season flu with a "lockdown" spread of Covid-19? You cant.

2. Ferguson's modelling was based on a "no lockdown" spread and consequential death calculation. Therefore unless he knows better its the "best guess" the Government had.

3. Globally most countries have implemented a lockdown of some sort to mitigate spread, so of course numbers are low, 320000 deaths globally.

4. 320000 Global figure is an absolute guess. Many countries don't,cant or haven't reliably recorded data.

5. A and E admission are down.......yup, time wasters are staying away,  people have less opportunity to have  accidents. Heart attacks... maybe they are less stressed than at work....?

6. Care homes, I wonder which have failed at preventing the spread, Private or Social Care ? This deserves and inquiry, a Private firm has Duty of Care, Social Service funded and run.....well the same Duty of Care.

7. Nocosomal spread is 20%, that means 80% is still spread through Societal transmission.

8. NHS tracing App......an absolute shambles no question

A very well written article but failing to address/ducking some important issues.

Iain

[Bleednipple]

2 minutes ago, iain said:

An interesting take, but fundamentally flawed in  many ways.

1. How can you compare spread of a normal season flu with a "lockdown" spread of Covid-19? You cant.

2. Ferguson's modelling was based on a "no lockdown" spread and consequential death calculation. Therefore unless he knows better its the "best guess" the Government had.

3. Globally most countries have implemented a lockdown of some sort to mitigate spread, so of course numbers are low, 320000 deaths globally.

4. 320000 Global figure is an absolute guess. Many countries don't,cant or haven't reliably recorded data.

5. A and E admission are down.......yup, time wasters are staying away,  people have less opportunity to have  accidents. Heart attacks... maybe they are less stressed than at work....?

6. Care homes, I wonder which have failed at preventing the spread, Private or Social Care ? This deserves and inquiry, a Private firm has Duty of Care, Social Service funded and run.....well the same Duty of Care.

7. Nocosomal spread is 20%, that means 80% is still spread through Societal transmission.

8. NHS tracing App......an absolute shambles no question

A very well written article but failing to address/ducking some important issues.

Iain

I had the same thoughts about your points 2 to 4. The writer ignores the fact that the epi-curve of C19 is an artificial one, due to the lockdown. But does it really matter whether the 'let-it-run' scenario was Imperial's 500,000 deaths, or 'only' say 100,000? The fallacy embedded in the 'herd immunity' contingency planning was that the public would be prepared to accept a 'light' or no lockdown on either of those outcome scenarios. And once the body pile started to approach the thousand a day level at Easter, the public would in any case have been (quite understandably) screaming for a full lockdown anyway.

The irony of that being (as I've argued some way back on this thread and still argue) that the week or so of dithering in March before imposing the measures is probably the single factor that will quite likely turn out to explain maybe as much as 80% of the UK's direct C19 deaths.

It's certainly going to be fascinating looking at the pandemic in hindsight, and the opening proposition of the article - that we are now more-or-less into the endgame, epidemiologically - seems to me probably correct. But with the virus persisting at low levels pending a vaccine, and every new cluster however small having potential to re-panic the population, I also agree with the writer's argument that getting out of the lockdown bunker is now the big challenge.

Nigel

 

[iain]

...but are we at the endgame.....until we open the doors we wont know. I'm still expecting that second peak. Especially as we see the crowds going on "holiday". Devon/Cornwall were a mess yesterday. 

Iain

[Bleednipple]

1 hour ago, iain said:

...but are we at the endgame.....until we open the doors we wont know. I'm still expecting that second peak. Especially as we see the crowds going on "holiday". Devon/Cornwall were a mess yesterday. 

Iain

I agree still plenty of uncertainties but we can look and see what's happened in other countries where lockdown is being eased. I'd hope SAGE is intensely focused on looking at that at this point.

Re people at beaches, in national parks etc, my read of things is that transmission outdoors is now understood as highly unlikely, and given the very low levels of infected people in the wider community after eight weeks of full lockdown, I'd be extremely surprised if a bit of people passing within 2 metres each other on footpaths and on the beachfront is going to be significant, either at a national level or regionally.

To back back that up - and okay I am quoting selectively here:

"Casual interactions outside don’t seem to be driving transmission. " - Adam Kucharski, LSHTM, quoted in Telegraph 11 May.

"Strikingly, only one instance of outdoor transmission — involving two men talking together in the village of Shangqiu, Henan province — was found among our 7,324 identified cases in China with sufficient descriptions.” - report on a study by University of Hong Kong, Southeast University and Tsinghua University, quoted in SFGate.

Ironic that the government and a lot of the public were blase about holding events like the Cheltenham Festival when things were all going pear shaped and transmission patterns were still poorly understood, but at this point when we do know much more about the way the virus seems to work and that it appears outdoor transmission risk is negligible, a full car park in a beauty spot is seen by many as an unacceptable risk, even by folks who aren't going there themselves. We seem to be locked into eight week old patterns of behaviour and even when the science changes, we can't.

Nigel

[foster461]

It is highly unlikely that you would get infected passing someone on a footpath for example or even in the aisle of a large building like a big supermarket. Infection needs exposure and duration. The longer you stay in close proximity to other people the more you need the face mask and social distancing. The masks my wife made are great, they fit well and tie behind the head. I wear mine for three hours at a time with no discomfort.

[barkerwilliams]

"....6. Care homes, I wonder which have failed at preventing the spread, Private or Social Care ? This deserves and inquiry, a Private firm has Duty of Care, Social Service funded and run.....well the same Duty of Care...."

Although I broadly agree with that sentiment I am aware through a friend's experience that some NHS patients with confirmed Coronavirus were discharged/transferred/whatever to care homes. So not necessarily all their own problem.

Alan

[Misfit]

Clean, Isolate, clean and protect, as a private business you make choices, if you are not satisfied that you have the facilities or equipment and can actually take care of the individual you can say No.

Surely you should say no. 

Edited May 21, 2020 by Derek Hurford

[SuzanneH]

No dates given, unfortunately.

Edited May 21, 2020 by SuzanneH

[iain]

Great graph, no source and no legend for the y-axis. I think the graph is a representation of this research.
https://www.carehomeprofessional.com/european-survey-reveals-england-has-lowest-rate-of-covid-19-care-home-deaths/

England has reported the lowest rate of COVID-19 deaths per total fatalities in a study of European nations.

The study by the European Centre for Disease Prevention and Control (ECDC) provides some welcome relief to the UK government which has come under increasing criticism for its handling of the care home crisis.

The research, using ONS data as of May 9, shows there were almost 7,000 COVID-19 care home fatalities in England, amounting to 21% of 33,000 fatalities. Wales reported a higher rate of 25%, while care home COVID-19 death rates in Scotland amounted to 45% of 3,200 COVID-19 fatalities as of May 10.

Elsewhere, the share of care home fatalities per total ranged from 37% in Germany to 66% in Spain, which had seen 18,000 deaths officially reported in care facilities as of May 11.

Rates were also high in France (50%) which reported more than 13,500 COVID-19 care home deaths as of May 11, Belgium (51%), Norway (61%) and Stockholm, Sweden (45%). Italy, which has Europe’s second highest overall fatality rate after the UK, was not included in the research.

While the European comparison favoured England, it should be borne in mind that the ONS is generally accepted to be underreporting the true love number of care home fatalities with the latest estimates suggesting that the ‘real’ death number of deaths is more than double their figure.
Data May 9 th  my Italics.

Iain

[barkerwilliams]

Derek,

Saying no would be great but....

https://www.bbc.co.uk/news/uk-northern-ireland-52762820?intlink_from_url=https://www.bbc.co.uk/news/uk&link_location=live-reporting-story

….there is a rotten underbelly out there.

Sad isn't it, especially for the innocents in the care homes who are just statistics with pre-existing conditions so they don't count.

Alan

[SuzanneH]

Here is how we have been celebrating the Clapping for the NHS workers for tha last few weeks. The young Bangra Drummer is Sachin our next door Neighbour. Most of our neighbours are Sikhs these days.

 

https://www.facebook.com/hogarthsue/videos/10223589670790283/

[Misfit]

On 3/15/2020 at 4:58 PM, Derek Hurford said:

 

When entering Dubai we were interviewed when boarding the ship, everyone’s temperatures was taken before we boarded and more forms. When entering India, more forms and my temperature was taken again. Everyone on board was made to attend the disembarking area whether going ashore or not it was compulsory.

 When we arrived in Heathrow there was nothing, auto passport check gates opened and straight through.  There was a gentleman on board BA flight 198 Row 29H coughing with difficulty breathing when I brought  it to the attention of cabin crew they just asked him was he Ok he said yes and that was it. I later saw the cabin crew rushing to catch an adjoining flight.

Hence I’m keeping clear of my family and everyone else for a week which runs out tomorrow night and even then not attending any events or gathering or visiting friends and  family for another week............

....... I was far more confident at Dubai and Mumbai even when planning to transfer from Dubai to Singapore than I am now. 

 

 

 

 

On 3/15/2020 at 6:30 PM, Mick Forey said:

An interesting analogy trying to illustrate why the timing of any large scale lock-down is important to get right.

Mick

 

Haven’t time changed.

[iain]

Here’s a UK review of the evidence for Vit D3 and Covid.

https://www.birmingham.ac.uk/news/latest/2020/05/high-doses-of-vitamin-d-supplementation-has-no-benefit-in-treating-covid-19.aspx

Having lit the blue touch paper I wait for Peters rebuttals.:-)

Iain

Edited May 22, 2020 by iain

[john.r.davies]

That simplistic demonstration misses the point that it wasn't the right or the wrong time to start or stop containment by testing and quarantine in March.      The UK, thanks to ten years of a political policy of austerity to reduce the size of the State, did not have the capability, as recommended by WHO, to test enough patients to make containment work.    The Gov could not fulfill its responsibility to protect the people, because it had run down all the possible resources that could have achieved it.   At the same time it had reduced the bed numbers in the NHS, HALVING them in the last thirty years, from nearly 300,000 in 1988 to 141,000 in 2018, with 20,000 of them going since 2010.     As a result the Gov panicked, realising that the NHS could not cope with as many sick people as were expected, that they could not contain it by the usual WHO means,  and closed down the country.   

There was, of course, a Labour Gov in that thirty years and some may seek to blame them.   OK, look at the impeccable KIngs Fund graph, and that during the last Labour Gov, bed losses ceased.  It has been Tory Govs that have betrayed the NHS and the Country.

Edited May 22, 2020 by john.r.davies

[RobH]

[Peter Cobbold]

35 minutes ago, iain said:

Here’s a UK review of the evidence for Vit D3 and Covid.

https://www.birmingham.ac.uk/news/latest/2020/05/high-doses-of-vitamin-d-supplementation-has-no-benefit-in-treating-covid-19.aspx

Having lit the blue touch paper I wait for Peters rebuttals.:-)

Iain

Note absence of any supporting evidence for hypercalcamia from high D3

No mention of physiological 25(OH)D3 is 100 - 150 nmol/L

No mention of black.asian vs caucasian responsivty to D3 and prevalence of BAME deaths

No assessment of D3 from sun, compared with contribution from supplements, and hence seasonality seen in NZ, Oz

No mention that skin can generate 10 to 20,000 IU pd from sun giving safe 250 nmol/L in California lifeguards

No mention of where 4000 came from ( USA Inst Med found no adverse effects at 40,000 pd and arbitrarily imposed a 10-fold cut)

No mention of covid severity with 25(OH) form Philippines, Indonesia, Switzerland, Belgium, ( the latter are not "developing counries"

No mention that COVID comorbidities diabetes, hypertension, obesity are also sequelae of D3 deficiency.

No mention that care home inmates have lowest 25(OH)D3 of any cohort.

 

With additions as above the paper could be written to support 2000  to 4000 IU for preventing COVID  Anyone determined to avoid evidence can make a biased opinion, and that is what they have done.  https://nutrition.bmj.com/content/early/2020/05/15/bmjnph-2020-000089  

Where I do agree is D3 does not work as an acute-acting therapeutic, by then its too late. D3 defends us, does not cure.it acts too slowly.

Peter

 

Edited May 22, 2020 by Peter Cobbold

[john.r.davies]

And on the VitD front (and I mean Front!) PeterC's heartfelt advocacy and deep research echoes, I fear that of Linus Pauling, one of the few double Nobel Laureates (Chemistry and Peace) for megadoses of Vitamin C as prophylaxis and treatment of the common cold (Ironically, the other corona virus).     His regime was 3 GRAMS a day (normal requirement, about 100mgs, or thirty times less) and 10 GRAMS if you fell ill.   The concept is no longer considered reasonable.

That such a pre-eminent scientist could be mistaken is just part of science.    Pauling saw his evidence pointing that way, and followed it.     No doubt we will hear more evidence about Vit D.   The Birmingam paper is, again, just part of science, that has no absolute truth to sell.