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1 hour ago, john.r.davies said:

That doesn't seem to be the story here, and elsewhere.   Poverty is a significant factor in the mortality form CV19.

TB in India is the classic example. Its a disease of the rich. Not enough data  from random sampling to know if same applies to COVID in sunny countries. We will wait and see.

Poverty ,as in dense housing, often multigenerational, will speed spread of virus but notnecessarily  the death rate, Without knowing the whole number infected , by random sampling, we cant tell. Poor diet is a factor in poverty, but D3 is not obtained from diet in signifcant amounts. Exposure to sunshine in impoverished populations eg Syria, Yemen, may protect but no data as yet, but an interesting absence of reports  of mass fatalities.

Blacks and  asians have low 25(OH)D3 AND are poor repsonders to  25(OH)D3 compared with caucasians and are disproportionately dying form COVID in UK and USA.  Political stances are being taken, when it might be effective to take a pill.

The poorer UK BAME are often in front line care jobs, increasing exposure to nthe virus, and large initial doses. BAME hospital consultnats and returning elderly GPs have died, and that cannot be blamed upon either poverty or education. 

I'm not covinced we can aportion suscpetibiltiy to COVID between poverty and physiology - yet.  

Peter

 

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1 hour ago, Bleednipple said:

Yeah and they do "tapps aff" in Glasgow any time the sun peeps oot. No heliophobes them.

:D

Very wise. Makes up for their addiction to deep-fried Mars bars.

https://scotsneedvitamind.com/

Peter

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1 hour ago, Peter Cobbold said:

TB in India is the classic example. Its a disease of the rich. Not enough data  from random sampling to know if same applies to COVID in sunny countries. We will wait and see.

Peter

 

I fear you are mistaken, Peter.  See: https://www.researchgate.net/profile/Malaisamy_Muniyandi/publication/5285122_Socioeconomic_inequalities_of_tuberculosis_in_India/links/54e421350cf282dbed6e988e/Socioeconomic-inequalities-of-tuberculosis-in-India.pdf  Only twelve years old and just the first that came up on the subject.   Quote, from abstract " The TB prevalence was significantly higher among people living below the poverty line compared with those above the poverty line (242 versus 149/100,000 population). Among the marginalised people, TB was 1.5 times more prevalent. TB was disproportionately high among the poor. Conclusion: Poverty and inequality were very closely linked."

Further, in 2016, Kashyap, Nayak, Husein et al found that "Poor Socioeconomic status and Living Conditions can be considered as strong risk factors linked with Latent TB Infection"   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4948223/

And Oxlade and Murray (2012) entitled their review in PLOS One "Tuberculosis and Poverty: Why Are the Poor at Greater Risk in India?" https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0047533

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4 hours ago, Peter Cobbold said:

TB in India is the classic example. Its a disease of the rich. Not enough data  from random sampling to know if same applies to COVID in sunny countries. We will wait and see.

Poverty ,as in dense housing, often multigenerational, will speed spread of virus but notnecessarily  the death rate, Without knowing the whole number infected , by random sampling, we cant tell. Poor diet is a factor in poverty, but D3 is not obtained from diet in signifcant amounts. Exposure to sunshine in impoverished populations eg Syria, Yemen, may protect but no data as yet, but an interesting absence of reports  of mass fatalities.

 

I worked on TB in India (Mumbai) for 2 years....TB is THE disease of the poor, almost per definition. This statement is too grotesque to be elaborated upon, Prof...pfff

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NHS would never accept that poverty played a part without a blind trial. It would need a large number of volunteers from both ends of the fiscal spectrum, obviously dressed alike to keep their status from the medical staff, patients probably not allowed to speak. Then infected with Coronavirus and record the outcomes.

Only in several years time after due deliberation would the medics pronounce that the study was flawed as the results did not agree with their political beliefs and must therefore be incorrect.

Or can some Covid treatments/causes be fast tracked if they are based on party dogma?

 

Alan

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4 hours ago, Geko said:

I worked on TB in India (Mumbai) for 2 years....TB is THE disease of the poor, almost per definition. This statement is too grotesque to be elaborated upon, Prof...pfff

And did you advise sunbathing safely?  ...........  I thought not.

In India TB is present in the educated wealthy . at ca 0,04 %. But not in UK. Granted Indian poor have higher incidence but there are huge numbers of them

And the TB/D3 science is rock solid.https://vitamindwiki.com/Overview+Tuberculosis+and+Vitamin+D

For f888ks sake a Nobel prize was won for UV treatment of a form of TB in 1903  https://www.nobelprize.org/prizes/medicine/1903/finsen/facts/

In countries with ample sun the fialure of the authorities, and aid agencies, to educate and advise safe sunbathing is abhorent, and ignorant, The sun comes free.

Peter

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7 hours ago, john.r.davies said:

I fear you are mistaken, Peter.  See: https://www.researchgate.net/profile/Malaisamy_Muniyandi/publication/5285122_Socioeconomic_inequalities_of_tuberculosis_in_India/links/54e421350cf282dbed6e988e/Socioeconomic-inequalities-of-tuberculosis-in-India.pdf  Only twelve years old and just the first that came up on the subject.   Quote, from abstract " The TB prevalence was significantly higher among people living below the poverty line compared with those above the poverty line (242 versus 149/100,000 population). Among the marginalised people, TB was 1.5 times more prevalent. TB was disproportionately high among the poor. Conclusion: Poverty and inequality were very closely linked."

Further, in 2016, Kashyap, Nayak, Husein et al found that "Poor Socioeconomic status and Living Conditions can be considered as strong risk factors linked with Latent TB Infection"   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4948223/

And Oxlade and Murray (2012) entitled their review in PLOS One "Tuberculosis and Poverty: Why Are the Poor at Greater Risk in India?" https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0047533

And no mention of D3 status whatsoever. See reply to Geko above,

Ignorance of D3 role in preventing TB is inexcusable.

Recall the NY physicians dying of mult-drug resistant TB?  Very high dose D3 as codliver oil was used successfullt in 20s and 30s to treat and cure TB. All forgotten when miracle antibiotics were available

The real tragedy is the sun is free, and the best  way to win D3, Diet is useless. Supplements cost/.distribution an obstacle in developing countires. All it needs are educationla broadcasts eg daily advice on how long to take the rays.  But no, polticing with poverty takes  priority. It is the same with BAME deaths from COVID in UK, poverty takes the blame, while the solution is utterly ignored.

Yes, I am angry.

Peter 

 

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1 hour ago, barkerwilliams said:

NHS would never accept that poverty played a part without a blind trial. It would need a large number of volunteers from both ends of the fiscal spectrum, obviously dressed alike to keep their status from the medical staff, patients probably not allowed to speak. Then infected with Coronavirus and record the outcomes.

Only in several years time after due deliberation would the medics pronounce that the study was flawed as the results did not agree with their political beliefs and must therefore be incorrect.

Or can some Covid treatments/causes be fast tracked if they are based on party dogma?

 

Alan

Many of NICE RCTs fail though lack of numbers.Whether we have enough poor to satisfy NICE is debatable. Though at the present rate of economic mayhem we may well run out of rich too.

 

You forgot smell as a confounder.   " You can tell he's a king 'cos he's not covered in sh*t "

Peter

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Peter...please get it right. NICE do not design or instigate any RCT’s. The role of NICE is purely to evaluate a technology on the published data available.

RCT design is driven by the regulatory process. That’s EMEA or MHRA or FDA as the main agencies to satisfy with your New or existing  technologies dossier.

When NICE was introduced it became known as the 4th Hurdle.  A new obstacle for a  pharmaceutical (Or a technology) to gain market acceptance and usage......because the role of NICE is primarily to ask, does this intervention bring anything new to the party and if so does it justify the associated cost? Hence 5he explosion in Cost Benefit analysis and the whole area of Health Economics.

I think the issue with VitD3 is because it has for decades been thought of as a food supplement, it’s not regulated by any of the above mentioned licensing authorities. The Patient data is therefore of low quality.  When it’s scrapped together by NICE who’s appointed team for Vit D3 are expecting robust well designed trial data they can only assess based on as you rightly sat the NICE Protocol, which not surprisingly comes out with the conclusions it does, based on the Clinical data it has been presented with to evaluate.

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"When it’s scrapped together by NICE who’s appointed team for Vit D3 are expecting robust well designed trial data they can only assess based on as you rightly sat the NICE Protocol, which not surprisingly comes out with the conclusions it does, based on the Clinical data it has been presented with to evaluate. "

I think you mean "scraped" together by NICE Ian ?

It underlines what the Proff and others here have said, we do understand that the processes NICE and PHE use are based upon well documented medical RCT trials before a decision can be made upon the efficacy of VitD3 in it's place as a defence to COVID and it's boosting of the immune system...but as of yet they don't exist.

That's why I and others have taken the decision to take VitD3 supplementation, on the basis of the US recommendation of 4000iu per day which is in itself a reflection that at trials of 40,000iu per day there were no observable side effects, so the reduced by a factor of 10 US recommendation would be a suitable dose unlikely to cause harm. Hopefully sometimes in the future the documented  RCT testing and design driven by the regulatory process and including the EMEA or MHRA or FDA main agencies will be satisfied one way or the other that VitD3 is either a benefit...or not taken at these larger doses.

Until then the balanced risk of a larger dose of VitD3 seems to be a decision many can make ignorant as we are of the benefits or pitfalls we may fall into by taking them whilst better science is established and proved.

Mick Richards 

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Iain,

And therein lies the rub.

We have horses and they can be treated with many medicines developed for humans, however some medication is not approved for horses, not because there is an issue but because the cost of a study is so high as to make it uneconomic to undertake a study for the undoubted benefits that the medication would bring to a small number of suffering horses. So the horses remain untreated and suffer - a good plan.

Now in my naivety I never expected that the same would apply to human medication, if something had a benefit when used to treat a specific condition it would be acceptable, but apparently not. What flows from  this policy is that medication will never be developed if there are a few patients and it is not the cost of medication development  but the cost of the study becomes prohibitive. Look no further than the failure to develop Ebola medication for economically poor infected patients until recently when the disease began to spread and a funding became available and poof it was a political issue and funding and medication became available. A pity for the people who had died over the decades because they were not worth treating.

I find it interesting though that developing such medications increases the knowledgebase and develops methodologies that can be used when new diseases emerge, so not a one-way street of spending.

Whatever the reasons surely there must be an acceptable method to approve medication with, for example, long term use and acceptable outcomes without only pharmaceutical companies deciding what to investigate, therefore no medication that does not have a patentable, and thus profitable  element can ever receive approval no matter how efficacious.

Alan

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I, like a lot if people, have been following the Governments rules on lockdown.

Yet again, another top nob has abused the instructions and basically stuck "two fingers " up at the rest of us.

Was wondering whether all those people who got fined for not abiding by the rules will be using the "Cummings Defence" to get the fine overturned

.... I was only doing what Mr Cummings was doing. He didn't get fined...Why is it different for him.

is it because I'm not a high powered technical adviser ....blah blah blah...."

 

 

 

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You may be amazed to find that I agree with you, Alan!     There are many "orphan diseases", that only affect a few people, so that the profit that may be gleaned from selling even a successful and complete treatment drug cannot outweigh the cost of development.    "Few" is a relative word and WHO defines it as less than 200,000 people, worldwide.

But we may safely ignore such a small number of unfortunates, can't we?    What is affecting  many and will affect many more, including you and me,  is the lack of  development of new antibiotics.     All the antibiotics that we use today were developed in a forty year period since WW2, none at all since the 80s.    Meanwhile, the fierce pressure of evolution has pushed many bugs to 'discover' resistance, from the stapholococci we all carry on our skin to TB.  In the world of 2016, 240,000 people died of multiple drug resistant TB (WHO) - so far 'only' 300,000 have died of Covid19.

 

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There's a similar tale of neglect by big pharma of unpatentable but possibly useful natural product.  Reseveratrol. Some TRRers may  remember the demon-driver French enthusiast Badfrog. He was  akey researcher in investigating the science of resveratrol, the best-researched active ingredient of red wine. They identified it as a high-affinity activator of sirtuin-1. It is of interest in Alz and Parkinson's disease. The sorry tale of its fate in  a big pharma is here:

https://scienceofparkinsons.com/?s=resveratrol

In trying to make a better derivative that could be patented, they fialed and shelved the whole project, published nothing.

There is of course a D3 angle. The vitamin D respeonse element has several proteins comprising it: the VitD receptor that binds the active hormone, the RXR that binds vitA ( we need vitA for D3 to work) and Sirt1. Resveratrol binds to SIRT1 and helps the vitamin D receptr to"work better".  resveratrol is part of my cocktail, I take it to resolve muscle cramps, and stop taking it when they go away. I am usually against taking xenobiotics but for resv I amke an exception. Thanks Badfrog.

Peter

 

 

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Crawfie,

Do you really believe that?

At the time we were told that Coronavirus was a high mortality disease for all of us, press reports of people feeling ill in the morning and that evening in intensive care.

So a couple that have a young child and the real possibility that they might both be off to intensive care within a day or so and have the option to relocate to an empty property with nearby relatives to care for the child if it hits the fan. I would do exactly the same and I do not believe that anyone I know not take similar action to protect their child. Its what all good parents do.

Problem with Dominic Cummings is that he was behind the Brexit campaign and the remain press are out gunning for him even if there is no issue. On the  evidence I have heard he did nothing wrong.

On the BBC yesterday lunchtime a young lady reporter concluded with something along the lines of ".. as there is as yet no information as to how many people he infected.." just inventing non-events to stoke up the  anti-Cummings story. That was not reporting it was disgraceful propaganda.

Alan.

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16 minutes ago, barkerwilliams said:

Crawfie,

Do you really believe that?

At the time we were told that Coronavirus was a high mortality disease for all of us, press reports of people feeling ill in the morning and that evening in intensive care.

So a couple that have a young child and the real possibility that they might both be off to intensive care within a day or so and have the option to relocate to an empty property with nearby relatives to care for the child if it hits the fan. I would do exactly the same and I do not believe that anyone I know not take similar action to protect their child. Its what all good parents do.

Problem with Dominic Cummings is that he was behind the Brexit campaign and the remain press are out gunning for him even if there is no issue. On the  evidence I have heard he did nothing wrong.

On the BBC yesterday lunchtime a young lady reporter concluded with something along the lines of ".. as there is as yet no information as to how many people he infected.." just inventing non-events to stoke up the  anti-Cummings story. That was not reporting it was disgraceful propaganda.

Alan.

I recall an Oxford (?) prof of epidemiology at the tiem when swine flu was coming, wehn asked waht about her young children, replied: They will go to stay with their grandparents in the country.  Cummings will have known from sitting in on SAGE that London was lighting uo with COVID, the most infectious place to be. In his situation I;d have done the same, except to keep them isolated from granny. If he and his wife had gone down with COVID in London, with no family nearby, what else could he do? - hand the kids over to social services?

Peter 

Edited by Peter Cobbold
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2 hours ago, Crawfie said:

I, like a lot if people, have been following the Governments rules on lockdown.

Yet again, another top nob has abused the instructions and basically stuck "two fingers " up at the rest of us.

Was wondering whether all those people who got fined for not abiding by the rules will be using the "Cummings Defence" to get the fine overturned

.... I was only doing what Mr Cummings was doing. He didn't get fined...Why is it different for him.

is it because I'm not a high powered technical adviser ....blah blah blah...."

 

 

 

As much as I don’t wish to disagree with a fellow Devonian, I think many individuals have let’s say interpreted the rules. Like taking unnecessary journeys popping out for a picnic or to get fish and chips or just wanting a drive. Even those having been requested to isolate, still deciding to take a drive with the excuse they needed it  to prevent going nuts. While ensuring that they distance themselves, still breaking the rules possibly.

Perhaps some don’t wish to throw stones as glass houses are not that much protection.

Personally I think giving this that much media hasn’t  achieved anything other than perhaps giving other a even bigger excuse to do the same and risk even further transmission of the virus.

Perhaps he felt his best option was travelling to where he felt was the safest place for him and his family was the appropriate thing to do with little risk to the public, not expecting the publicity he has now which I believe will encourage others to do the same for perhaps less reason.

Edited by Derek Hurford
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4 hours ago, Motorsport Mickey said:

"When it’s scrapped together by NICE who’s appointed team for Vit D3 are expecting robust well designed trial data they can only assess based on as you rightly sat the NICE Protocol, which not surprisingly comes out with the conclusions it does, based on the Clinical data it has been presented with to evaluate. "

I think you mean "scraped" together by NICE Ian ?

It underlines what the Proff and others here have said, we do understand that the processes NICE and PHE use are based upon well documented medical RCT trials before a decision can be made upon the efficacy of VitD3 in it's place as a defence to COVID and it's boosting of the immune system...but as of yet they don't exist.

That's why I and others have taken the decision to take VitD3 supplementation, on the basis of the US recommendation of 4000iu per day which is in itself a reflection that at trials of 40,000iu per day there were no observable side effects, so the reduced by a factor of 10 US recommendation would be a suitable dose unlikely to cause harm. Hopefully sometimes in the future the documented  RCT testing and design driven by the regulatory process and including the EMEA or MHRA or FDA main agencies will be satisfied one way or the other that VitD3 is either a benefit...or not taken at these larger doses.

Until then the balanced risk of a larger dose of VitD3 seems to be a decision many can make ignorant as we are of the benefits or pitfalls we may fall into by taking them whilst better science is established and proved.

Mick Richards 

Mick  I don't argue with your comments, however that is a personal decision made by yourself for which you will be taking full responsibility I am sure. Some wouldn't.

All I have tried to do is point out that there are other views. Some on here have already said they have modified their ingestion of VitD3 based on the data I posted re drug interaction. That to me is a positive point also and Peter acknowledge that. The Prof is not  a prescribing physician, but a retired cell biologist whose knowledge is not in doubt, but whose doses recommendations for VItD3 are, rightly or wrongly, not currently endorsed by any UK professional prescribing body.

Iain 

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2 hours ago, barkerwilliams said:

Crawfie,

Do you really believe that?

At the time we were told that Coronavirus was a high mortality disease for all of us, press reports of people feeling ill in the morning and that evening in intensive care.

So a couple that have a young child and the real possibility that they might both be off to intensive care within a day or so and have the option to relocate to an empty property with nearby relatives to care for the child if it hits the fan. I would do exactly the same and I do not believe that anyone I know not take similar action to protect their child. Its what all good parents do.

Problem with Dominic Cummings is that he was behind the Brexit campaign and the remain press are out gunning for him even if there is no issue. On the  evidence I have heard he did nothing wrong.

On the BBC yesterday lunchtime a young lady reporter concluded with something along the lines of ".. as there is as yet no information as to how many people he infected.." just inventing non-events to stoke up the  anti-Cummings story. That was not reporting it was disgraceful propaganda.

Alan.

We'll all have formed our own views on his actions and of their compatibility with being the PM's advisor and architect of the 'Stay At Home' policy and messaging. But at the same time, I do actually believe that the majority of the public, who are quite capable of making up their own minds just as we are, will think the whole thing absolutely stinks.

And even the Daily Mail is now demanding Cummings is sacked, for god's sake.

Politically, someone urgently needs to whisper to the PM: "Remember the poll tax, Boris?".

Nigel

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Nigel,

So you believe that the press now rules the government and sets the agenda for government?

Gosh.

Just so pleased that we got WW2 over and done with before the rise of the journalist.

With that sort of government we will soon have criminals in the middle east running the UK's migration policy  by deciding who can pay them enough to be smuggled into the UK.

Let the government govern, then when their term is up have your say at the ballot box.

Alan

 

 

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52 minutes ago, iain said:

 

Mick  I don't argue with your comments, however that is a personal decision made by yourself for which you will be taking full responsibility I am sure. Some wouldn't.

All I have tried to do is point out that there are other views. Some on here have already said they have modified their ingestion of VitD3 based on the data I posted re drug interaction. That to me is a positive point also and Peter acknowledge that. The Prof is not  a prescribing physician, but a retired cell biologist whose knowledge is not in doubt, but whose doses recommendations for VItD3 are, rightly or wrongly, not currently endorsed by any UK professional prescribing body.

Iain 

I think the alternative views are just as important Ian, it helps the rounded argument which allows all of us to make a decision based upon likely outcome. Taking an intake of VitD3 which is of the same order as that recommended by the US which has the reputation of being the most litigious country in the world, and lawyers prowl health clinics looking for prey is not in my view going to be very risky. Otherwise they wouldn't go anywhere near these figures and is a likely reason why they have reduced their recommendation down to 4,000iu as against the 40,000iu at which they have completed tests and found no observable side effects.  

Mick Richards

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1 hour ago, iain said:

 

Mick  I don't argue with your comments, however that is a personal decision made by yourself for which you will be taking full responsibility I am sure. Some wouldn't.

All I have tried to do is point out that there are other views. Some on here have already said they have modified their ingestion of VitD3 based on the data I posted re drug interaction. That to me is a positive point also and Peter acknowledge that. The Prof is not  a prescribing physician, but a retired cell biologist whose knowledge is not in doubt, but whose doses recommendations for VItD3 are, rightly or wrongly, not currently endorsed by any UK professional prescribing body.

Iain 

What recommnedations? I provide information and its interpretation, and tell what I take. And point out where NICE, SACN and PHE have gone so terribly wrong. Likewise you pointed su to drug interactions that reduced 25(OH)D3 for a given supply. I too found that useful for a family member. Exchanging information is what the forum is about. Peter

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