I had a Dream by David Grimes

The following is extracted from the book 'Vitamin D deficiency and Covid19 - Its central role in the global pandemic' © David C Anderson and David S Grimes, 2020 Published by Tennison Publishing All rights of this book may be reproduced, adapted, stored in a retrieval system by any means, electronic, mechanical, photocopying, or otherwise without the prior permission of the author. The rights of David C Anderson and David S Grimes to be identified as the authors of this work have been asserted in accordance with the Copyright, Designs and Patents Act 1988 A CIP catalogue is available from the British Library ISBN 978-0-9562132-8-0 (ePub) ISBN 978-0-9562132-9-7 (Mobi)

I had a Dream by David Grimes

Day 0 (May 2020)

The scene: The Press Room, 10 Downing Street, London W1

The reporters are waiting, now on-line.

Enter three men, and stand behind their lecterns.

Prime Minister, Boris Johnson

This morning we have, er, some very good news for you all. I will ask Chris Whitty to give more details.

Professor Chris Whitty, Chief Medical Officer

Thank you Prime Minister. The good news today is that we now have a new way to reduce dramatically serious illness and deaths from Covid-19. The way to do this is actually simple and it is available immediately. We have heard a great deal about the development of vaccines to provide immunity, but it is unlikely that they will be available and tested for safety until the end of the year. In the meantime we have a great opportunity. It is vitamin D. It will boost our immunity and reduce deaths at a stroke (© Edward Heath).

Prime Minister

So there we are. I told you that we had really good news today, great news. I will turn to Patrick to explain further.

Sir Patrick Vallance, Chief Scientist

Thank you Prime Minister. Vitamin D is not new. In fact it first appeared on the evolutionary scale 1.2 billion years ago, but its importance in immunity has been a feature of only the past 500 million years. The next bit is slightly technical. Vitamin D is created by the action of the sun on 7- dehydro-cholesterol that is manufactured in our skin. It becomes activated in the liver and kidneys and, combining with vitamin D receptors (VDRs) on the cell surface, it activates several genes. These include genes that enable the proliferation in response to infection of the defensive immunity cells, such as T-lymphocytes and macrophages.

Prime Minister

I think I can just about understand that. Would you like to add anything Chris?

Chris Whitty

It was realised early in the 20th century that vitamin D was important for immunity. At that time rickets was common in our industrial cities and this was shown to be due to shortage of vitamin D, the result of air pollution preventing the penetration of full intensity sunlight to ground level. It was noted that rickets and tuberculosis frequently co-existed within families. It is now clear from the experience of the AIDS epidemic in particular that tuberculosis becomes activated when immunity is suppressed.

Prime Minister

Do you mean that air pollution causes suppression of immunity?

Patrick Vallance

Yes, and in the pandemic of Covid-19 we have seen that it took hold in northern Italy, which has the greatest air pollution in Europe and where blood level of vitamin D are particularly low. It will also explain why the pandemic is causing more deaths in our inner cities than in rural areas.

Prime Minister

There is more evidence concerning the value of vitamin D in Covid19.

Patrick Vallance

Yes. It is possible to measure the amount of vitamin D in the body by a simple blood test that has been available in all NHS hospitals for several years, and it is available in many countries in the world. It is important for the blood level of vitamin D to be greater than 30ng/ml, or 75nmol/L. Less than 10 is regarded as serious deficiency. An imaginative study has been reported from the Philippines by Professor Mark Alipiorrt, who unfortunately has been very ill with pneumonia, but I am told that he is now recovering. Vitamin D testing was undertaken in 212 patients with proven Covid-19 in three hospitals in south-east Asia.

Prime Minister

Chris, can you tell us the results?

Chris Whitty

The results are dramatic. Of the 55 patients with ideal blood levels of vitamin D, 47 had just mild disease. In 4 the disease was moderate, in 2 severe and in 2 critical. But on the other hand, in the 157 patients with low blood levels of vitamin D, only 2 had mild disease, and in the other 155 patients the disease was moderate, severe or critical.

Prime Minister

Gosh! So there was a clear benefit from having a good blood level of vitamin D. I think there has been another study. Patrick.

Patrick Vallance

Yes Prime Minister. This was in Indonesia. As the pandemic started in the far East, there have been more opportunities for research. 780 patients with Covid-19 were tested for blood levels of vitamin D, and they were followed up to observe clinical outcome. Chris.

Chris Whitty

Almost half of the patients had low levels of vitamin D, and almost half of the patients died. Of the 380 with good levels of vitamin D, that is above 30, only 16 died. Of the 400 with low levels of vitamin D, almost all died.

Prime Minister

This is really amazing. Are there any other studies?

Chris Whitty

Yes. I have just received this morning a report from an imaginative Dr Gerry Schwalfenberg in Edmonton, Alberta, in Canada. He realised a little while ago that low blood vitamin D level is a bad thing and especially common in elderly people living in care homes. He looks after residents in a nursing home and so he gave them all vitamin D 2,000units each day by mouth and later he tested the blood levels. in 94% of the residents, the levels were above 32ng/ml (80nmol/L). Those whose blood levels remained low were given a higher dose of vitamin D.

Prime Minister

Has that been of benefit to them?

Chris Whitty

Yes it has. Not a single resident of this nursing home has been ill with Covid-19, whereas there have been many cases in all the other neighbouring nursing homes.

Prime Minister

That is even more really good news. Are there any more examples, Chris?

Chris Whitty

Yes. With exception of San Marino, Belgium has in Europe the highest number of Cid-19 deaths relative to population size. We have just the morning read a report from Belgium that vitamin D levels are much lower in the patients who died from Covid-19.

Prime Minister

So we have a great opportunity to protect the wonderful and proud people of our great country, and defeat the most dangerous enemy that we have faced since the second world war. Patrick, what is the next step?

Patrick Vallance

We have these clinical studies and we have the basic science of the vital role of vitamin D in the process of immunity. We need to protect people by issuing them with vitamin D. There are two dosage regimes. The first is to use capsules or tablets of vitamin D. A dose of 2,000 units a day is usually adequate, but at this time of national emergency I would recommend 4,000 units a day. An alternative is to give a single dose of 100,000 units, in an oil which can be given by injection or by mouth. Its effect will last for about two months.

Prime Minister

Will this be expensive? Do we need to ask the permission of the Chancellor of the Exchequer?

Patrick Vallance

It is cheap. The single dose will cost about £1, and the 4,000 unit capsules will cost about £10 for a year’s supply. We obviously must multiply these numbers by the number of the UK population.

Prime Minister

That is even more good news. I am sure that our Chancellor of the Exchequer Rashi Sunak will be very pleased. Chris, do you have any comments?

Chris Whitty

It will take a little time for the public health departments in the UK to organise the distribution of vitamin D.

Prime Minister

But surely this is very urgent. People are still dying from Covid-19, about 500 each day.

Chris Whitty

Yes, and we need to prioritise distribution to those most at risk. This will obviously be health service workers, and then care workers, and then the residents of care homes.

Prime Minister

I think that I might have heard a suggestion that people of black African and Asian ethnicity might be at risk from Covid-19. Patrick, do you know if this might be true?

Patrick Vallance

I might have also have heard the suggestion that people of black African and Asian ethnicity might be at special risk. There is a view that they must all be rehoused as a matter of urgency. I am also given to understand, but I have not seen any official figures, that 25 of the 26 UK doctors who have died from Covid-19 were of black African and Asian ethnicity. It has been known for a long time that such people are almost all deficient in vitamin D as the result of dark skin and sun-avoiding behaviour.

Prime Minister

And so must they also have a priority for receiving vitamin D?

Sir Patrick Vallance

Yes, Prime Minister. But the more people who have priority, the more difficult the task of distribution.

Prime Minister

But if the vitamin is so cheap people might want to buy their own supplies.

Chris Whitty

Yes Prime Minister, that is what I have done.

Sir Patrick Vallance

And so have I.

Prime Minister

I think I was given an injection of vitamin D when I was in hospital.

Chris Whitty

That is probably why you recovered so well and so quickly when you were so close to death.

Prime Minister

Yes, and once again I would like to thank all the brave staff for the wonderful treatment and care that I was given. So, the vitamin D story seems to be straightforward.. Are there any dissenting voices?

Patrick Vallance

There are a few. Notably the Oxford group, who are busy developing and testing a vaccine. They feel that vitamin D is an untested diversion from what they are doing.

Chris Whitty

And there are many who feel that social justice for the ethnic and socio-economically disadvantaged should have priority over vitamin D supplements.

Prime Minister

That is tricky. So I think we must go ahead with vitamin D immediately. Today at the latest. Are there any questions? Laura.

Laura Keuensberg (BBC)

Thank you all for this welcome news. Could I please ask where vitamin D supplements come from and is there an adequate supply?

Prime Minister

Patrick, this is one for you.

Patrick Vallance

Thank you Laura. Most of the vitamin D supplements come from sheep’s wool, and some from fish oil. The oil from sheep’s wool must be processed to isolate 7-dehydro-cholesterol, and then this must be irradiated with UV light to convert it into vitamin D. A possible problem is that the great majority of this production takes place in China. I believe the world annual production is about 7 million tonnes. Most of it goes into animal feed, very important now that so many animals are kept indoors. The UK might require about 1 million tonnes.

Prime Minister

Thank you Laura. Beth, you have a question.

Beth Rigby (Sky News)

You have mentioned the Oxford group who are inventing a vaccine at this moment. I am told that they demand a randomised control trial to see if there is any truth in the idea that vitamin D might be helpful in Covid-19. Is a trial under way in the UK?

Prime Minister

Patrick should be able to answer this one.

Patrick Vallance

I do not have a full picture of any research that is going on at present. Perhaps Chris would know more.

Chris Whitty

I do not know of any, but any research that individual hospitals do is up to themselves. The information about vitamin D that I have is that common sense tells us how good it is, and that is why I take it. If we have a controlled trial, half the subjects will take vitamin D and half will take a placebo, a dummy tablet. I would not be happy for me or any of my family or friends (with an occasional exception) to take the placebo as it might put me or others at a high risk of death. Unless we keep the subjects in the dark (perhaps literally) I do not see a controlled trial taking place. In other words at this stage, to conduct a placebo controlled trial of vitamin D with informed consent would not be ethical. The weight of evidence for vitamin D to be helpful in preventing serious illness and death from Covid-19 is well beyond reasonable doubt, to use a legal expression. We know that vitamin D is safe, but we do not yet have this information about the Oxford Vaccine.

Prime Minister

Thank you Chris. That is very clear.Heather, you have a question.

Heather Stewart (Guardian)

We hear great deal about testing. How many people in the UK have had their blood vitamin D levels tested?

Prime Minister

Chris, can you answer this?

Chris Whitty

The short answer is that I have no idea. Hospitals do not inform the centre about the blood tests that they undertake.

Prime Minister

Thank you Heather. I think you have another question.

Heather Stewart

Yes Prime Minister. Thank you. At the Guardian I am told that during the past month we have had a lot of letters about the value of vitamin D in the pandemic, mainly written by doctors. We published just one letter but we thought that the others must be from food-fad enthusiasts. Do you mean to say that they were all right in what they had written to us?

Prime Minister

Patrick, you might answer this.

Patrick Vallance

Well, Heather, it looks as though they were right.

Prime Minister

Tim, you have question.

Tim Shipman (Times & Sunday Times)

It sound as though there might be widespread knowledge of the value of vitamin D in immunity and defence against infection. We have just heard about it for the first time this morning, and so may I ask when you first heard about it?

Prime Minister

Speaking for myself, it was just after breakfast this morning. What about you Patrick?

Patrick Vallance

I heard about it yesterday evening. I was alerted by a member of staff who had just seen some interesting Blog posts and Emails.

Prime Minister

And you Chris ? When did you first hear about it?

Chris Whitty

When Patrick phoned me yesterday evening.

Tim Shipman

Why did you as Chief Medical Officer not know about the value of vitamin D in defensive immunity?

Chris Whitty

Well, I can’t be expected to know everything. I thought vitamin D was all about bones and children with rickets. The importance for immunity is new to me.

Prime Minister

Let’s move on. Bob, you have a question.

Robert Peston (ITV News)

Prime Minister, what can people do if supplies of vitamin D are not sufficient for our needs?

Prime Minister

That is difficult one Bob. Over to you Patrick.

Patrick Vallance

We can eat oily fish, such as mackerel in particular. Do you remember the days when as children we were given disgusting Cod Liver Oil? It turns out that our mothers were right. We can also obtain vitamin D from the sun, and in fact we obtain most of our vitamin D from the sun. We need to expose our skin, not quite all of it, to the sun, at this time of the year in the UK up to an hour between 10:00am and 4:00pm. We can do this in our gardens, in the parks, and on the beach, or anywhere that is isn’t too cold, and of course when it is not raining.

Prime Minister

That might be bit tricky with social distancing, but we must act very quickly. I suppose we might do what I believe is happening in supermarkets and other places. People would apply for a ticket to lie semi-naked in a park (not in a supermarket) or on a beach so that there are not too many people in one place at one time. We would need to have police on patrol. We should be able to create a web-site for it this evening and set this up by tomorrow morning. Are there any more questions?

Goes on for another half hour with the usual questions and usual evasive answers. Day 1

Daily Covid-19 briefing becomes chaotic as Matt Hancock (Secretary of State for Health), Angel McLean (Deputy Chief Scientific Advisor), and Jenny Harries (Deputy Chief Medical Officer) are inundated with questions about vitamin D that they are unable to answer.

The briefing is brought to a rapid close.

Newspaper headlines:

All hospital patients with Covid-19 given Vitamin D

Crowds outside pharmacies

Vitamin D is in short supply

Demand for permits is overwhelming

Web-site for permits to sunbathe in public places crashes.

Public parks crowded with semi-naked people

Queues of cars at approaches to beaches

Asian groups complain that sunbathing advice is against their religious practices.

Day 2

Newspaper headlines:

Government suspends daily Covid-19 announcements

Vitamin D supplies to the public are exhausted

Black market develops for vitamin D

People fighting for entry into parks

Sunbathers refuse to leave after one hour

Police cannot control crowds.

Day 3

Newspaper headlines:

Public Health agencies are struggling to prioritise the vitamin D supplies that they have been able to obtain.

China refuses to release more vitamin D

It is not yet warm enough to shear sheep

Fish shops noting a big demand for mackerel.

Day 4

Newspaper headlines:

Vitamin D : Civil disobedience.

Family doctors are struggling with demand for vitamin D blood tests

Crowds outside hospitals demanding vitamin D

Heavy rain diminishes crowds in parks.

Day 5

Newspaper headlines:

Why was vitamin D not stockpiled?

If vitamin D has been known for a long time to help immunity, why was it not recommended two months ago?

Large protests in Trafalgar Square

Chief Medical Officer and Chief Scientist resign

Calls on Prime Minister to resign.

Day 6

Newspaper headlines:

Sudden end of deaths from Covid-19

Lockdown ended to enable to people go outside to work or to sunbathe.

Day 7

Newspaper headlines:

In anticipation of future epidemics, Government sets up Scientific Advisory Committee for Immune Defence.

... And then I woke up, listened to the radio news and I realised that it had all been a dream, but a pleasant dream. It would have been nice to remain asleep but now I was awake I had to continue with the daily nightmare of Covid-19 with no action taken to stop deaths. How many more will die today?

Thanks to Dr David Grimes for original source ~ I had a Dream

Dr David Grimes and Dr David C Anderson, in their book 'Vitamin D deficiency and Covid19 - Its central role in the global pandemic', recommend all adults take 4,000 IU per day, or 100,000IU of Vitamin D3 per month at this time.

Please click here ~ more detailed information Vitamin D

Please click here for the website of Dr David Grimes ~ Dr David Grimes.com

Update 29th January 2021 ~ 'How can we avoid looking stupid ?'

On a unrelated note (i.e. not about Vit D3), but yet indirectly related, regarding the subject of the most commonly used 'test' for the SARS-cov2 virus (RT-PCR), particularly with emphasis on 'Cycle Thresholds', here is a menu of food for thought and external links for the purpose of knowledge and debate:- click for page ~ Cycle Thresholds in RT-PCR