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Vitamin D Seems to Play a Role in Preventing Severe Illness and Death From #COVID19 #Coronavirus

intubation, mechanical ventilation, ventilator
If you have to be on a life-support breathing machine (ventilator), this qualifies as severe COVID-19 disease. Ventilator is at the bedside out of the picture. To tolerate the tube in your throat, you’ll be in the “medically-induced coma” you read about in the news.

From Northwestern Now:

After studying global data from the novel coronavirus (COVID-19) pandemic, researchers have discovered a strong correlation between severe vitamin D deficiency [based on blood levels] and mortality rates.

Led by Northwestern University, the research team conducted a statistical analysis of data from hospitals and clinics across China, France, Germany, Italy, Iran, South Korea, Spain, Switzerland, the United Kingdom (UK) and the United States.

The researchers noted that patients from countries with high COVID-19 mortality rates, such as Italy, Spain and the UK, had lower levels of vitamin D compared to patients in countries that were not as severely affected.

Our bodies have two source of vitamin D. Our skin can make it if given sufficient exposure to sunlight, or we can ingest it. Many folks don’t swallow and/or absorb enough of it, or don’t get enough sun exposure.

I’ve never been to Europe and readily confess I don’t know much about it. I figured the UK doesn’t get much sunlight, but Spain and Italy do (at least southern Italy). Maybe the heavy air pollution in northern Italy—e.g., Lombardi—blocks out the sun.

trees, forest, sunlight
Not a lot of sunlight penetrating through this forest

The researchers say that vitamin D keeps the immune system from over-reacting to the virus infection. A hyperactive immune system response causes widespread inflammation, which in turn damages various body tissues, leading to severe illness and sometimes death. This is the “cytokine storm” you may have heard about. That’s the theory anyway.

I never knew vitamin D was involved in the immune system, or if I did, I forgot. Like most physicians, my interest in vitamin D relates to calcium metabolism and bone health/fracture prevention.

Professor Backman is quoted in the article:

It is hard to say which dose [of vitamin D supplement] is most beneficial for COVID-19,” Backman said. “However, it is clear that vitamin D deficiency is harmful, and it can be easily addressed with appropriate supplementation. This might be another key to helping protect vulnerable populations, such as African-American and elderly patients, who have a prevalence of vitamin D deficiency.

Clicking this link may take you to the prepublication original research report.

A few days ago, CNN reported that black people are four times more likely to die from COVID-19 than are whites. Here in the U.S., we’ve seen disproportionately high fatalities among blacks living in Chicago, New Orleans, and Milwaukee County, Milwaukee. I’m not the first to wonder if vitamin D deficiency is a contributing factor. I mentioned earlier that our skin makes vitamin D when exposed to sufficient sunlight. But that process is less efficient in darker skin. And folks at more northern latitudes tend to get less sun exposure, particularly in winter. (Lack of sunlight shouldn’t be a problem in New Orleans). We’ve know for years that U.S. blacks have “sub-optimal” vitamin D blood levels. Click for even more reading on this issue if you’re crazy; it’s complicated. Despite low blood levels of 25-hydroxyvitamin D, blacks are not prone to thin-bone osteoporotic fractures like whites and east asians. Some experts suggest that higher rates of diabetes and hypertension in U.S. blacks is related to low vitamin D levels.

What we don’t know is:

  • If you have COVID-19 and try to augment your vitamin D level with a supplement, will you have a better outcome?
  • If you are deficient in vitamin D now but take measures to raise your blood level (via food or supplementation), will you be less likely to contract COVID-19 and able to avoid serious illness if you do get sick?
  • Would the answers to the first two questions depend on whether you have black, brown, white, pink, or polka-dotted skin?

Hey, doc. Tell me something concrete I can do now to improve my odds of surviving this pandemic!

If you’re black of otherwise dark-skinned, I don’t know what to tell you.

If you qualify as a vulnerable person, why not ask your doctor to order a vitamin D blood level (called 25-OH-vitamin D)? If that’s not possible, ask your doc if 1,000 units of vitamin D3/day (cholecalciferol) by mouth is a good idea.

     Steve Parker, M.D.

PS: About a week ago I ran across a study finding that pre-sickness use of vitamin D supplements was linked to worse outcomes in COVID-19. I tried to find it a few days later but couldn’t. I’m sorry if this perplexes you. Welcome to the scientific literature and nature of medical practice.

The Electoral College Declares the President-Elect, Not the Mainstream Media

I’m neither a Republican nor Democrat and this is not a political blog. However I do have at least a little concern that the recent U.S. presidential election was influenced by fraudulent “voting.” Investigations are underway and maybe we’ll have an answer by Dec 14, 2020, the deadline for the electoral college to declare a clear and legal winner. I’m reproducing these tweets here, hoping that they’ll be preserved even if Twitter decides to censor and delete them. Twitter would not allow me to copy one of President Trump’s tweets of Nov 7.

On a lighter note, here’s a pic of a jade plant started from a clipping from an outdoors jade plant from Oceanside, CA, from summer of 2019. It has tripled size since then, but does not do well in 100+ degree heat.

Dr Craig Wax Wants Hospital Price Transparency

Which is less expensive?

The following excerpt was in a letter by Craig Wax to U.S. News and World Report. The final paragraph may be news to you.

IN THE CURRENT DAY [2017], when health insurance and health care delivery are not only regulated, but mandatory for citizens to buy, patients as consumers must know costs. U.S. News & World Report’s annual listing of “Best Hospitals,” based on your rating scales, needs to include hospital service and procedure costs.

Consumer Reports monthly periodical is one such example; it not only reports their definition of quality rating scales but also costs. This is vital for consumers of any product or service to compare all variables, when able. Although, on some health care instances, such as emergencies, you cannot compare when your life or limb may be at risk. However, patients can compare hospitals and other providers of health care service at most other times. In this way, they can develop an understanding of the variables and have a general understanding and preference for facility.

Let’s take the so-called top three children’s hospital pricing schemes.

Most hospitals are designated nonprofit, as are the top three pediatric hospitals in the article. This seems to sound like they are operating at minimal reimbursement margins, but the reverse is true. They set, “chargemaster,” pie-in-the-sky prices but will accept various insurance contract prices as payment in full. Nonprofit is merely a tax designation to dodge business, state and federal taxes, while at the same time, hospitals actively solicit state taxpayer funds and private donations. They seldom offer direct care cash prices due to federal government Medicare health care price fixing.

Please understand that due to federal government Medicare law, that cash prices cheaper than Medicare rates may not be formally offered or posted. The federal government considers it illegal to offer a quality product at a cash discount over Medicare mandated rates.

Source: U.S. News Hospital Rankings Should Include Retail Procedure Costs | Letters | US News

Steve Parker, M.D.

PS: Avoid the medical-industrial complex by getting and staying as healthy as possible. Let me help.

President Trump’s Healthcare Reform Proposals

Somewhere in the Southwest?

Washington Examiner has an opinion piece on Pres. Trump’s proposed (or initiated/) healthcare reforms:

“Patient choice and control are at the heart of Trump’s plan. It includes alternative forms of coverage, such as association health plans and short-term limited duration plans. It invests in telehealth services, which have been critical for patients during the COVID-19 pandemic. It gives major discounts to seniors for their prescription drugs. The plan increases access to direct primary care, which all but eliminates the insurance bureaucracy that decides what patients will and won’t get.

Perhaps most importantly, it requires price transparency, so patients know what services and procedures cost before they are forced to pay for them. It tips the scales in favor of patients to lower premiums and the cost of care. There will be no more surprise billing bankrupting families.”

Click for the President’s September 2020 executive order. I haven’t read it yet.

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet
http://amazon.com/author/steveparkermd Click the link to purchase at Amazon.com. E-book versions also available at Smashwords. com.

What Happened to the Tomatoes of My Youth?

Chicken salad on a bed of greens plus tomatoes

From Appalachian Magazine:

Big, soft, juicy and sweet, America’s tomatoes of yesteryear were culinary delights that were as beloved as any candy.

Whether sliced and heavily salted, slapped betwixt two pieces of bread with mayonnaise, or eaten raw, these tomatoes were nothing short of pure ecstasy and children craved these garden treats!

Fast-forward a handful of generations and American school children are throwing away tomatoes faster than the lunchroom cafeteria workers can slap them onto a tray.

What happened?  Why have America’s youngest fallen out of love with what was once its beloved fruit?

The answer may not surprise you all that much: It’s not that our children have changed, it’s that tomatoes have changed.

Source: A Generation That’s Never Tasted a Real Tomato | Appalachian Magazine

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

Click the pic to purchase at Amazon.com. E-book versions also available at Smashwords. com.

Legalized Recreational #Marijuana Increases Traffic Fatality Rates

“By analyzing additional experimental states over a more recent time period, we have provided additional data that legalization of recreational marijuana is associated with increased traffic fatality rates. Applying these results to national driving statistics, nationwide legalization would be associated with 6800 (95% CI, 4200-9700) excess roadway deaths each year. Despite certain methodological differences, we found an increase similar to that reported by Aydelotte et al. They reported an increase of 1.8 fatal crashes (equivalent to 2.0 fatalities) per BVMT. We concur with their opinion that changes may not be detected immediately after legalization but only after a longer time period or after commercial sales begin.”

Source: Change in Traffic Fatality Rates in the First 4 States to Legalize Recreational Marijuana | Emergency Medicine | JAMA Internal Medicine | JAMA Network

Steve Parker MD, Advanced Mediterranean Diet

Click the pic to purchase at Amazon.com. E-book versions also available at Smashwords. com.

Have You Heard of the Three C’s to Prevent a Second Wave of #COVID19 ?

I’m ready for the 2nd wave in AZ

From Calculated Risk:

Some countries have been able to open their economies without an increase in [coronavirus] infections. For example, in Japan, the economy is mostly open, however 1) everyone wears a mask, 2) there is robust contact tracing, and 3) everyone is urged to follow the 3 C’s (avoid Closed spaces, Crowded places, and Close-Contact settings).   However, in the US, contact tracing is still ramping up, many people aren’t wearing a mask or face covering, and many people are not following the 3Cs.

Source: Calculated Risk: Economic Outlook: The Gathering Storm

Steve Parker MD, Advanced Mediterranean Diet

Click the pic to purchase at Amazon.com. E-book versions also available at Smashwords. com.

Recommended Movie: #Blindspotting

Radical Idea: Judge Jame Blacklock Says Both State and Federal Constitutions Should Be Honored Even in a Pandemic #COVID19

No rule of law here. It’s the law of the jungle.

This a May 5, 2020, legal opinion of Texas Supreme Court Justice James D. Blacklock Justice:

“The Constitution is not suspended when the government declares a state of disaster.” In re Abbott, No. 20-0291, 2020 WL 1943226, at *1 (Tex. Apr. 23, 2020). All government power in this country, no matter how well-intentioned, derives only from the state and federal constitutions. Government power cannot be exercised in conflict with these constitutions, even in a pandemic

In the weeks since American governments began taking emergency measures in response to the coronavirus, the sovereign people of this country have graciously and peacefully endured a suspension of their civil liberties without precedent in our nation’s history. In some parts of the country, churches have been closed by government decree, although Texas is a welcome exception. Nearly everywhere, the First Amendment “right of the people to peaceably assemble” has been suspended altogether. U.S. Const. amend. I. In many places, people are forbidden to leave their homes without a government-approved reason. Tens of millions can no longer earn a living because the government has declared their employers or their businesses “ ‘non-essential.’ ”

Those who object to these restrictions should remember they were imposed by duly elected officials, vested by statute with broad emergency powers, who must make difficult decisions under difficult circumstances. At the same time, all of us—the judiciary, the other branches of government, and our fellow citizens—must insist that every action our governments take complies with the Constitution, especially now. If we tolerate unconstitutional government orders during an emergency, whether out of expediency or fear, we abandon the Constitution at the moment we need it most.

Any government that has made the grave decision to suspend the liberties of a free people during a health emergency should welcome the opportunity to demonstrate—both to its citizens and to the courts—that its chosen measures are absolutely necessary to combat a threat of overwhelming severity. The government should also be expected to demonstrate that less restrictive measures cannot adequately address the threat. Whether it is strict scrutiny or some other rigorous form of review, courts must identify and apply a legal standard by which to judge the constitutional validity of the government’s anti-virus actions. When the present crisis began, perhaps not enough was known about the virus to second-guess the worst-case projections motivating the lockdowns. As more becomes known about the threat and about the less restrictive, more targeted ways to respond to it, continued burdens on constitutional liberties may not survive judicial scrutiny.

Ideally, these debates would play out in the public square, not in courtrooms. No court should relish being asked to question the judgment of government officials who were elected to make difficult decisions in times such as these. However, when constitutional rights are at stake, courts cannot automatically defer to the judgments of other branches of government. When properly called upon, the judicial branch must not shrink from its duty to require the government’s anti- virus orders to comply with the Constitution and the law, no matter the circumstances.

 

The Rest of the Story: What’s the Deal with Meatpacking and #COVID19

Artist’s rendition of Coronavirus

The snippet below is only a sliver of the story. RTWT.

I heard on local radio a few days ago that 82% of the meat in the U.S. food system is processed by only four companies, two of which are Brazilian-owned.

From Wired.com:

So what is it about these places that makes them such dangerous incubators for the novel coronavirus? It’s a question that urgently needs answers, especially now that concerns over food shortages and an order given on April 28 by President Donald Trump classifying meat processors as critical infrastructure are already forcing workers back to the production line. Like most aspects of the pandemic, this one, too, is complicated by a dearth of data. Figuring out how exactly the disease is spreading between workers and which slaughterhouse practices are to blame is going to take time and lots of epidemiological legwork. But there are some clues.

According to the CDC’s latest report, the chief risks to meatpackers come from being in prolonged close proximity to other workers. A thousand people might work a single eight-hour shift, standing shoulder to shoulder as carcasses whiz by on hooks or conveyor belts. Often, workers get only a second or two to complete their task before the next hunk of meat arrives. The frenzied pace and grueling physical demands of breaking down so many dead animals can make people breathe hard and have difficulty keeping masks properly positioned on their faces. To allow for social distancing, the agency recommended that meat processors slow down production lines to require fewer workers, and that they stagger shifts to limit the number of employees in a facility at one time.

Source: Why Meatpacking Plants Have Become Covid-19 Hot Spots | WIRED

Steve Parker, M.D.

Click pic to purchase at Amazon.com. E-book versions also available at Smashwords. com.