Are Stay-at-Home Orders Decimating Vitamin D Levels?

Analysis by Dr. Joseph Mercola Fact Checked

Story at-a-glance -

  • Stay-at-home recommendations may have been a bad idea. In New York, 66% of new hospital admissions for COVID-19 were individuals who had been sequestering at home
  • Chinese researchers have noted that a majority of outbreaks in the 320 municipalities reviewed were the result of indoor spread of the disease, with the home accounting for 79.9% of cases
  • It’s well-known that vitamin D is important for innate immunity and that it boosts your immune function against viral diseases. Growing evidence suggests your vitamin D status may also play an important role in the development of COVID-19, as well as the severity of the illness
  • Vitamin D concentrations are lower in patients with positive PCR (polymerase chain reaction) tests for SARS-CoV-2, and countries with lower vitamin D levels have higher mortality rates from COVID-19
  • Recent research also shows vitamin D levels are strongly correlated to the severity of the illness experienced

Recent scientific papers have highlighted the role vitamin D may be playing in the COVID-19 pandemic, especially in severe cases. Considering researchers have also shown that SARS-CoV-2 is rapidly inactivated by sunlight,1 areas that are banning people from parks and beaches, are undoubtedly committing a grave error.

In fact, it has been nearly impossible to document outdoor transmission of the disease.  This is because one factor for catching disease is dependent on the viral load - the amount of exposure which is quickly diluted outdoors and inactivated by sunlight.

Outdoor clinics should be seriously considered, as healthcare facilities are primary locations spreading the disease.

The coronavirus will follow the usual seasonal patterns we witness with influenza, as higher temperature, humidity, and our time spent outdoors are detrimental for spreading these respiratory infections.

Stay at Home Order Is a Miserably Failed Experiment

Stay-at-home recommendations in general may also have been a bad idea overall. Indeed, New York Gov. Andrew Cuomo stated,2 May 6, 2020, that 66% of new hospital admissions for COVID-19 were individuals who had been sequestering at home.

A majority of those cases were also minorities such as African-Americans, who are far more prone to vitamin D deficiency due to their darker skin.3 When Cuomo first heard about it, he said he immediately thought maybe people had been going out in spite of the shelter-in-place order, and maybe taking public transportation.4

In actuality they were all at home where they were supposed to be. Interestingly, Dr. David Katz, president of True Health Initiative and founding director of the Yale-Griffin Prevention Research Center, predicted5,6 this would happen.

Chinese researchers have also noted that a majority of outbreaks in the 320 municipalities reviewed were the result of indoor spread of the disease, with the home accounting for 79.9% of cases, followed by transportation at 34%.

According to the authors,7 "All identified outbreaks of three or more cases occurred in an indoor environment, which confirms that sharing indoor space is a major SARS-CoV-2 infection risk." As noted in a May 11, 2020, American Thinker article:8

"Very likely, you already instinctively know that the guidelines suggesting that it's somehow helpful to keep a six-foot space between healthy people, even outdoors, is not based on science, but just an arbitrary suggestion we've been conditioned to accept without evidence.

And your gut feeling would be right. There's a reason that "social distancing 'wasn't a buzzword common to the American lexicon prior to 2020. There's very little science behind "social distancing' at all. 

'It turns out,' Julie Kelly writes9 at American Greatness, 'as I wrote10 last month, 'social distancing' is untested pseudoscience particularly as it relates to halting the transmission of the SARS-CoV-2 virus. On its website, the CDC provides no links to any peer-reviewed social distancing studies that bolster its official guidance.' There's a reason for the lack of peer-reviewed studies on the CDC website. She continues:

'The alarming reality is that social distancing never has been tested on a massive scale in the modern age; its current formula was conceived during George W. Bush's administration and met with much-deserved skepticism.

'People could not believe that the strategy would be effective or even feasible,' one scientist told11 the New York Times last month. A high school science project12 — no, I am not joking — added more weight to the concept.

'Social distancing' is very much a newfangled experiment, not settled science. And, Kelley writes, the results are suggesting that our 'Great Social Distancing Experiment of 2020' will be 'near the top of the list' of 'bad experiments gone horribly wrong.'"

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Banning Outdoor Activities — A Disastrous Idea

In the video above, published May 11, 2020, on Medscape.com, Dr. JoAnn E. Manson, professor of medicine and chief of the division of preventive medicine at Harvard Medical School, discusses the protective role of vitamin D against COVID-19.

Manson points out that growing evidence suggests your vitamin D status may in fact play an important role in your risk of developing COVID-19, as well as the severity of the illness. It's well-known that vitamin D is important for innate immunity and that it boosts your immune function against viral diseases.

Importantly, as noted by Manson, vitamin D also has "an immune modulating effect and can lower inflammation, and this may be relevant to the respiratory response during COVID-19 and the cytokine storm that's been demonstrated."

Manson cites evidence from three South-Asian studies showing people with serious COVID-19 infection are far more likely to have insufficient levels of vitamin D compared to those with mild illness. Vitamin D deficient patients had, on average, an eightfold higher risk of serious COVID-19 illness compared to those with sufficient levels.

Harvard Medical School is starting a study to investigate whether vitamin D supplementation lowers the risk of COVID-19 specifically, and/or improves clinical outcomes, but in the meantime, Manson urges people to spend more time outdoors to improve their vitamin D levels through sun exposure, and to optimize their vitamin D levels through food and supplements.

Manson is far from alone in her recommendations. Irish researchers recently published an editorial13 highlighting the role of vitamin D deficiency in severe COVID-19 infections. According to the authors:14

"… the evidence supporting a protective effect of vitamin D against severe COVID‐19 disease is very suggestive, a substantial proportion of the population in the Northern Hemisphere will currently be vitamin D deficient, and supplements, for example, 1,000 international units (25 micrograms) per day are very safe.

It is time for governments to strengthen recommendations for vitamin D intake and supplementation, particularly when under lock‐down."

Low Vitamin D Linked to Greater SARS-CoV-2 Infection Risk

A May 6, 2020, report15 in the journal Nutrients points out that vitamin D concentrations are lower in patients with positive PCR (polymerase chain reaction) tests for SARS-CoV-2. As noted in this report, which retrospectively investigated the vitamin D levels obtained from a cohort of patients in Switzerland:16

"In this cohort, significantly lower 25(OH)D levels were found in PCR-positive for SARS-CoV-2 (median value 11.1 ng/mL) patients compared with negative patients (24.6 ng/mL); this was also confirmed by stratifying patients according to age >70 years. On the basis of this preliminary observation, vitamin D supplementation might be a useful measure to reduce the risk of infection."

Low Vitamin D Levels Linked to Increased COVID-19 Mortality

Another May 6, 2020, report,17 published in Aging Clinical and Experimental Research (its prepublication featured in the Daily Mail May 118), found that countries with lower vitamin D levels also have higher mortality rates from COVID-19. According to the authors:19

"The Seneca study showed a mean serum vitamin D level of 26 nmol/L in Spain, 28 nmol/L in Italy and 45 nmol/L in the Nordic countries, in older people. In Switzerland, mean vitamin D level is 23 nmol/L in nursing homes and in Italy 76% of women over 70 years of age have been found to have circulating levels below 30 nmol/L.

These are the countries with high number of cases of COVID-19 and the aging people is the group with the highest risk for morbidity and mortality with SARS-CoV2."

In the preprint version20 of this paper, the authors concluded: "We believe that we can advise vitamin D supplementation to protect against SARS-CoV2 infection." In the final version,21 they toned down the recommendation to: "We hypothesize that vitamin D may play a protective role for COVID-19."

GrassrootsHealth Study

Data22 from a clinical trial by GrassrootsHealth — an organization that we have supported for over 13 years — also reveals a link between vitamin D status and COVID-19 severity.

Mark Alipio — who received no funding for his work — released data from an analysis of 212 people with lab-confirmed COVID-19 and for whom serum 25(OH)D levels were available. Using a classification of symptoms based on previous research, he employed statistical analysis to compare the differences in clinical outcomes against the levels of vitamin D.

Of the 212 people, 49 had mild disease; 59 had ordinary disease; 56 were severe and 48 were critical. In the initial study group of 212 patients (see Table 1 below), 55 had normal vitamin D levels, which Alipio defined as greater than 30 ng/ml; 80 had insufficient levels of 21 to 29 ng/ml and 77 had deficient levels of less than 20 ng/ml.

descriptive statistics

Vitamin D levels were strongly correlated to the severity of the illness experienced. It is important to note that most experts consider 30 ng/ml half of what an optimum vitamin D level should be, which is 60 to 80 ng/ml.

vitamin d covid-19 severity

Of the 49 with mild illness, 47 had normal vitamin D levels. For those of you who are not good with math that means that 96% of the patients with mild illness had "normal" levels of vitamin D. Note again this "normal" level was above 30 ng/mL, and most experts would raise that to 60 ng/mL.

Of the 104 with severe or critical illness, only four had normal levels of vitamin D. That is 4% or the reciprocal of the mild group. How much stronger a correlation could one hope for? Alipio concluded:23

"… this study provides substantial information to clinicians and health policy-makers. Vitamin D supplementation could possibly improve clinical outcomes of patients infected with Covid-2019 based on increasing odds ratio of having a mild outcome when serum (OH)D level increases."

Vitamin D Protects Against Viral Infections

Indeed, there is strong scientific evidence vitamin D plays a central role in your immune response and your ability to fight infections in general, so there's little reason to think it wouldn't provide similar protection against COVID-19.

In this video, Ivor Cummins, biochemist and chief program officer for Irish Heart Disease Awareness, explains how higher levels of vitamin D may reduce your risk of negative outcomes from COVID-19.

He also reviews some of the conditions associated with low vitamin D levels, such as insulin resistance and high levels of inflammation. As discussed in "The Real Pandemic Is Insulin Resistance," obesity, high blood pressure, diabetes and heart disease are comorbidities for severe COVID-19, and insulin resistance is the underlying problem in all of these.

As noted in "Vitamin D and the Antiviral State," a literature review article published in the Journal of Clinical Virology in 2011:24

"Interventional and observational epidemiological studies provide evidence that vitamin D deficiency may confer increased risk of influenza and respiratory tract infection. Vitamin D deficiency is also prevalent among patients with HIV infection.

Cell culture experiments support the thesis that vitamin D has direct anti-viral effects particularly against enveloped viruses. Though vitamin D's anti-viral mechanism has not been fully established, it may be linked to vitamin D's ability to up-regulate the anti-microbial peptides LL-37 and human beta defensin 2."

SARS-CoV-2 is an enveloped type of virus,25 which means vitamin D may actually have a direct antiviral effect on it. Future studies will have to confirm that, but in the meantime, there's absolutely no reason to ignore your vitamin D level. As reported in a recent GrassrootsHealth press release:26

"Vitamin D has several mechanisms that can reduce risk of infections. Important mechanisms regarding respiratory tract infections include:

  • inducing production of cathelicidins and defensins that can lower viral survival and replication rates as well as reduce risk of bacterial infection
  • reducing the cytokine storm that causes inflammation and damage to the lining of the lungs that can lead to pneumonia and acute respiratory distress syndrome

Vitamin D deficiency has been found to contribute to acute respiratory distress syndrome, a major cause of death associated with COVID-19 … To reduce risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/day (250 micrograms/day) of vitamin D for a few weeks to rapidly raise 25-hydroxyvitamin D [25(OH)D] concentrations, followed by at least 5000 IU/day.

The goal should be to raise 25(OH)D concentrations above 40-60 ng/ml (100-150 nmol/l), taking whatever is necessary for that individual to achieve and maintain that level. For treatment of people who become infected with COVID-19, higher vitamin D doses would be required to rapidly increase 25(OH)D concentrations."