Yesterday I was Zooming with the lovely Rapunzel still locked-lonely in her tower whose only companion has been a lone magpie sitting high on her roof turret,
One for sorrow,
Two for joy
for many days. Gazing down into her window, one aloof he stands sentinel. During our session Rapunzel was distracted when almost rapturously she called out my name, not something I can recall her doing before: ‘Jane! There are now two magpies sitting on the edge of the tower!’ Magpies are birds of the Corvidae family. The black and white Eurasian magpie is widely considered one of the most intelligent animals in the world and one of only a few non-mammal species able to recognize itself in a mirror test. Ah, back to narcissism. Magpies also mate for life, and some live until they are twenty-six. I cannot imagine how their phenomenal life attachment works in principal, but it seems that some species of birdlife are better at fidelity than humans.
DEFRA has just come down with the babe and reported that Bell is sorry for herself, feverish with a sore throat. The house is still in lockdown and although she has been to the park she has not come within passing distance of anyone. Yesterday, she came down to watch the iconic film The Red Balloon ; I mentioned to her she looked porcelain-pale, even paler than our new personalised Farrow and Ball high fashion colour: ‘Pallor’. Needless to say I wont feel properly myself again until I know she is well…
So much seems to be serendipity in the diary. No sooner do I write about ‘pallor’ than one of my closest friends and medical colleagues, the most dedicated consultant psychiatrist in town who even has his own therapy dog, Lady Golda, Dr James Arkell, sends out the Vitamin D info to our ‘Doctor’s Group’. ( I am not a medic but for twelve years now I have been ‘Chairing’ with Tanya a monthly ‘Doctor’s Group’ for consultant psychiatrists, GP’s and one gastro, the Apollonian Prof Matt Banks (!), nine of us in all. We meet monthly and the doctors are forbidden to speak about patients; only themselves and ‘us’ other group members. It is essentially a play group.
THE DEBATE ABOUT VIT D
The mainstream media was flooded this week with reports speculating on what role, if any, vitamin D may play in reducing the severity of COVID-19 infection.
Observational data comparing outcomes from various countries suggest inverse links between vitamin D levels and the severity of COVID-19 responses, as well as mortality, with the further suggestion of an effect of vitamin D on the immune response to infection.
But other studies question such a link, including any association between vitamin D concentration and differences in COVID-19 severity by ethnic group.
And while some researchers and clinicians believe people should get tested to see if they have adequate vitamin D levels during this pandemic — in particular frontline healthcare workers — most doctors say the best way to ensure that people have adequate levels of vitamin D during COVID-19 is to simply take supplements at currently recommended levels.
This is especially important given the fact, that during ‘lockdown’ scenarios, many people are spending more time than usual indoors.
Clifford Rosen, MD, senior scientist at Maine Medical Center’s Research Institute in Scarborough, has been researching vitamin D for 25 years.
“There’s no randomized controlled trial for sure, and that’s the gold standard,” he told Medscape Medical News, and “the observational data are so confounded, it’s difficult to know.”
Whether from diet or supplementation, having adequate vitamin D is important, especially for those at the highest risk of COVID-19, he says. Still, robust data supporting a role of vitamin D in prevention of COVID-19, or as any kind of ‘therapy’ for the infection, are currently lacking.
Rose Anne Kenny, MD, professor of medical gerontology at Trinity College Dublin, Ireland, recently coauthored an article detailing an inverse association between vitamin D levels and mortality from COVID-19 across countries in Europe.
“At no stage are any of us saying this is a given, but there’s a probability that [vitamin D] — a low-hanging fruit — is a contributory factor and we can do something about it now,” she told Medscape Medical News.
Kenny is calling for the Irish government to formally change their recommendations. “We call on the Irish government to update guidelines as a matter of urgency and encourage all adults to take [vitamin D] supplements during the COVID-19 crisis.” Northern Ireland, part of the UK, also has not yet made this recommendation, she said.
Meanwhile, Harpreet S. Bajaj MD, MPH, a practicing endocrinologist from Mount Sinai Hospital, Toronto, Canada, said: “Vitamin D could have any of three potential roles in risk for COVID-19 and/or its severity: no role, simply a marker, or a causal factor.”