By LUCY JOHNSTON
First Published Tue, Oct 27, 2020
VITAMIN C could be a key weapon in the fight against COVID-19, research reveals. A study of 54 intensive care patients with coronavirus carried out in China found there were 68 percent fewer deaths among those given high doses of the supplement through a drip, compared with those given a dummy dose.
Some UK intensive care units, including the Chelsea and Westminster and the Royal Surrey County Hospital, are already giving high-dose vitamin C supplements.
The latest research, carried out in three hospitals across the central province of Hubei, concluded: “The addition of high-dose vitamin C may provide a protective clinical effect in critically ill patients with COVID-19.”
Although not formally recognised as a treatment by the NHS, a global platform of drug trials involving 19 countries – known as Remap-Cap – has also launched a trial.
The head of Remap-Cap in the UK, Professor Tony Gordon, a consultant at St Mary’s Hospital in London, said: “We don’t yet have conclusive evidence of benefit and we need clarity.”
According to the Remap-Cap report, vitamin C stimulates immune system cells and can also dampen down dangerous inflammation.
The head of research at the Chelsea and Westminster ICU Dr Marcela Vizcaychipi began adding the vitamin to the standard treatment package for Covid-19 at the start of the pandemic. She said: “It makes sense. It is vital for a healthy immune system.”
She became aware of its benefits for infected patients while doing her medical training in Argentina.
“We gave them good nutrition plus mineral and vitamin supplements. I saw first-hand how effective vitamin C could be.”
Official figures for ICU deaths puts Dr Vizcaychipi’s unit about 25 percent below average. However, she said it is not clear if the use of vitamin C is the reason.
No Vitamin C
Separate research shows badly infected COVID patients have been found with almost no vitamin C in their blood.
A Barcelona intensive care unit found 17 out of 18 critical patients had undetectable levels. “It’s as if they’ve got scurvy,” said one researcher.
Professor Iain Whitaker from Swansea University Medical School, who is NHS Consultant at the Welsh Centre for Burns and Plastic Surgery, said: “Given its safety profile and relatively low cost, vitamin C should be considered based on emerging evidence from critical care groups worldwide.”
Vitamin C and Covid by Steve Bennett (September 2021)
Over the past year, there has been a huge debate over vitamin C and its link to covid, especially when it comes to treatment.
BACKGROUND: VITAMIN C
I see vitamin C pretty much as a wonder drug. If it was patentable, it would be hailed as the best wonder drug ever invented (well in truth it would be joint first place with dark chocolate and eggs).
There are many books written about the benefits of vitamin C for our heart, with Dr Malcolm Kendrick listing it as a vital vitamin to minimise the risk of heart attacks. I really could go on and on singing its praises…
A great book to read is Curing the Incurable – Vitamin C, infectious diseases and toxins written by Dr Thomas Levy.
The goat creates 15 grams of vitamin C every single day, but when it is sick, it produces over 100g! If I ever get the slightest incline that I am heading for a cold, I become goat-like and take one full gram every hour until all symptoms go away. Does it work? Absolutely.
In August 28th, 2021, we saw a march in London by a group of well intentioned individuals, who are getting a little frustrated at the lack of backing for vitamin C as a treatment for those hospitalised with COVID. And I fully understand why…
THE BACKGROUND TO THE COVID & VITAMIN C DEBATE
The first randomised controlled trial, published in December, showed vitamin C to be more than twice as effective in saving lives that the steroid drug dexamethasone in critically ill patents.
Here we catalogues the ducking and diving, and anti-vitamin institutional caution that amounts to a form of recklessness that has, and is costing, thousands of lives. That is why so many individuals joined the protest on August 28th.
To get the ball rolling back, in 2020 Patrick Holford and a group of experts, most members of the Scientific Advisory Board of vitaminC4covid.com, a not-for-profit initiative supported by over 1,000 medical and nutrition health practitioners and scientists, wrote a review entitled “Vitamin C – an Adjunctive Therapy for Respiratory Infection, Sepsis and COVID-19”. This was published in the leading journal, Nutrients in December 7th. It cited over 120 studies, established vitamin C’s remarkable safety even at high doses, and has had over 20,000 downloads and not one critique. It makes the case for vitamin C and Covid, both in prevention and treatment, undeniable. This review was/is ‘noted’ by the above organisations but has not been acted on.
In their defence, back in December, there had not been actual ‘intervention’ trials, but what you could call circumstantial evidence such as the high incidence of vitamin C deficiency in those dying of covid and that patient’s vitamin C levels predicted their survival. Most of those who died had scurvy levels of vitamin C as a consequence of unresolved viral infection.
But then the intervention, prevention and observational trials of covid patients given vitamin C started to be published and, as they did, Patrick and his team circulated them to all these agencies. The first, a randomised-placebo controlled trial in Wuhan ICUs, gave intravenous vitamin C for 7 days and reported a 70% reduced hospital and ICU duration. It also found that there was an 80% reduction in mortality in the most critically ill ventilated patients, plus improved oxygenation and reduced inflammation in all covid patients given vitamin C. These results were statistically significant and much better than the 30% reduction in mortality in ventilation patients seen in the dexamethasone recovery trial.
Then, a trial giving less critically ill covid outpatients 8 grams of oral vitamin C versus placebo showed an improved recovery rate of 70% – better than any anti-viral drug tested to date. There are now seven other trials and all bar one has shown vitamin C to be effective with, broadly speaking, the higher the dose and the longer the treatment the greater effect.
YOU CAN’T PATENT A VITAMIN
I have discussed this many times on all types media. From podcasts to blogs, from books to conferences. My message is simple. Because you can’t patent something from nature, it is impossible for big pharmaceutical companies to make gigantic profit from selling them. So instead they constantly develop and patent chemical cocktails and drugs to the delight of their shareholders. Then with those profits, they spend huge sums to discredit the benefits of vitamins and minerals. Literally billions of pounds are spent each year on lobbying and influencing those in power. But I will stop right now, because there are so many books you can read on the subject.
But back to to Vitamin C and COVID. Let me now hand you over to Patrick Holford for the rest of my blog and lets ask him the following question, “Why is Public Health England reluctant to disclose any vitamin C review?”…
“SACN had told us they’d review the evidence in their June meeting. It now appears, in their March meeting minutes obtained through a Freedom of Information request (FOI) they were instructed not to. As Jo Churchill says “SACN will not be duplicating work of other organisations and will therefore exclude studies focusing specifically on vitamins C and D, as these are being undertaken as part of the RAPID-C19 initiative.”
This is bizarre since, as she says “SACN is monitoring emerging evidence of nutrition and immune function specifically in relation to COVID-19. SACN’s remit is to assess risks and benefits of nutrients/foods to health by evaluating published scientific evidence and, based on its assessment, make dietary recommendations for the UK’s general healthy population.” Is there anything more important in the field of nutrition right now than to assess the role of vitamin C and D status in reducing incidence, duration and severity of covid? Why have our neighbours, Ireland, told its public to supplement 1,000ius of vitamin D daily all year round for this very reason?
The point is, as she says, “SACN has a public health focus and the treatment of disease is therefore outside its remit” but when does a vitamin deficiency that increases likelihood and severity of a disease stop being a public health issue and start being a ‘treatment’ issue? The whole point of separating NHS England, treating disease, and creating Public Health England (PHE), was to prevent disease. Does vitamin C not do exactly this this? By stopping covid positive people developing severe symptoms that need hospitalisation and treatment is vitamin C not potentially doing exactly what PHE was set up to do – take the burden off the NHS?
So, we issued an FOI on PHE/SACN to disclose their June meeting minutes, which they had been promising was the time vitamin C would be discussed. PHE’s reply states: “It is in the public interest to withhold the information in line with the publication schedule, so the information is accessible to the wider general public at the same time”. We’ve now issued an FOI to get this ‘publication schedule’. A year and a half has passed since covid struck in the UK and still no statement on vitamin C. Jo Churchill says “Based on the data currently available, we do not believe that there is sufficient evidence at this stage to conclude that vitamin C is a safe and effective treatment for COVID-19.” It implies that PHE, advised by SACN, has reviewed the evidence, but have they? Can we see it? Apparently not. Vitamin C is actually safer than water and all studies confirm this including a study of 9,328 patients given an average intravenous dose of 24 g of vitamin C every 4 days, primarily for cancer, infection or fatigue, reported that 101 (1%) had side effects, mostly minor, including lethargy/fatigue, a change in mental status and vein irritation/phlebitis.[i] Remember, these are sick patients, most with advanced cancer.
“How slow is RAPID C19?”
You may recall calls for more transparency of who was actually in SAGE (the Scientific Group for Emergencies) advising on covid strategy. This then morphed into NERVTAG (New and Emerging Respiratory Virus Threats Advisory Group). We could, at least, find a list of their members and supplied them with all the evidence for vitamin C – with zero response. Well, it’s morphed again into RAPID C19 (Research to Access Pathway for Investigational Drugs for Covid-19) under the auspices of NICE (National Institute for Clinical Excellence). It’s described by NICE as ‘a multi-agency initiative to ensure safe and timely patient access to treatments that show evidence of benefit in preventing and treating COVID-19’. Sounds like vitamin C would fit right in. We had, by the way, already supplied NICE with all the studies showing just how effective vitamin C was and asked them if they had or would review the evidence. They said that RAPID C19 was doing it.
So I contacted James Palmer, RAPID C-19’s National Medical Director employed by NHS England and NHS Improvement asking if they had reviewed the evidence for vitamin C. He replied saying “To date, RapidC19 considers that there is insufficient evidence to recommend Vitamin C for roll out as a potential routine therapy for patients infected with COVID-19, but will continue to keep this under review.’ I replied asking to see their assessment to support this statement. He replied saying “These assessments are held by NICE.”
I responded saying ‘NICE have never replied, never done a review, or at least shown one, and someone in their contact team passed us on to RapidC19, hence yourself. When you say ‘To date, RapidC19 considers that there is insufficient evidence to recommend Vitamin C for roll out as a potential routine therapy but will continue to keep this under review.’ it suggests that RapidC19 has actually reviewed the evidence. Are you telling me that RapidC19 haven’t and rely on NICE, who also haven’t?
Our request is very simple – if either RapidC19 or NICE have actually done of review of the evidence for vitamin C for COVID-19 can we, as members of the scientific and medical community, see it?’
I am reminded of one of those football games where the ball keeps being passed from player to player, backwards and forwards, but no-one scores a goal. PHE say SACN advises them. SACN say they been told to drop the vitamin C ball and pass to RAPIDC19. RAPIDC19 kicks it over to NICE. NICE passes it back to RAPIDC19. There’s certainly a whole lot of duck and diving going on.
So, we issued a FOI request on NICE and RAPIDC19. They responded, after considerable delay explained by numerous holidays, with a ‘briefing on vitamin C’ document dated 9th September, 2020 – almost one year ago. It states that “Vitamin C (ascorbic acid) has potential benefit in patients with severe and critical COVID-19 because these patients are likely to experience oxidative stress or severe inflammation.”… “There is only 1 published randomised controlled trial investigating ascorbic acid injection reporting preliminary results. This shows no significant difference in 28-day mortality or ventilation outcomes, however this trial is still recruiting.” This was referring to the Wuhan trial. There’s then a link to an appendix which says “the vitamin C group showed a significant reduction in 28-day mortality (p=0.05) in more severe patients. The significance was lost after adjustment (p=0.06,)” it also says that the vitamin C patients had a steady rise in oxygenation (p=0.01) and reduction in inflammation (p = 0.04).
Those in medical science will know that ‘p’ is the probability that the result is real and not random. Anything equal to or less than P=0.05, which means in layman’s terms that if you ran the same experiment 100 times you’d expect this result 95 times, is usually considered statistically significant. When the Wuhan trial was published, in December, the 80% reduction in mortality in the most critically ill ventilated patients had p=0.04. Of course, RAPIDC19 know this because we sent them and NICE the paper with the relevant sections highlighted. Less death, less inflammation, improved oxygenation – all statistically significant. This compares to the dexamathasone trial where the ventilated patients were 30% less likely to die.
The RAPIDC19 September briefing also states ‘There is currently no evidence indicating any signal of harm.’ So where is Jo Churchill getting her information from to state that there is insufficient evidence that vitamin C is safe?
In this briefing RAPIDC19 also state that ‘there are 14 ongoing randomised trials; 13 for treatment of COVID-19 and 1 in the prevention of COVID-19. 1 randomised trial with a target enrolment of 140 patients has reported early results (the Wuhan study). The ongoing prevention study is a randomised double-blind study of healthcare workers with a target enrolment of 600 patients (the JAMA 8g vitamin C for outpatients study); and 8 ongoing trials investigate vitamin C injection, 1 trial investigates oral vitamin C and 8 trials do not state the vitamin C formulation.’
So, back in September, they list the studies underway to watch out for, eight of which have been published, seven of which show clear benefit. Have they really not reviewed them? We have, after all, supplied the papers. So, we issued a further FOI request for any such review or statement since September last year. So far, no response.
Double Standards for Drugs and Vitamins
Never mind anti-vax are we seeing evidence of anti-vits? Given that vitamin C no safety issues and is also part of the body’s natural biochemistry with multiple beneficial immune, antioxidant and anti-inflammatory effects surely the bar to its use should be set lower not higher? The reverse seems to be the case.
Yet less effective anti-viral drugs such as Ronapreve (Regen-Cov in the US), which reduced the risk of death by 20 per cent in a subset of hospitalised patients, are being licensed for covid with much less evidence of benefit, more adverse effects and considerably more cost, with each dose costing £1,500.[ii] Bear in mind that the usual process in medical science is someone other than the company who makes the drug runs a trial. That has not yet happened with the vaccines, and safety trials are far from complete which is why vaccines remain unlicensed.
One argument given by Government is to wait for the results of the UK’s only participation in a vitamin C trial, namely REMAP-CAP. This is a trial that several ICUs are signed up for, giving critical covid patients either vitamin C or placebo added to standard treatment. Personally, I think at this stage of evidence it is unethical to deprive any critical covid patients of vitamin C. For this very reason leading ICUs such as the Chelsea and Westminster Foundation who already give vitamin C have refused to participate. But there is the very real possibility that REMAP-CAP is designed to fail by giving vitamin C for only 4 days. The reason this is too short, as it would be for steroids or antibiotics, is that you don‘t stop a life-saving treatment in a patient hovering on the edge of death until they are out of the woods. Withdrawing vitamin C, steroids or antibiotics too soon can trigger a worsening on symptoms. Now, if you measure results on day 10 that would obscure a positive effect, but if you measure results on day 4 that should still count.
But the biggest issue with REMAP-CAP is that it hasn’t started. According to the RAPIDC19 briefing in September ‘the RAPIDC19 vitamin C arm is closed’ due to lack of vitamin C supplies! The suppliers, however, never ran out. It meant that non-one got the vitamin C treatment in the second wave. Now, they say, vitamin C supplies are available so, hopefully, some will get treated in the third wave if there is one. In her most recent letter to MPs Jo Churchill says ‘The REMAP-CAP trial into vitamin C started recruiting in November and we expect recruitment to increase. This is dependent on the number of patients in intensive care.’ This is a considerable stretch of the truth because ICUs we followed up in June hadn’t treated a single person – and you can’t recruit a critical patient without having vitamin C. Is this a delay tactic?
My view is that all this anti-vitamin institutional caution and trial delays is a form of irresponsible recklessness that has, and is costing, thousands of lives. Never mind a third wave, we need a third way based on supporting natural immunity, not just the current two pronged strategy of avoiding transmission with lockdowns, masks and tracking and vaccinations.”