Dr. Raphael Nyarkotey Obu’s thoughts … COVID-19: Could the sun be the reason for the low mortality rate in Ghana?


For thousands of years, humans have recognized that the sun plays a role in the emergence and transmission of viruses. William Bryan, science and technology advisor to the Department of Homeland Security secretary, told reporters at the White House that government scientists had found ultraviolet rays had a potent impact on the pathogen, offering hope that its spread may ease over the summer.

“Our most striking observation to date is the powerful effect that solar light appears to have on killing the virus, both surfaces and in the air,” he said. “We’ve seen a similar effect with both temperature and humidity as well, where increasing the temperature and humidity or both is generally less favorable to the virus.”

But the paper itself has not yet been released for review, making it difficult for independent experts to comment on how robust its methodology was. It has long been known that ultraviolet light has a sterilizing effect, because the radiation damages the virus’s genetic material and their ability to replicate.

A key question, however, will be what the intensity and wavelength of the UV light used in the experiment was and whether this accurately mimics natural light conditions in summer. “It would be good to know how the test was done, and how the results were measured,” Benjamin Neuman, chair of biological sciences at Texas A&M University-Texarkana, told AFP. “Not that it would be done badly, just that there are several different ways to count viruses, depending on what aspect you are interested in studying.”

The setback:

Though, it is a good news for us in Ghana with the abundant of sunlight! The setback is that, having a darker skin makes it more difficult for the skin to absorb enough sun to manufacture Vitamin D. Our bodies are also less efficient at creating Vitamin D as we age, thus many of the elderly are typically Vitamin D deficient. And a lack of sufficient Vitamin D is closely associated with common chronic diseases such as cardiovascular disease and diabetes, among others. Could this also accounts for the rising cases of cardiovascular disease, diabetes etc in Ghana as our president pushes for preventative lifestyle?

Misinformed news

In a recent article in the New York Post, consuming Vitamin D to prevent or co-manage COVID-19 infections was downplayed. Other news outlets such as CNN jumped on trivializing the Vitamin D bandwagon.

These utterly misinformed news platforms quoted “experts” in saying, “Although there is some evidence that low Vitamin D is associated with acute respiratory tract infections, there is currently insufficient evidence for Vitamin D as a treatment for COVID-19. Over-supplementing must be avoided as it could be harmful.”

Allow me to share with you how ridiculous this statement is…

Making of Vitamin D

Vitamin D is an essential nutrient, which means the human body needs it but can’t make it. While some foods contain Vitamin D, people have traditionally gotten most of their Vitamin D from the sun: When exposed to ultraviolet light, a chemical reaction takes place in the skin that results in the production of Vitamin D; but do remember, our dark skin is problematic!

Some Scientific evidence?

In one recent 2020 research study by Fiona Mitchell titled “Vitamin-D and COVID-19: do deficient risk a poorer outcome”? published in the prestigious Lancet-Vitamin D strengthens innate immunity and prevents overactive immune responses. That’s key.

An overactive immune response, which leads to a cytokine storm, is precisely why people with COVID-19 die. For instance, in another recent 2020 study by Daneshkhah et al addresses titled “The Possible Role of Vitamin D in Suppressing Cytokine Storm and Associated Mortality in COVID-19 Patients”. The study investigates the possible role of Vitamin D deficiency via unregulated inflammation in COVID-19 complications and associated mortality. The study concludes that Vitamin D, at higher blood levels, may prevent a cytokine storm.

Interestingly, almost all who die from COVID-19 in the Philippines are Vitamin D Deficient. This research was conducted by Mark Alipio, 2020 titled “Vitamin D Supplementation Could Possibly Improve Clinical Outcomes of Patients Infected with Coronavirus-2019 (COVID-19)”,  the study involved a retrospective multicentre of 212 cases with laboratory-confirmed infection of SARS-CoV-2.

Data pertaining to clinical features and serum 25(OH)D levels were extracted from the medical records. Of the 212 cases of COVID-19, majority had ordinary clinical outcome. Mean serum 25(OH)D level was 23.8 ng/ml. Serum 25(OH)D level was lowest in critical cases, but highest in mild cases. Serum 25(OH)D levels were statistically significant among clinical outcomes. Majority had insufficient Vitamin D status, most of them were not severe. Vitamin D status is significantly associated with clinical outcomes.

The results suggest that an increase in serum 25(OH)D level in the body could either improve clinical outcomes or mitigate worst (severe to critical) outcomes, while a decrease in serum 25(OH)D level in the body could worsen clinical outcomes of COVID-2019 patients. In conclusion, this study provides substantial information to clinicians and health policy-makers.  Two groups of people who make the majority of deaths from COVID-19 are the elderly and blacks.  According to  Fiona Mitchell, 2020, blacks and older people are extremely deficient in Vitamin D.

Interestingly, Scandinavian countries have the lowest incidences of COVID-19 mortality. This was addressed in a research by Ilie et al 2020 titled “The Role of Vitamin D in the Prevention of Coronavirus Disease 2019 Infection and Mortality”. The study aim was to propose a hypothesis that there is a potential association between mean levels of Vitamin D in various countries with cases and mortality caused by COVID-19.

The mean levels of Vitamin D for 20 European countries and morbidity and mortality caused by COVID-19 were acquired. Negative correlations between mean levels of Vitamin D (average 56 mmol/L, STDEV 10.61) in each country and the number of COVID-19 cases/1 M (mean 295.95, STDEV 298.7, and mortality/1 M (mean 5.96, STDEV 15.13) were observed. Vitamin D levels are severely low in the aging population especially in Spain, Italy and Switzerland. This is also the most vulnerable group of the population in relation to COVID-19.

They also consume cod liver oil and Vitamin D supplements and possibly less sun avoidance. While it is difficult to conclude their lower COVID rates are due to healthier levels of Vitamin D, such possibility should not be overlooked. Before these COVID days, a study conducted by Martineau et al 2017 looking at randomized trials showed that people with low Vitamin D levels had a higher probability of having and dying from acute respiratory infections compared with those with normal Vitamin D levels.

Asyary  and  Veruswati, 2020  study aims to present the correlation between sunlight exposure and Covid-19 statuses in Jakarta, Indonesia, involves  secondary data analysis  derived from surveillance data for Covid-19 from government authorities, including the Ministry of Health, the Meteorological, Climatological, and Geophysical Agency, and the local government of Jakarta. Three statuses related to Covid-19 were examined in the study: incidence, death, and recovered. Meanwhile, sunlight exposure was presented as daily duration of it. Only the number of recovered patients correlated significantly with sunlight exposure. This study’s findings showed that sunlight exposure was associated with recovery from Covid-19.

Is Vitamin D toxic?

“Over-supplementing must be avoided as it could be harmful.” – New York Post.  Meaning that, they are saying, “Vitamin D is important for protection against viral infections, but is it safe?” Let me be clear here; all the safety concerns about Vitamin D potential toxicity is unnecessary.

The upper level recommended dose with Vitamin D is 4000 units a day. I usually provide patients with 5000 to 10,000 units a day of Vitamin D.  In news outlets, these dosages are considered “mega-doses.” But are they? Is all that fear-mongering worthy? Everything has a poisonous dose. EVERYTHING! That includes drinking too much water, which can cause a coma and can be deadly.

Araki et al 2011 reports two separate  case of two men consuming very high doses of Vitamin D due to manufacturing error. The nutritional supplement was supposed to contain about 1600 IU of Vitamin D.  For context, most multivitamins contain about 400 IU of Vitamin D. Standalone Vitamin D can range from 1000 IU a pill to 10,000 IU a pill.  Recommendations from nutritionally oriented physicians can be up to 10,000 IU a day.

However, In the case report, the two men consumed 1,000,000 IU (one million units) a day for three weeks before developing symptoms strong enough to seek care.

Astonishingly, none of these men died from an extraordinary and immeasurable amount of Vitamin D consumption. Symptoms of extreme Vitamin D toxicity (which would never happen under normal circumstances) include unexplained fatigue, nausea, excess urination, and blood in the urine.

My opinion on Vitamin D based on research studies

Almost all the information you read has the disclaimer of speaking to your doctors if you are thinking of taking high amounts of Vitamin D. The problem is that most doctors, health workers and scientists are as confused about Vitamin D as patients.

That’s likely because there’s virtually no nutritional training in Conventional Medical School unlike the training Naturopathic or holistic doctors received in Naturopathic Medical schools. The basis of Naturopathic or holistic medicine is sound clinical nutritional education. So  Seeing a functional medicine or naturopathic doctor like myself might be a good idea in case  you need any information on natural ingredients.

Another line you probably read that may discourage one from taking Vitamin D is that the studies show correlation but not causation. This is true.  For instance, Kumar V, Srivastaa A, 2020 study titled “Spurious Correlation? A review of the relationship between Vitamin D and Covid-19 infection and mortality” argued that correlation alone may not be useful in establishing a relationship between Vitamin D levels and Covid-19 infections and mortality.

The analysis of data from European and perhaps other countries is problematic for a couple of reasons. One is that the 25OHD concentrations used may not be appropriate for those who develop COVID-19 due to age mismatch or not being for winter. Another is that life expectancy, an index for the fraction of the population that is elderly, has a stronger influence on COVID-19 rates than does 25OHD.

The natural Vitamin D levels are way higher than the average levels found in populations living in the civilized world. Biologically normal Vitamin D levels are between 120 nmol/l and 250 nmol/l. Levels below 100 nmol/l are from a natural biological point of view extremely low, but such levels are the norm in the civilized World, even in the tropics as people there too spend most of the day indoors.

Studies like this that look into the correlation between Vitamin D levels naturally found in society and harmful effects of COVID-19 effect are interesting, but they cannot detect all of the effects of the severe Vitamin D deprivation of the western population. It’s similar to a study into the effects of exercise on heart disease if you’re studying a population of couch potatoes.

You may detect a difference between those couch potatoes that don’t sit all day long on the couch and those that hardly get up at all during the day. But the large effects on heart health that kick in when you run for more than half an hour a day, cannot be extracted from such a study.

In other words, a randomized trial looking at Vitamin D versus placebo to show if it’s beneficial for health has not been conducted. The simplest randomized trials cause millions of dollars.  However, Observational studies (and clinical experience) hold value, especially when the substance in question is relatively safe.   According to Dr. Geo Espinoza, naturopathic doctor,  suggests taking enough Vitamin D where blood test comes up between 40 and 60ng/ml as recommended by Ekwaru et al 2020.titled       “The Importance of Body Weight for the Dose Response Relationship of Oral Vitamin D Supplementation and Serum 25-hydroxyvitamin D in Healthy Volunteers”.

  1. To get in that range, an amount between 4000 IU and 10,000 IU is required.
  2. The upside to taking a tiny, inexpensive pill of Vitamin D is immense.
  3. While Vitamin D is not a cure-all, no one substance is the benefit outweighs the risk.
  4. Vitamin D supplementation may indeed protect against COVID-19 and most viral infections. But that’s not all.

Chowdhury et al 2014 study titled “Vitamin D and risk of cause specific death: systematic review and meta-analysis of observational cohort and randomised intervention studies” posits that Having healthy levels of Vitamin D in the body reduces the risk of dying prematurely from any disease-related cause”.

As an aside, another upside (pun) to taking Vitamin D. A systemic review titled “Is There an Association Between Vitamin D Deficiency and Erectile Dysfunction? A Systematic Review and Meta-Analysis” by Crafa et al 2020 on this vital nutrient shows that ample amounts help with erectile dysfunction.

Lastly, be super cautious about where you get your health information from. I think the internet and some news media do a good job delivering good, actionable information. Others not as much. There are a plethora of media platforms competing for your attention. And headlining anything about vitamins like Vitamin D draws attention. There are far more questions than answers when it comes to the relationships between sunlight and Covid-19. But the evidence to date hints that getting some sun may help protect people from the virus.

DISCLAIMER This post is for enlightenment purposes only and should not be used as a replacement for professional diagnosis and treatments. Remember to always consult your healthcare provider before making any health-related decisions or for counselling, guidance and treatment about a specific medical condition.

The writer is an honorary Professor of Holistic Medicine-Vinnytsia State Pedagogical University, Ukraine, President of Nyarkotey College of Holistic Medicine, Tema Community 7 and currently, LLB law/MBA Student. He is the formulator of FDA approved Nyarkotey Hibiscus Tea for Cardiovascular Support and wellness, Men’s Formula for Prostate Health and Women’s Formula for wellness. Contact: 0241083423/0541234556

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