One of the most frustrating aspects of tracking and attempting to decipher the risk factors concerning COVID-19 is the lack of consistency and solid “root cause” data being shared by recognized experts. The World Health Organization (WHO) lost tremendous credibility with their blatant “follow the leader” approach to regurgitating what China was telling them, much of which was misleading. As the United States wrestles with the enormity of re-opening up a struggling economy due to the world pandemic and resultant shut-down, more and more cases of COVID-19 are being reported. Some of that, frankly, is to be expected given the increased number of testing facilities, the hundreds of thousands of people who violated all social distancing suggestions and rules and elected to riot, protest and vandalize in major cities across the country, and the fatigue of quarantine that drove tens of thousands of people to beaches, parks and recreational areas to enjoy some time outside.
In business, and in life, we use data to help us make better decisions. Many times you don’t have all the facts, so you need to use intuition, historical situations for reference, analogous problems or issues, and sound reason to help steer through uncertainty, like we are trying to do now.
Influenza. A Starting Point
The United States loses 35K – 60K people EVERY YEAR to influenza. When assessing the people that are at highest risk of suffering from severe symptoms, those with chronic health conditions are the highest risk citizens of suffering, and ultimately dying, from influenza. What is a chronic condition? The CDC definition: Chronic diseases are defined broadly as conditions that last 1 year or more and require ongoing medical attention or limit activities of daily living, or both. Some examples include:
- Heart Disease
- Obesity
- Diabetes
- Chronic Pulmonary Disease
- Arthritis
- Asthma
Specifically with Influenza, additional conditions like HIV/Aids are also considered. What do All of these health conditions have in common? Inflammation. In every single one of these conditions, the body is under severe inflammation and/or the immune system is compromised.

So, if a virus (influenza) is able to penetrate a body that is already compromised due to high levels of inflammation, that body will likely react in one of two ways:
- The weakened state of the body will enable the virus to take hold, cause even more severe symptoms & further weaken the body where life-saving medical treatment may be required.
- The body will elicit an immunogenic response to the external pathogen that will cause an over-reaction, and actually cause the person’s immune system to go on the attack, causing possible life threatening symptoms. A cytokine storm would be an example of this occurrence.
Introducing Vitamin D
Vitamin D is one of the fat soluble vitamins considered essential for optimum health. Long associated with normal growth & development, it aids in the absorption and metabolism of calcium & phosphorus to support strong bones & teeth, and helps prevent skeletal deformities such as rickets. It can help prevent/reduce osteoporosis, help muscle strength and is involved in cell division. While food sources like quality beef, eggs, sardines and liver can provide through nutrition, the primary method to absorb Vitamin D? Sunlight.
One of the functions that is not discussed widely, though, is how Vitamin D is also important in helping maintain immune function, which Dr. Berg talks about in more detail in the below video:
Application to COVID-19
The daily mail published results of an SSRN study of 780 Indonesian patients who had COVID-19. The study sought to understand any type of root cause or correlation to the severity, and fatality, of the suffering patients. What they found was staggering (note: this data still needs additional peer review).
In the COVID-19 study of Indonesian sufferers who tested positive, the death rate data breaks down as follows:
- For those with normal Vitamin D levels, there was a 4.1% death rate.
- For those with insufficient Vitamin D levels, the death rate skyrocketed to ~ 88%.
- For those who were deficient in Vitamin D, almost 99% died.
- Vitamin D-deficient patients were 10 times more likely to die when age, gender and co-morbidities (chronic diseases or other health issues) were taken into account.

Implications
While there is obviously more analysis needed, this is a startling data point that warrants more urgent review. With 9.5M cases of COVID-19 diagnosed worldwide, we have ample data points to review and consider whether this type of Vitamin D commonality can be traced among other countries. Think about the following (noted in the report):
- One in five British adults and one in six children is lacking in vitamin D, thanks to poor diets, indoor lifestyles and lack of sunshine.
- Experts estimate around 1 billion(!) people worldwide are deficient in the vitamin, with the figures having been described as a ‘global public health issue.’
- Some scientists fear that the lockdown and months of indoor living have cut levels even further.
- Some ethnic groups tend to be at higher risk because their skin is less able to make the vitamin in response to sunlight.
- Older people are also in danger because the body gets less efficient at producing the vitamin with age.
Understanding the impact of chronic conditions, inflammation and vitamin deficiency can help us create a sustainable, pragmatic approach to prevention vs. taking a “scorched earth” approach by shutting the entire global economy down. We have the data; we need to use it to create a clear understanding of the root cause drivers (NOT just the symptoms), and a recommended action plan.