FOR IMMEDIATE RELEASE
Orthomolecular Medicine News Service, Apr 30, 2020

Protected Group Immunity, Not a Vaccine, is the Way to Stop the COVID-19 Pandemic

Commentary by Richard Z. Cheng, MD, PhD

(OMNS Apr 30, 2020) Due to the lengthy development of at least 2 years, vaccines are not effective for stopping or controlling new epidemics. Group immunity (as the term "herd" generally implies animals other than humans) may be the only way to stop an ongoing new epidemic. However, unprotected exposure of the public to new pathogens (viruses) may result in high morbidity, mortality and economic losses. It may also seem irresponsible or unethical for governments not to offer any protection to its citizens. Early and sufficient use of vitamin C (along with vitamin D3, zinc, magnesium and other nutrients) is able to offer a high level of protection. A strategy of combining supplements of vitamin C and other nutrients with traditional herd immunity to form the basis of the "Protected Group Immunity" is worth further study and may become a better preventive measure to stop Covid-19 and future epidemics.

Epidemics/Pandemics are on the rise.

In a short period of only 4 months, Covid-19 pandemic has caused more than 200,000 fatalities, with 2.7 million confirmed cases of SARS-Cov-2 infections, and economic losses in the trillions of USD worldwide.

An article in the Wall Street Journal's Economy section on March 6, 2020, read "Global viral outbreaks like Coronavirus, once rare, will become more common." [1] BBC also reported on March 25, 2020 (Covid-19: the history of pandemics) that the rate of new epidemics like SARS, MERS and Covid-19 has increased 4-fold over the past century. The annual outbreak of epidemics in the last 40 years has doubled. [2] In the short 20 years of the 21st century, there have been over 60 epidemics compared to the less than 100 epidemics in the entire 19th and 20th centuries combined. This is about a 650% annual increase in the number of epidemics in the last 20 years compared to the 200 years prior! Moreover, there have been 11 epidemics in the 21st century that caused more than 1,000 fatalities, compared to the 14 epidemics in the 200 years prior. If we use fatality of 1,000 as a marker for severity, there has been an increase of 785%. [3]

What's the plan of our governments, the World Health Organization (WHO), the pharmaceutical industry, and the leading medical institutions to deal with the disturbing trend of increasing epidemics?

Probably the most common term used to describe prevention of epidemics is "vaccine." International agencies like WHO, sovereign governments, major foundations, pharmaceutical industry, as well as leaders in major medical institutions all appear to be focused on vaccine and vaccine only.

We wish we would have a Covid-19 vaccine today. We wish we had a Covid-19 vaccine 4 months ago. But unfortunately, we didn't and we don't. The best estimate of a vaccine is at least 18-24 months away, if possible at all.

Vaccine is not an ideal answer to new epidemics

The nature of vaccine development makes the vaccine strategy against new epidemics a less than ideal one.

Let's look at the process of how a vaccine is developed.

First, a new pathogen (e.g., SARS-Cov-2 virus that has caused the Covid-19 pandemic) appears and causes a local infectious disease outbreak. This eventually catches the attention of the local medical agencies and governments. Scientists then begin to study the new infectious disease, identify the new pathogen, develop a vaccine, which needs to go through clinical trials to demonstrate its safety and effectiveness. If the clinical trial is successful, an application for approval by the FDA is then submitted. If a vaccine is finally approved by the FDA, it is then mass produced and distributed for clinical use. This is a lengthy process, with at least 2 years after a new epidemic breaks out. To make things worse, due the frequent mutations of viruses, especially for RNA viruses, and due to the delay in finally mass-producing a vaccine, the virus will likely have mutated to lower the vaccine's efficacy.

Covid-19 has already caused trillions of dollars in economic damage in a short period of four months. Likely many more lives and much more economic damage will occur in the next 18 to 24 months while we are waiting and expecting a vaccine. What if we will never see an effective vaccine? In the history of medicine, there has never been a vaccine developed in a timely manner to stop an ongoing new epidemic. Successful vaccines today are only effective against an existing infectious disease or recurrent epidemic, not a new epidemic. Even so, for most of the many recent epidemics like SARS, MERS, Ebola, Marburg, Zika, and Dengue, to name just a few, there is no vaccine.

Further, vaccines can only prevent an infection. Vaccines are not treatment for infections.

Ideal preventive and treatment measures against all epidemics, both new and recurrent, are urgently needed.

We clearly need better preventive and treatment measures to deal with the disturbingly increasing trend of epidemics. Ideally good preventive and treatment measures for new epidemics should have the following characteristics:

1. Nonpathogen specific and universal: treatments that can lower the risk of infection from a virus or other pathogens, or can reduce the severity of the infection. This characteristic would allow us to prevent and treat any epidemic when it occurs, without any unnecessary delay.
2. Effective and safe.
3. Readily available: when an epidemic breaks out, we need to have it available right away to stop an epidemic.
4. Affordable: this is yet another key characteristic for large scale application to stop an ongoing epidemic.

For new epidemics, vaccines clearly don't meet the above criteria.

Our natural defense mechanisms including nutrients like vitamin C are among the few options that meet the above characteristics. They can defend us from catching diseases, and can prevent the disease from progressing. Other such nutrients include vitamin D3, zinc, magnesium, selenium etc.

Vitamin C has pleiotropic biological effects including but not limited to its antiviral and antimicrobial effects, immune-boosting effects, as well as antioxidant effects.

1. Vitamin C has potent antiviral effects through virucidal and immune modulating effects. [4-13]
2. Vitamin C is a prototypical potent antioxidant that plays a critical role in the prevention and treatment of the marked inflammatory response to viruses and other pathogens. Clinically, vitamin C is effective in preventing and treating pneumonia [12], multi-organ failure [14], and acute respiratory distress syndrome (ARDS). [14-18] Another related antioxidant that has shown promise for acute cases of pneumonia is glutathione. [19]
3. Preliminary clinical evidence from China and elsewhere seems to show high-dose IV vitamin C is effective in treating Covid-19 patients. [20,21]
4. Out of the few treatments being tried for Covid-19, high-dose intravenous vitamin C (HDIVC) shows very promising results in treating critical cases of Covid-19 with reduced fatalities, reduced ICU or hospital stays [22-25] and is very safe, without significant side effects (caveat, G6PD deficiency). [22,26] HDIVC's effectiveness in treating infectious (including viral) diseases and its high safety profile is based on solid science with decades of basic and clinical research reflected in tens of thousands of research papers in the world's largest biomedical library, the United States National Library of Medicine, hosted at the NIH (pubmed.gov).
5. Given the lack of proven and widely accepted effective treatments of Covid-19, the high safety profile of HDIVC and promising effectiveness of HDIVC makes the compassionate use of HDIVC very reasonable. In my opinion, not to give HDIVC to critically ill Covid-19 patients seems unthinkable, even unethical.

Protected Group Immunity.

With vaccines against Covid-19 not anywhere near, the only other hope to stop the Covid-19 pandemic seems to be group immunity: when enough members of a population develop immunity.

Yet to leave the public without any protection from the risk of a SARS-Cov-2 infection seems cruel, unethical and may even cause a public outcry.

However, sufficient doses of vitamin C (3000 mg/d in divided doses), and other nutrients such as vitamin D3 (2000-5000 IU/d), zinc (20 mg/d), magnesium (400 mg/d), and selenium (100 mcg/d), lower the risk of the public developing the infection, and can protect patients in the initial stages of infection from progressing to more serious disease. [22] Vitamins C and D are known to assist and empower the immune system to prevent viral infection, [22-31] and vitamin C in high oral doses to bowel tolerance [32,33] can denature viruses and prevent damage to the body from oxidative stress. Supplemental high-dose oral or intravenous vitamin C is indicated in severe infections and oxidative stress because they cause the vitamin C level to drop to zero. [27]Zinc, magnesium, and selenium are known anti-viral agents. [30,31] With such a treatment that has worked to prevent serious infection of a variety of other viruses, further research is clearly indicated here. Moreover, the WHO currently recommends research on vitamin C as a promising treatment for COVID-19. [34] When proven, this strategy not only can help stop Covid-19 pandemic, it will also protect us in the future epidemics.

Acknowledgment: thanks to the members of the editorial board of the Orthomolecular Medicine News Service who reviewed and critiqued this manuscript, including the choice of "group immunity" over "herd immunity."

References

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2. Walsh, B. Covid-19: The history of pandemics. (2020). https://www.bbc.com/future/article/20200325-covid-19-the-history-of-pandemics

3. Timeline: Major Epidemics in the U.S. (2020) https://www.infoplease.com/math-science/health/diseases/major-us-epidemics#timeline

4. Pauling, L. (1971) The Significance of the Evidence about Ascorbic Acid and the Common Cold. Proc Natl Acad Sci USA 68:2678-2681. https://www.ncbi.nlm.nih.gov/pubmed/4941984

5. Chen Q, Espey MG, Krishna MC et al. (2005) Pharmacologic ascorbic acid concentrations selectively kill cancer cells: action as a pro-drug to deliver hydrogen peroxide to tissues. Proc. Natl. Acad. Sci. USA 102:13604-13609. https://www.ncbi.nlm.nih.gov/pubmed/16157892

6. Chen Q, Espey MG, Sun AY et al. (2007) Ascorbate in pharmacologic concentrations selectively generates ascorbate radical and hydrogen peroxide in extracellular fluid in vivo. Proc. Natl. Acad. Sci. USA 104:8749-8754. https://www.ncbi.nlm.nih.gov/pubmed/17502596

7. Du J, Martin SM, Levine M et al. (2010) Mechanisms of ascorbate-induced cytotoxicity in pancreatic cancer. Clin. Cancer Res. 16:509-520. https://www.ncbi.nlm.nih.gov/pubmed/20068072

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10. Hemilä H, Chalker E. (2013) Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev CD000980. https://www.ncbi.nlm.nih.gov/pubmed/23440782

11. Nabzdyk CS, Bittner EA. (2018) Vitamin C in the critically ill - indications and controversies. World J Crit Care Med 7:52-61. https://www.ncbi.nlm.nih.gov/pubmed/30370227

12. Hemilä, H. (2017) Vitamin C and Infections. Nutrients 9(4). pii: E339. https://www.ncbi.nlm.nih.gov/pubmed/28353648

13. Colunga Biancatelli RML, Berrill M, Marik PE. (2020) The antiviral properties of vitamin C. Expert Rev Anti Infect Ther. 18:99-101. https://www.ncbi.nlm.nih.gov/pubmed/31852327

14. Vincent JL, Moreno R, Takala J et al. (1996) The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med. 22:707-710. https://www.ncbi.nlm.nih.gov/pubmed/8844239

15. Kashiouris MG, L'Heureux M, Cable CA et al. (2020) The Emerging Role of Vitamin C as a Treatment for Sepsis. Nutrients. 12(2). pii: E292. https://www.ncbi.nlm.nih.gov/pubmed/31978969

16. Sawyer, M., Mike, J. & Chavin, K. (1989) Antioxidant therapy and survival in ARDS (abstract). Crit Care Med. 17:S153.

17. Marik PE, Khangoora V, Rivera R et al. (2017) Hydrocortisone, Vitamin C, and Thiamine for the Treatment of Severe Sepsis and Septic Shock: A Retrospective Before-After Study. Chest 151:1229-1238. https://www.ncbi.nlm.nih.gov/pubmed/27940189

18. Boretti A, Banik BK. (2020) Intravenous Vitamin C for reduction of cytokines storm in Acute Respiratory Distress Syndrome. PharmaNutrition. 12:100190. https://www.ncbi.nlm.nih.gov/pubmed/32322486

19. Horowitz RI, Freeman PR, Bruzzese J. (2020) Efficacy of glutathione therapy in relieving dyspnea associated with COVID-19 pneumonia: A report of 2 cases. Respir Med Case Rep. 30:101063. https://www.ncbi.nlm.nih.gov/pubmed/32322478

20. Video conference with Dr. ZY Peng, of the world's first high-dose IVC trial. (2020) Cheng Integrative Health Center Blog. http://www.drwlc.com/blog/2020/04/16/video-conference-with-dr-zy-peng-of-the-worlds-first-high-dose-ivc-trial

21. Cheng RZ (2020) Can early and high intravenous dose of vitamin C prevent and treat coronavirus disease 2019 (COVID-19)? Medicine in Drug Discovery 5, 100028. https://www.ncbi.nlm.nih.gov/pubmed/32328576

22. Orthomolecular Medicine News Service Editorial Review Board (2020) Rationale for Vitamin C Treatment of COVID-19 and Other Viruses. http://orthomolecular.org/resources/omns/v16n21.shtml

23. Player G, Saul AW, Downing D, Schuitemaker G. (2020) Published Research and Articles on Vitamin C as a Consideration for Pneumonia, Lung Infections, and the Novel Coronavirus (SARS-CoV-2/COVID-19) Orthomolecular Medicine News Service. http://orthomolecular.org/resources/omns/v16n20.shtml

24. Front Line COVID Critical Care Group (2020) Early Intervention Protocol for COVID-19 Can Save Lives. April 15, 2020. https://covid19criticalcare.com

25. Carr AC, Maggini S. (2017) Vitamin C and Immune Function. Nutrients 9(11) pii: E1211. https://www.ncbi.nlm.nih.gov/pubmed/29099763

26. Prier M, Carr A, Baillie N. (2018) No reported renal stones with intravenous vitamin C administration: a prospective case series study. Antioxidants (Basel) 7: 68. https://www.ncbi.nlm.nih.gov/pubmed/29883396

27. Berger MM. (2009) Vitamin C Requirements in Parenteral Nutrition. Gastroenterology 137:S70-78. https://www.ncbi.nlm.nih.gov/pubmed/19874953.

28. Grant WB, Baggerly CA (2020) Vitamin D Supplements Could Reduce Risk of Influenza and COVID-19 Infection and Death. Orthomolecular Medicine News Service. http://orthomolecular.org/resources/omns/v16n23.shtml

29. Grant WB, Lahore H, McDonnell SL, et al. (2020) Evidence That Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients 12(4). pii: E988. https://www.ncbi.nlm.nih.gov/pubmed/32252338

30. Gombart AF, Pierre A, Maggini S. (2020) A review of micronutrients and the immune system-working in harmony to reduce the risk of infection. Nutrients 12(1). pii: E236. https://www.ncbi.nlm.nih.gov/pubmed/31963293

31. Calder PC, Carr AC, Gombart AF, Eggersdorfer M. (2020) Optimal Nutritional Status for a Well-Functioning Immune System Is an Important Factor to Protect against Viral Infections. Nutrients 12: 1181. https://www.ncbi.nlm.nih.gov/pubmed/32340216 https://doi.org/10.3390/nu12041181

32. Cathcart RF. (1981) Vitamin C, titrating to bowel tolerance, anascorbemia, and acute induced scurvy. Medical hypotheses 7:1359-1376. https://vitamincfoundation.org/www.orthomed.com/titrate.htm

33. Hickey S, Roberts HJ, Cathcart RF. (2005) Dynamic Flow: A New Model for Ascorbate. J Orthomol Med. 20:237-244. http://orthomolecular.org/library/jom/2005/pdf/2005-v20n04-p237.pdf

34. World Health Organization (2020) A Coordinated Global Research Roadmap: 2019 Novel Coronavirus. March, 2020, p 36-37. https://www.who.int/blueprint/priority-diseases/key-action/Coronavirus_Roadmap_V9.pdf

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