The Spanish Flu of ~100 years ago took over the world and infected one third of the world’s population (~500 million people) worldwide, and killed ~50 million (~3% of the world’s population). Most of us probably didn’t know or didn’t care much about the Spanish Flu until Covid-19. With today’s advanced hygiene, economy and technology compared to a century ago, most of us probably thought pandemics of that scale are long gone. Well, I did.

What a shock, here we are, ~10 months later, we are still immersed in the Covid-19 panic and chaos, with >1 million people killed and trillions of dollars lost. The world is still in a locked down mode, many people, if not affected by Covid-19 directly, are most definitely affected by the hardship due to lock-down.

Since the Spanish flu, the world has seen many epidemics and pandemics, but none at the scale of Covid-19. One would expect that the leadership in our public health systems, the medical establishment and worldwide governments have learned how to deal with such a public health hazard. Needless to say, we all have been sadly disappointed, particularly at the responses from the leadership in the public health and the medical establishment.

Covid-19 provided a litmus test for the politicians, their top medical advisors, leaders in various industries including social media and other societal activists. I am sure many global citizens share with me the view that most of them have failed us miserably in this Covid-19 global fight!

Covid-19 is a major crisis, but it also presents a great opportunity. In Chinese, crisis is translated into 危機, which is consisted of 2 characters, Danger (危) and Opportunity (機). Great disasters often call for deep reflections and soul searching, which may bring about great reforms. We, the global villagers (the consumers, the healthcare professionals, industrial leaders and the politicians), all need to reflect on Covod-19: what we have done right, and what we have done wrong and how could we improve in the management of Covid-19 down the road and future public disasters. Yes, Covid-19 won’t be the last one, epidemics and pandemics are on the rise¹.

Digging deeper, Covid-19 is revealing more problems in our current medical system, “Evidence-Based Medicine” (EBM), than just a catastrophic pandemic!

In this article I’ll discuss briefly some key problems in EBM, followed by a summary review of the common pathological features of viral infections including those of Covid-19, to point out the key underlying biochemical and pathological mechanism: disturbance in redox homeostasis, concluding with an analysis of redox therapy including antioxidants such as vitamin C in Covid-19 intervention.

Shortcomings of Evidence-Based Medicine, revealed in Covid-19 management

One of the major problems of EBM is the gradually increasing bias in what constitutes as “evidence” in EBM. Another is the lack or insignificant role of mechanistic reasoning, or lack of “logical reasoning” in EBM. The third is what I consider as the “Nobel Prize Mentality” dominance in today’s clinical medicine, i.e., using the narrowly focused basic science research principles and tools to address complex and holistic clinical problems. The management (or better mismanagement) of Covid-19 illustrates these problems. The mismanagement is causing more problems than the problems directly due to Covid-19 per se.

Evidence-based medicine (EBM) movement, started in the 1990s, has gradually become the central dogma of today’s medical practice. Of course, this doesn’t mean the medicine practiced in the past thousands of years is not evidence based. Even today, ~50% of what a clinician does in the clinic is still so-called empirical medicine (or experience based), despite the dominance of EBM. Medicine practiced in the past thousands of years, if not longer, has always been “evidence” based. The key question here is what is considered as evidence.

What is Evidence-Based Medicine (EBM)?

Evidence-based medicine is interpreted as the integration of best research evidence with clinical expertise and patient values². EBM aims for the ideal that healthcare professionals should make conscientious, explicit, and judicious use of current best evidence in their everyday practice”².

Randomized controlled clinical trials (RCTs) are only part of the evidence in EBM. There are several levels of evidence in EBM.

There is no doubt that evidence is important. The center of EBM is “evidence”. There are generally 4 different levels of evidence, from RCTs to case studies to clinical expert experience (empirical)³. It’s clear here that, although RCTs have the highest weight in “evidence”, RCTs are not the only evidence in EBM. However, all the scientists and medical doctors whom I know and have communicated with view RCT as the only evidence. They seem to think that if there is no RCT data, then it’s not EBM. They have no idea that EBM has several levels of evidence. To be honest, I didn’t know what EMB exactly is either until I looked it up in the literature. I venture to say that this is quite common among scientists and clinicians.

Another major problem of EBM is the lack of clinical or mechanistic reasoning. RCT results and treatment guidelines contain limitations and financial conflicts which may result in bias. We clinicians must still reason through the best choices for an individual patient even in the absence of full and secure knowledge⁴, as is in this Covid-19 pandemic. Covid-19 is a new disease, but it doesn’t mean we knew nothing in the treatment and prevention of Covid-19. Even without thorough research, there is plenty we already know about viral infections, Covid-19 included, that we can apply in prevention and treatment.

Disturbingly increasing trend of biased “Evidence” favorable to for-profit patentable drugs in EBM.

Publicly funded RCTs have been declining, while for-profit industry funded RCTs are on the rise, a trend with a deep and potentially biased and unfair influence on our healthcare policy, with potentially grave consequences.

There is no doubt that RCTs are important. Well-designed RCT results are considered the strongest evidence in EBM. But RCTs are very costly and are becoming more and more limited to organizations with strong financial backings. A 2015 Johns Hopkins University study found the number of clinical trials funded by for-profit industry increased 43% while those funded by the NIH decreased by 24%, between 2006 and 2014⁵. While the goals of NIH-funded RCTs are not to make a profit on the market, the for-profit industry funded RCTs are clearly for profit.

There is no doubt that lifestyle and nutrition play fundamentally important roles in our health maintenance and disease prevention and treatment. However, lifestyle and nutrition research results are usually not patentable. There is no financial incentive in doing RCTs by for-profit industry, leading to a bias towards low representation of lifestyle and nutrition medicine in the “evidence database” that EBM relies on. But can anyone tell me that lifestyle and nutrition medicine is not important?

With a growing dominance of for-profit industry sponsored RCTs making up the “best evidence” in EBM, no wonder, medical practice today is biased and heavily influenced by the big pharma.

Some other facts:

• For profit Industry doesn’t fund trials most important for public health due to lack of financial incentive.⁶ This includes the lifestyle and nutrition medicine discussed above.
• The Johns Hopkins University’s Comprehensive Cancer Center found conflicts of interest in more than one-third of 1,500 cancer studies published in prominent medical journals in 2006⁶.
• As many as 70% of approved drugs are not new drugs, wasting billions of dollars of unnecessary clinical trials.⁷

Today’s clinical medicine has been dominated by the basic science mentality (“Nobel-prize mentality”).

Nobel prize is the crown jewel that attracts the top medical and biological scientists. Those who reach the top of various medical specialties have spent most of their careers in basic research. There is a dichotomy between those who lead in medicine and those who actually practice medicine. Those influential medical experts, who write “disease management guidelines” and influence healthcare policies, are mostly attracted and dominated by the “Nobel-prize mentality”. This disturbing trend is partly illustrated in the gradual decrease of Nobel prizes awarded to clinicians over the past 100 years (Fig. 1).

The proportion of clinicians to win Nobel prize in physiology and medicine have been steadily declining over the past 100+ years, from 65%-90% ~100 years ago to a merely ~20% in the 21^st century.⁸  While basic research is important, only ~1% of the highly promising basic research is translated into clinical medical practice.⁹ Today’s Nobel prizes may not be what Mr. Alfred Nobel intended in his will. The Nobel committee over 100 years ago interpreted Mr. Nobel’s will as: “the domain of physiology or medicine” was understood to encompass the theoretical as well as the practical medical sciences^8,10.

Fig. 1. Nobel Prizes in medicine: are clinicians out of fashion? Source: Ashrafian, H., Patel, V. M., Skapinakis, P. & Athanasiou, T. J R Soc Med 104, 387–389 (2011).

The approaches to clinical medicine and to basic medical research are and should be different. Basic research is to dissect complex problems into smaller and unit level questions, often looking at a particular molecule or a mechanism, irrespective of the whole system, and try to find answers. Whereas clinical medicine should teach how to integrate knowledge learned from various aspects into one holistic treatment plan for a particular patient. Clinical medicine should view a patient as a whole, trying to understand not only the clinical manifestations, but also the root causes as well as the processes connecting the root causes and the clinical presentations (Fig. 2). Only when we address the root causes, the disease processes and the clinical manifestations, the it becomes possible for us to cure the patients.

All diseases have their root causes, which, via certain pathological mechanisms or processes, lead to clinical signs and symptoms (Fig. 2). Research into disease root causes and management are usually not patentable, whereas specific agents (drugs) to manipulate pathological mechanisms are. As a result, the medical literature is full of research papers studying the biological processes, which may lead to new drug discoveries and handsome financial rewards. But we know clearly, interfering only at the mechanism level, not at the root cause level, is only part of a disease management plan, not a complete solution. But this is what medicine is teaching our doctors today: one or a few drugs based, incomplete treatment plan, without addressing the root causes of diseases. As a result, although the market is full of redundant drugs for common chronic diseases such as diabetes mellitus and hypertension, none of these chronic diseases are curable with these existing drugs. More and more clinical research shows that chronic diseases such as diabetes and hypertension are reversible with lifestyle changes including dietary changes^11–14. We have helped numerous diabetic or hypertensive patients to go off their drugs in our clinics with this integrative approach. This simple logic, unfortunately, is forgotten and not mentioned in today’s medicine.

Fig. 2. The root causes, processes and clinical manifestations of diseases.

Disturbance of redox homeostasis, or increased oxidative stress, is the key underlying pathology of viral infections, including Covid-19.

              A common feature of many viral infections, including the upper and lower respiratory infections caused by respiratory viruses is the disturbance of redox homeostasis, or increased oxidative stress. Redox homeostasis describes the balance between the production of reactive oxygen or nitrogen species (ROS, RNS, respectively, or RONS, collectively) and their scavenging. Redox biology plays a critical role in various cellular processes, including proliferation, differentiation, signaling, and metabolism. Redox homeostasis and the disturbance thereof plays an important role in pathology and may lead to oxidative stress, chronic activation of immune responses, and inflammation^15,16. Chronic elevation of ROS may lead to oxidizing damages to DNAs, proteins, lipids and resulting in dysfunction of organelles and apoptosis¹⁷.

The group of viruses that may cause respiratory infections include influenza, human respiratory syncytial, human rhino, human metapneumo, parainfluenza, adeno and coronaviruses (SARS-Cov), the latter includes the virus responsible for Covid-19, SARS-Cov-2, a new member of the coronaviruses.

A large body of evidence exists in the literature that demonstrates the correlation between the significant increase in ROS and most, if not all, viral respiratory infections¹⁸. Moreover, elevated ROS is not only a feature of respiratory infections, but is also present in other viral infections such as hepatitis B, C and many others. Covid-19 is no exception. Early research shows SARS-Cov-2 infection, Covid-19, is associated with significantly increased oxidative stress, often described as “cytokine storm”.

Key pathologies of Covid-19 and mechanisms of vitamin C in the treatment of viral infections.

“Cytokine storm” or significant oxidative stress plays a significant role in Covid-19 pathology. Oxidative stress is actually a common mechanism in many viral infections. Vitamin C is a prototypical antioxidant. Vitamin C’s powerful antioxidant effect probably explains the clinical improvement observed in pneumonia, sepsis and respiratory distress^19–22.

A review of worldwide reactions to and the management of Covid-19 reveals a few severe problems.

1. Covid-19 management worldwide has been severely politicized. This is reflected both internationally and domestically. Covid-19 pandemic is a huge challenge to the mankind and we, of all nations and races, should have united to face the common enemy. But instead, international and domestic politics have mostly hijacked this public health crisis and caused unnecessary chaos and mismanagement with severe consequences.
2. The medical advisors to governments worldwide including WHO have been providing incomplete medical advises which may have been misleading to government leaders. These public health officials carry the major responsibility of assessing and analyzing the pandemic problem, reviewing the knowledge we learned in the past and synthesizing comprehensive (and contingency) plans to combat the pandemic. However, the responses from the public health officials we have seen worldwide have been incomplete and disappointing. This probably reflects much deeper problems rooted in the contemporary medicine.

What have the public health officials, top medical agencies and advisors and governments done worldwide to fight Covid-19 pandemic? What we have seen and heard mostly is nothing but a lot of fighting, arguments and expectation of vaccines, especially in the US. I don’t hear any of these top experts or medical agencies talk about prevention, particularly nutritional importance in prevention and treatment of Cvoid-19. Our health depends on nutrition. This is simply logical and a common sense. In the absence of specific “anti-Covid” drugs, our own immunity is all we have to hold the virus at bay. Even with specific drugs, our immunity still plays a major role in disease fighting.  But why don’t we hear much about it? Why don’t the top experts recommend it? It’s too “low tech”? Many conscientious healthcare professionals and others stand out and promote healthy lifestyle and nutrition to prevent Covid-19 or fight against it once one gets it, including vitamin C and vitamin D.  Dr. Anthony Fauci, the top medical advisor to the Trump Administration, is reportedly taking vitamins C and D privately, but I never heard him recommending it publicly²³.  Are vitamins C and D good enough for him, but not good for the public? Not only didn’t we hear these public recommendations, those science based nutritional recommendations, like the ones Dr. Fauci was taking, have been mostly censored by the major media. I am one of the victims of the censorship.

When faced with the common enemy, Covid-19 pandemic, we should have united to fight against it. But we all have been sourly disappointed and felt betrayed by those politicians, top medical experts and the media as well. Some of these interest groups have hijacked this global tragedy for their hidden agenda. I have never seen medicine to be so politicized in my 40 plus years in medicine.

I came across Dr. Linus Pauling’s work on vitamin C 20 some years ago. In recent years, I spent more time researching vitamin C.  I was amazed that as a tiny molecule, vitamin C has a wide variety of biological effects on nearly every aspect of our life, including, but not limited to, antimicrobial, antioxidant, and as an essential cofactor in collagen synthesis^24,25. You may be surprised to learn that vitamin C even plays a critical role on your mood.²⁶ Most people probably don’t really realize the importance of collagen in our body. But we won’t discuss that here. What’s relevant to Covid-19 pandemic is vitamin C’s antimicrobial and antioxidant effects.

The ignorance or suppression of vitamin C reflects the lack of logic or “common sense” in mainstream medicine.

• Vitamin C can prevent and improve pneumonia.

A meta-analysis of 148 animal studies show that vitamin C can alleviate or prevent bacterial, viral and protozoan infections. Vitamin C cuts the risks of colds by 50% in physically active adults. Two randomized and controlled studies (RCT) show a dose-dependent response in the therapeutic effects of vitamin C in common colds. Three RCTs demonstrate that vitamin C can prevent pneumonia and 2 RCTs show vitamin C can improve pneumonia treatment. One RCT shows vitamin C is beneficial in the treatment of tetanus²⁷.

• High dose intravenous vitamin C (HDIVC) shortens mechanical ventilation.

HDIVC improves severe pneumonia patients. A recent meta-analysis pooled the data from 9 qualified clinical trials and found strong evidence that high dose IV vitamin C shortens patient time on mechanical ventilation by 14-25% with only relatively small vitamin C doses (1,000 mg – 6,000 mg)²⁸.

• HDIVC reduces mortality in patients with acute respiratory distress syndrome (ARDS) and in Covid-19 patients

In a clinical trial of 32 ARDS patients, HDIVC (1,000 mg + N-acetyl cysteine + selenium + vitamin E, every 6 hours IV) showed a 47% reduction in mortality rate compared to the 71% mortality rate in the control group²⁹. Another recent study of 96 septic patients with HDIVC (6,000 mg of vitamin C + hydrocortisone + thiamine, every 6 hours IV) cut the mortality rate by ~32%³⁰. HDIVC for the treatment of Covid-19 was first reported in China.  In a clinical study of 54 severe to critically ill Covid-19 patients shows HDIVC (24,000 mg/24 hours IV) reduced 28-day mortality and significant improvement of oxygenation and inflammatory status³¹. In a separate clinical series study of 12 severe and critical Covid-19 patients, HDIVC showed significant clinical oxygenation improvement with reduction in inflammatory markers and organ failure (SOFA) score³¹.

• Oral high dose vitamin C can prevent common cold.

Several studies in the past have shown that vitamin C prevents common cold and reduces the disease severity once catching the cold including one earlier this year, a randomized controlled trial of 1444 young army recruits. This Korean study showed that vitamin C at doses as high as 6,000 mg daily reduced the odds of developing common cold³².

• Vitamin C deficiency is more common than we realized, both in sick patients and in the general population.

Vitamin C deficiency is common among patients with acute and chronic diseases. 40% of ICU patients with septic shock have blood levels of vitamin C near zero, diagnostic of scurvy (Vit C < 11 umol/L), with the remainder of ICU patients have hypovitaminosis C (Vit C < 23 umol/L). ~50% of non-septic ICU patients also show hypovitaminosis C³³.  Low plasma vitamin C levels are associated with more severe organ failure and increased mortality^34,35. Hypovitaminosis C is relatively common in Western populations and vitamin C deficiency (VC < 11 umol/L)  is the 4^th leading nutrient deficiency in the US³³. The 2007-2010 U.S. National Health and Nutrition Examination Survey of approximately 16,000 children and adults found that almost 40% had low levels of vitamin C, while 88% of the U.S. population did not meet the daily requirement for vitamin E (noted to enhance the effects of vitamin C)³⁶.

• Covid-19 patients have undetectable or very low blood levels of Undetectable Vitamin C.

Vitamin C was not detectable in 17 out of 18 Covid-19 patients with ARDS, a Spanish study reports, with the remaining patient showing very low blood vitamin C level³⁷.

• Vitamin C is safe and is without significant side effects, even at very high doses.

An NIH expert panel consensus document (updated in February 2020) clearly states that HDIVC is safe even at very high doses³⁸. Early clinical studies show HDIVC is highly promising in Covid-19 treatment^1,19,38–40. Based on these and their clinical experience of HDIVC, the governments of Shanghai and Guangdong officially included HDIVC in their Covid-19 treatment protocols^41,42. The science and rationale for HDIVC in treatment of Covid-19 were reviewed and presented in my NIH guest speech⁴³. These early Chinese experiences in HDIVC on Covid-19 caused worldwide interest which was in part kicked off by my new associates at ITM Ltd. and The First Dragon Foundation™ Ltd. (In organization)  who issued a global release⁴⁴ that also included introduction to the New USA Federal “Right to Try Act”:  According to the peer-reviewed Orthomolecular Medicine News Service, vitamin IVs can be arranged in virtually any hospital, anywhere in the world, and the new federal “Right to Try Act” gives patients the power to demand IV vitamin C treatment⁴⁵.

Are vaccines the answer to the Covid-19 pandemic?

As I clearly stated previously, it’s clear that the epidemics and pandemics are on the rise¹. Covid-19 is just a wake-up call. Due to the nature of vaccine research and development, there is always a significant delay between the outbreak of an epidemic and the clinical wide availability of effective vaccines. Eight months into the Covid-19 pandemic, there is still no SARS-Cov-2 specific vaccines available. And yet, the only universally accepted and recommended “miracle” that nearly all governments worldwide are hoping is a magic vaccine(s). Clearly this “vaccine” only Covid-19 strategy is incomplete. An integrative approach is clearly indicated to include healthy lifestyle with sufficient nutrition, esp. vitamins C, D and minerals like magnesium and zinc^1,46.

Protected Population Immunity with vitamin C and other nutrients and healthy lifestyle should be part of the integral strategy to the prevention and treatment of Coivd-19 and future such epidemics¹.

Where is “common sense” in evidence-based medicine?

Various organizations, doctors and citizens alike worldwide have been calling for their local and national governments on vitamin C’s potential effects on Covid-19. Some conscientious doctors at the highest level of the US department of Health and Human Services have also tried to call attention to vitamin C. It should be plain common sense to try HDIVC in Covid-19 treatment. The FDA even allows “compassionate drug use” which stipulates the use of new and unapproved drug to treat seriously ill patient when no other treatments are available⁴⁷.

An ounce of prevention is worth a pound of cure, as the old saying goes. Have those top medical advisors (and medical agencies) forgotten the old wisdom? Why are they so much against antiviral nutrients such as vitamin C and vitamin D?

In summary, vitamin C, taken both orally or intravenously, is very safe and is effective in the prevention and treatment of both mild and severe viral infections. There is nothing to lose, but a lot to gain with vitamin C use in Coivd-19. But why such great remedies are being suppressed?

Another problem that Covid-19 has highlighted is that the medical establishment views Covid-19 as a totally new disease and ignores what we learned from the previous research on viruses and disease. Yes, Covid-19 is a brand-new disease caused by a brand-new virus, SARS-Cov-2 virus. However, many viral infections, particularly the family of coronaviruses including the viral agents that caused 2003 SARS pandemic and MERS pandemic in 2013, and Covid-19 now share much in common, particularly the significantly elevated oxidative stress (or cytokine storm)^1,19. Most, if not all, of the pathologies seen in Covid-19 can be traced to the oxidative damages induced by SARS-Cov-2. This is the rationale for why antioxidants have shown promising results in the treatment of Covid-19 including HDIVC, vitamin C being a prototypical antioxidant.

The current medical system views diseases at from their symptoms and often fails to recognize their root causes and common biological features and pathways.  Of course, this view of diseases is conveniently compatible with the needs of the medical establishment for publications and research grants: more diseases, more research grants and more research dollars. This view is also conveniently compatible with the pharmaceutical interests where more drugs can be developed and more drug sales.  Of course, all these are at the expense of consumers and their health. This scenario is common in the management of most chronic diseases. Top diabetes experts are very eloquent on the complicated mechanisms of antidiabetic drugs when a simple measure of significantly reducing the carbohydrates in the diet along with supplements of essential nutrients could return blood sugar to normal levels.

Evidence based medicine is the main school of thought that guides the clinical medicine today. A review of the definition of EBM finds the lack of logics or “common sense” having any place in EBM^2,3. What’s presented in this article makes it quite clear that there is a lack of common sense in EBM and that vitamin C should have a place in the treatment of Covi-19 pandemic.

Many consumers and healthcare professionals may not realize these problems ordinarily, but now with the outbreak of Covid-19, and huge losses in lives and economies with nearly everyone in every corner of the world affected, this distorted and incomplete view of diseases by the medical establishment should serve as a wake-up call to all of us, healthcare professionals and consumers alike. Many lives could have been saved.  Many lives would be saved should the governments start incorporating HDIVC into the Covid-19 fight, just like Shanghai and Guangdong did. Entire cities don’t have to be locked down. The economy can be revived more rapidly.

But are they listening?

References

1. Richard Z. Cheng. Protected Population Immunity, Not A Vaccine, Is The Way To Stop Covid-19 Pandemic. J Clin Immunol Immunother 6, 1–4 (2020).
2. Hines, K. Evidence-Based Medicine. https://www.hopkinsmedicine.org/gim/research/method/ebm.html.
3. Tenny, S. & Varacallo, M. Evidence Based Medicine (EBM). in StatPearls (StatPearls Publishing, 2020).
4. Sniderman, A. D., LaChapelle, K. J., Rachon, N. A. & Furberg, C. D. The necessity for clinical reasoning in the era of evidence-based medicine. Mayo Clin. Proc. 88, 1108–1114 (2013).
5. Ehrhardt, S., Appel, L. J. & Meinert, C. L. Trends in National Institutes of Health Funding for Clinical Trials Registered in ClinicalTrials.gov. JAMA 314, 2566–2567 (2015).
6. Cohn, M. Industry funds six times more clinical trials than feds, research shows – Baltimore Sun. https://www.baltimoresun.com/health/bs-hs-trial-funding-20151214-story.html (2015).
7. Boston, 677 Huntington Avenue & Ma 02115 +1495‑1000. Remove the For-Profit Variable from Clinical Drug Trials. Health and Human Rights Journal https://www.hhrjournal.org/2017/05/remove-the-for-profit-variable-from-clinical-drug-trials/ (2017).
8. Ashrafian, H., Patel, V. M., Skapinakis, P. & Athanasiou, T. Nobel Prizes in medicine: are clinicians out of fashion? J R Soc Med 104, 387–389 (2011).
9. Contopoulos-Ioannidis, D. G., Ntzani, E. & Ioannidis, J. P. A. Translation of highly promising basic science research into clinical applications. Am. J. Med. 114, 477–484 (2003).
10. Alfred Nobel’s health and his interest in medicine. NobelPrize.org https://www.nobelprize.org/alfred-nobel/alfred-nobels-health-and-his-interest-in-medicine/.
11. Athinarayanan, S. J. et al. Long-Term Effects of a Novel Continuous Remote Care Intervention Including Nutritional Ketosis for the Management of Type 2 Diabetes: A 2-Year Non-randomized Clinical Trial. Front Endocrinol (Lausanne) 10, 348 (2019).
12. DONG, T. A. et al. Intermittent Fasting: A Heart Healthy Dietary Pattern? Am J Med 133, 901–907 (2020).
13. van Namen, M., Prendergast, L. & Peiris, C. Supervised lifestyle intervention for people with metabolic syndrome improves outcomes and reduces individual risk factors of metabolic syndrome: A systematic review and meta-analysis. Metabolism 101, 153988 (2019).
14. Kord-Varkaneh, H. et al. The Influence of Fasting and Energy Restricting Diets on Blood Pressure in Humans: A Systematic Review and Meta-Analysis. High Blood Press Cardiovasc Prev 27, 271–280 (2020).
15. Mittal, M., Siddiqui, M. R., Tran, K., Reddy, S. P. & Malik, A. B. Reactive oxygen species in inflammation and tissue injury. Antioxid Redox Signal 20, 1126–1167 (2014).
16. van der Vliet, A. & Janssen-Heininger, Y. M. W. Hydrogen peroxide as a damage signal in tissue injury and inflammation: murderer, mediator, or messenger? J Cell Biochem 115, 427–435 (2014).
17. Circu, M. L. & Aw, T. Y. Reactive oxygen species, cellular redox systems, and apoptosis. Free Radic Biol Med 48, 749–762 (2010).
18. Khomich, O. A., Kochetkov, S. N., Bartosch, B. & Ivanov, A. V. Redox Biology of Respiratory Viral Infections. Viruses 10, (2018).
19. Cheng, R. Z. Can early and high intravenous dose of vitamin C prevent and treat coronavirus 2019 (COVID-19)? Medicine in Drug Discovery (2020).
20. Schönrich, G., Raftery, M. J. & Samstag, Y. Devilishly radical NETwork in COVID-19: Oxidative stress, neutrophil extracellular traps (NETs), and T cell suppression. Adv Biol Regul 77, 100741 (2020).
21. Delgado-Roche, L. & Mesta, F. Oxidative Stress as Key Player in Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) Infection. Arch Med Res 51, 384–387 (2020).
22. Zarbafian, M., Dayan, S. & Fabi, S. G. Teachings from COVID-19 and aging-An oxidative process. J Cosmet Dermatol (2020) doi:10.1111/jocd.13751.
23. How to Avoid Getting Sick When You’re Around People All Day. Washingtonian https://www.washingtonian.com/2016/01/15/how-to-avoid-getting-sick-when-youre-around-people-all-day/ (2016).
24. Levy, T. Primal Panacea. (MedFox Publishing).
25. Levy, T. & 成长. 万应灵丹: 关于维生素C的百科全书. in (Kindle Publisher, 2017).
26. Wang, Y. et al. Effects of vitamin C and vitamin D administration on mood and distress in acutely hospitalized patients. Am. J. Clin. Nutr. 98, 705–711 (2013).
27. Hemilä, H. Vitamin C and Infections. Nutrients 9, (2017).
28. Hemilä, H. & Chalker, E. Vitamin C may reduce the duration of mechanical ventilation in critically ill patients: a meta-regression analysis. J Intensive Care 8, 15 (2020).
29. Sawyer, M., Mike, J. & Chavin, K. Antioxidant therapy and survival in ARDS (abstract). Crit Care Med (1989).
30. Marik, P. E., Khangoora, V., Rivera, R., Hooper, M. H. & Catravas, J. Hydrocortisone, Vitamin C, and Thiamine for the Treatment of Severe Sepsis and Septic Shock: A Retrospective Before-After Study. Chest 151, 1229–1238 (2017).
31. Cheng, Richard Z. Preliminary Report of Chinese High Dose Vitamin C for Covid-19 Treatment Studies.
32. Kim, T. K., Lim, H. R. & Byun, J. S. Vitamin C supplementation reduces the odds of developing a common cold in Republic of Korea Army recruits: randomised controlled trial. BMJ Mil Health (2020) doi:10.1136/bmjmilitary-2019-001384.
33. Carr, A. C. et al. Hypovitaminosis C and vitamin C deficiency in critically ill patients despite recommended enteral and parenteral intakes. Crit Care 21, 300 (2017).
34. de Grooth, H.-J. & et al. Early plasma vitamin C concentration, organ dysfunction and ICU mortality. Intensive Care Medicine 40, (2014).
35. Vincent, J. L. et al. 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 (1996).
36. ‘Unusual’ IV High-Dose Vitamin C Success Story in COVID-19 | MedPage Today. https://www.medpagetoday.com/casestudies/infectiousdisease/87976.
37. Chiscano-Camón, L., Ruiz-Rodriguez, J. C., Ruiz-Sanmartin, A., Roca, O. & Ferrer, R. Vitamin C levels in patients with SARS-CoV-2-associated acute respiratory distress syndrome. Crit Care 24, 522 (2020).
38. NIH PDQ. High-Dose Vitamin C (PDQ®)–Health Professional Version – National Cancer Institute. https://www.cancer.gov/about-cancer/treatment/cam/hp/vitamin-c-pdq.
39. Cheng, R. Covid-19 Presentations. drwlc.com http://www.drwlc.com/Covid-19_talks.shtml.
40. Cheng, R., Kogan, M. & Devra, D. Ascorbate as Prophylaxis and Therapy for COVID-19—Update From Shanghai and U.S. Medical Institutions – Richard Z Cheng, Mikhail Kogan, Devra Davis, 2020. https://journals.sagepub.com/doi/full/10.1177/2164956120934768.
41. Shanghai Government Officially Recommends Vitamin C for COVID-19. http://orthomolecular.org/resources/omns/v16n16.shtml.
42. Cheng, Richard. Shanghai and Guangdong Governements’ official recommendation of Vit C in Covid-19 treatment. http://www.drwlc.com/blog/2020/04/16/covid-19-vitamin-c-and-integrative-medicine-3/.
43. Cheng, Richard. NIH Guest Speech: HDIVC on Covid-19. http://www.drwlc.com/Covid-19_talks.shtml.
44. ITM. ITM: The Treatment to Defeat Coronavirus Pneumonia has Arrived for Early Stage Onset and Hospitalized Critically Ill ICU Patients. itmltd.com/ITM-The-Treatment-to-Defeat-Coronavirus-is-Saving-Lives-in-China-and-Beginning-to-Save-Lives-in-NYC.pdf.
45. Saul, Andrew & Yanagisawa, A. Intravenous Vitamin C Treatment, Coronavirus, hospital, high doses, antiviral, vitamin C, instructions for intravenous vitamin C, Intravenous Therapy, acute viral infections, influenza, herpes zoster, common cold, rubella, mumps, idiopathic sudden hearing loss, Bell’s palsy, IVC, viral infections, Vitamin C, Magnesium sulfate, Vitamin B complex, depletion of vitamin C, therapy for sepsis, administering vitamin C intravenously, pneumonia-like virus, Riordan Clinic, Intravenous Vitamin C Protocol, cancer patients, articularly viral illnesses, peak-plasma concentration, IVC infusions, plasma vitamin C levels, Riordan protocol, IVC administration, viral diseases, hospitalization, Failure to provide intravenous vitamin C, coronavirus infection, Vitamin IVs, Right to Try Act. http://orthomolecular.org/resources/omns/v16n07.shtml.
46. Levy, T. E. COVID-19: How can I cure thee? Let me count the ways. http://orthomolecular.org/resources/omns/v16n37.shtml.
47. Compassionate Drug Use. https://www.cancer.org/treatment/treatments-and-side-effects/clinical-trials/compassionate-drug-use.html.

 Covid-19 Vaccines May Be a Double Edged-Sword.

by Richard Cheng, M.D., Ph.D.

Summary:

80% of people who contract Covid-19 develop only mild diseases. 20% of those who contract Covid-19 show no symptoms. The death rate of Covid-19 for young people up to 50 years of age is similar to an influenza. Between 50 and 70, it starts to increase (but still may not be much worse than a flu, unfortunately there is no age-specific breakdown data to compare with). At age above 75, the risk starts going up significantly.

While for most people, Covid-19 vaccine may not be necessary nor worthwhile, these vaccines may cause deleterious side effects. Antibody-Dependent Enhancement, described above, is just one of such concerns. Distrust of vaccines has been a long standing issue, which can’t be simply dismissed as anti-vaccine mentality¹.

Covid-19 Vaccines: Light at the end of the very long tunnel?

The whole world has been immersed in the Covid-19 panic for the most part of 2020. Like US politics, the world also seems split towards Covid-19. Most people experience fear, anxiety and hopelessness, while a significant number of people seem to downplay the danger of Covid-19, not adhering the general warnings of facial masks and social distancing. Americans are not very patient people. After a couple of months of Covid fear and anxiety in the spring, we saw a decline of Covid statistics in the summer resulting in relaxed attitude towards Covid-19. But now, early winter, Covid stats seem to be creeping up again. We begin to see reports that some European countries and US states start locking down again. In the backdrop of unsettled US presidential election, I sense rising levels of fear, anxiety, anguish and even anger in the air. Some even fear the breakout of yet another civil war. This time of the year, winter blues and holiday depression will usually also begin to emerge. Just when the pieces for a perfect storm seem to be falling into places, Pfizer and Moderna both announced their “highly effective” vaccine.

What a shot in the arm: finally, the long-awaited savior has arrived.

Really?

After the initial excitement, some of us need to calm down and do a reality check. After some analysis with a dose of common sense, the picture down the road may not be as rosy as most of us want to believe, or at least not in the coming months.

Pfizer reported a Covid-19 vaccine effective in ~90% of 43,000 people. Moderna also reported their similar mRNA vaccine trial on ~30,000 people with 94% effectiveness. These reports really excited the world, offering a glimpse of light at the end of the long Covid-19 tunnel. These vaccines are mRNA vaccines, a new class of vaccines. In a nutshell, instead of injecting a piece of the virus (dead or alive) as in conventional vaccines, Pfizer’s and Moderna’s vaccines inject a messenger RNA to instruct the recipient’s body to start an immune reaction against the spike protein of the SARS-Cov2 virus. This spike protein is what this virus uses to infect and enter the host cell. If we can block this process, then we can block the infection or render it less harmful, at least. This is a brand-new vaccine strategy, one that has never been tested before. Questions towards both the effectiveness and safety arise. Some of the questions are pretty serious².

1. The mRNA vaccine technology is the first of its kind, longtime effectiveness and safety are unclear. Only time will tell. Pfizer says viral mutations are not a problem for their mRNA vaccine which will be effective against SARS-Cov2 viral mutants. This also remains to be seen.
2. Among the younger population, Covid-19 is not more threatening than a seasonal flu. The population that Covid-19 causes more problems is primarily the eldest of the elderly and immune compromised. Will the vaccine protect the elderly, children, pregnant women and immune compromised? We don’t know the answer.
3. Safety concerns. Several Covid-19 vaccine attempts have met with side effects severe enough to halt the clinical trial. Although Pfizer and Moderna didn’t report serious side effects of their vaccines so far among the 43,000+ and 30,000+ recipients. One of the concerns is a phenomenon called Antibody-Dependent Enhancement (ADE). More below on ADE.
4. Other problems. To effectively halt the spread of Covid-19 worldwide, it’s estimated that ~2/3 of the world’s population need to develop immunity to Covid-19, whether through vaccine or viral exposure/infection. To immunize several billions of people worldwide or ~200 million in US is a daunting task, let alone that a large number of US residents are reported to be resistant to vaccines. CNN reports recently that up to 45% of people in a survey were against Covid-19 vaccines. Only about half of the people in the survey were willing to receive vaccines. To immunize half of the US population, it’ll still take a considerable amount of time to manufacture, distribute and immunize. We don’t know when that will happen, but we probably shouldn’t expect that before summer of 2021.

ADE (Antibody-Dependent Enhancement)

A Nature article in September 2020 cautioned the potential risks of ADE (Antibody-Dependent Enhancement) of Covid-19 vaccines³. ADE describes a biological phenomenon where vaccines do not protect the vaccine recipients, but instead the vaccine make it easier for the virus to infect and enter cells and may potentially make the recipient develop more serious disease had they not been vaccinated. In other words, vaccines will not protect these patients and instead when they are infected with the virus, the vaccine will make it worse for these patients.

Previous vaccine attempts have been made towards respiratory coronaviruses SARS-Cov (2002-2003), MERS-Cov (2012) and also Respiratory Syncytial Virus (RSV) all seemed to trigger ADE^4,5. ADE has become a serious concern to vaccine deveopment^6,7. ADE has been observed in many viruses including HIV^8,9, Ebola^10,11, Influenza¹² in addition to SARS-Cov, MERS-Cov and RSV.

So far there has been no vaccines SARS-Cov, MERS-Cov or RSV vaccines approved. ADE is part of the reason.

Worse, there is evidence to suggest that elderly people may be more prone to develop ADE disease^5,13. In other words, the population that needs protection the most is also more likely to develop the serious ADE effects.

Should you get the Covid-19 vaccines? 

              The million (or maybe billion) dollar question is why nearly half of US residents are not interested in getting the Covid-19 vaccines?

Covid-19 is a serious disease that, compared to flu, transmits more rapidly and has a longer incubation period (2-14 days for Covid-19 compared to 1-4 days for flu), these 2 factors make Covid-19 spread to more people than flu. Covid-19 also seems to be more serious in some people than influenza. Infection Fatality Ratio (IFR) is one of the metrics to measure the severity of a disease. It measures the proportion of deaths among all infected individuals. In other words, IFR measures the probability of death if you catch Covid-19.

Using this metric, IFR for Covid-19 is similar to that of influenza and may be even lower, at least for people (Table 1), according to CDC. Another study published at the Annals of Internal Medicine recently also estimates the Covid-19 IFR for people 40 years or younger at 0.01% and for people 60 years or older at 1.71%¹⁴, in line with CDC’s estimates. These data show that for most people, esp. young people, Covid-19 is not a more serious disease than an influenza. It’s the older population and the population with immune-compromised conditions that may display more serious symptoms when they catch SARS-Cov2.

Table 1. Infection Fatality Rate (CDC) for Covid-19¹⁵ and IFR (WHO) for Influenza¹⁶

So, if you are young and generally healthy, and don’t want Covid-19 vaccines, and don’t want to catch Covid-19, or if you catch it, you hope you don’t develop serious diseases, is there anything you can do? I’ll answer these questions in the next article. Stay tuned.

References

1. Shodiya, Z. W., Titilayo. Why So Many Americans Are Skeptical of a Coronavirus Vaccine. Scientific American https://www.scientificamerican.com/article/why-so-many-americans-are-skeptical-of-a-coronavirus-vaccine/.
2. Allen, A. Five Important Questions About Pfizer’s COVID-19 Vaccine. Kaiser Health News https://khn.org/news/pfizer-covid-19-vaccine-effectiveness-5-things-to-know/ (2020).
3. Lee, W. S., Wheatley, A. K., Kent, S. J. & DeKosky, B. J. Antibody-dependent enhancement and SARS-CoV-2 vaccines and therapies. Nature Microbiology 5, 1185–1191 (2020).
4. Cardozo, T. & Veazey, R. Informed consent disclosure to vaccine trial subjects of risk of COVID-19 vaccines worsening clinical disease. International Journal of Clinical Practice n/a, e13795.
5. Mercola, Joe. How COVID-19 Vaccine Can Destroy Your Immune System. Mercola.com http://articles.mercola.com/sites/articles/archive/2020/11/11/coronavirus-antibody-dependent-enhancement.aspx.
6. Tirado, S. M. C. & Yoon, K.-J. Antibody-dependent enhancement of virus infection and disease. Viral Immunol 16, 69–86 (2003).
7. de Alwis, R. Impact of immune enhancement on Covid-19 polyclonal hyperimmune globulin therapy and vaccine development. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7161485/.
8. Robinson, W. E., Montefiori, D. C. & Mitchell, W. M. Antibody-dependent enhancement of human immunodeficiency virus type 1 infection. Lancet 1, 790–794 (1988).
9. Robinson, W. E. et al. Antibody-dependent enhancement of human immunodeficiency virus type 1 (HIV-1) infection in vitro by serum from HIV-1-infected and passively immunized chimpanzees. Proc Natl Acad Sci U S A 86, 4710–4714 (1989).
10. Takada, A., Watanabe, S., Okazaki, K., Kida, H. & Kawaoka, Y. Infectivity-enhancing antibodies to Ebola virus glycoprotein. J Virol 75, 2324–2330 (2001).
11. Takada, A., Feldmann, H., Ksiazek, T. G. & Kawaoka, Y. Antibody-dependent enhancement of Ebola virus infection. J Virol 77, 7539–7544 (2003).
12. Ochiai, H. et al. Infection enhancement of influenza A NWS virus in primary murine macrophages by anti-hemagglutinin monoclonal antibody. J Med Virol 36, 217–221 (1992).
13. Wu, Fan & Et al. Neutralizing antibody responses to SARS-CoV-2 in a COVID-19 recovered patient cohort and their implications. 20.
14. Blackburn, J., Yiannoutsos, C. T., Carroll, A. E., Halverson, P. K. & Menachemi, N. Infection Fatality Ratios for COVID-19 Among Noninstitutionalized Persons 12 and Older: Results of a Random-Sample Prevalence Study. Ann Intern Med (2020) doi:10.7326/M20-5352.
15. CDC. Coronavirus Disease 2019 (COVID-19). Centers for Disease Control and Prevention https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html (2020).
16. WHO. Coronavirus disease 2019 (COVID-19) Situation Report – 46. (2020).

Covid-19, Vitamin C, Vaccine and Integrative Medicine

-The journey of a Chinese American doctor, caught between the East and the West, the contemporary and integrative medicine.

The Chinese IVC Clinical Trials

I guess our call for VC was getting somewhere.  Or maybe it’s making other people more willing to stand up and try VC. Anyways, I began to make new friends. I got connected with Dr. Peng, the principal investigator of the first announced high-dose intravenous VC (HDIVC) trial in the treatment of Wuhan pneumonia. Dr. Peng’s IVC trial used 24,000 mg/day IVC in treating these patients. It was like a shot in the arm, that probably encouraged more dcotors to use HDIVC. Before we knew it, the 2^nd and 3^rd IVC trials were initiated.  I and our international members got in touch with these trial teams and other teams that were interested in either studying HDIVC or direclty using HDIVC. We were intimately involved in the design of some of these trials.

A Wuhan family is saved from the new corona viral infection with VC.

In my WeChat group (a social media APP, very popular in China), someone told me a story of a lady in Wuhan about VC. I did some research and found that lady, Niu Niu and she told me her story.

Niu Niu lives in Wuhan with her teenage daughter, and her parents and brother-in-law couple, are not far away. The 6 of them gathered together regularly especially around the Chinese New Year.  They went shopping together for the New Year supply and the whole family, like the rest of the country, showed exuberant festive happiness.

Then just a few days before the big day, grandma came down with what looked like a common cold.  She felt a bit sick with cough, fatigue and a low-grade fever.  Nothing serious. Around this time, the Wuhan pneumonia rumor was widely spreading, despite the rigorous suppression of this information. Niu Niu had taken some courses on nutrition and knew about VC. So she immediately advised the entire family to take VC. The whole family followed her advise and was taking high-dose VC, around 10,000 mg-20,000 mg daily.  But the grandma wasn’t entirely compliant and was taking only around 5,000 mg a day. The next 10 days went by, grandma was more or less the same, and didn’t get much worse.  The family of 6 ate together nearly every day. No one was wearing a mask nor wearing gloves at home.  No one took grandma’s cold too seriously: Grandma was doing just fine. Grandma is 71 years old with diabetes mellitus and coronary heart disease with stents placed.  She also had a few other chronic diseases. She is not in good health. With her age and health problems, grandma was in the high mortality risk group for the new corona virus.

By the end of January, it gradually became clear of the seriousness of the new corona virus epidemic. Grandma, still on VC daily, went to hospital to check out if she had the virus. Sure enough, she received a diagnosed of new corona viral infection and was admitted to the hospital. While in the hospital grandma’s temperature quickly went up to 39⁰C (~103⁰F). Niu Niu, her brother and sister-in-law took turn to take care of grandma. Her condition continued to deteriorate and soon she began to develop respiratory difficulties, requiring ECMO (extra corporeal membrane oxygenation, or iron lung) and was transferred to ICU. Grandma even lost her consciousness while at ICU. At this time, the first IVC clinical trial was announced.  Niu Niu took the official IVC trial information to the ICU chief and begged for high-dose IVC use for grandma.  Luckily the ICU chief agreed, but would only give 10,000 mg per day. Even on 10,000 mg daily IVC, Grandma gradually improved, stabilized and was discharged to the regular ward. She spent about 10 days in ICU.

Not only grandma was recovering from a severe Covid-19 pneumonia with respiratory distress, Niu Niu and other 5 members of the family also did not catch Covid-19 infection, despite close contact with a confirmed Covid-19 patient with only masks and gloves for protection.  In particular, Niu Niu, her brother and sister-in-law were taking care of grandma in a hospital where there were many other Covid-19 patients.

I recorded a video and uploaded onto Youtube. This video went viral and received 300,000 views in just 7 days. Then one morning, I received an email notice from Youtube saying my video “violated Youtube’s community rules” and thus was removed. I emailed Youtube and informed them that this was my real interview of Niu Niu, not some story that I made up. But Youtube didn’t care.

So much for “free speech”. I guess we have the right of free speech, but they control what is allowed and what is not.

I have since moved my videos to Brighteon.com. The above mentioned video can be found at: https://www.brighteon.com/53ccca6a-e33b-4dd6-8278-968f68abee5d

Shanghai Medical Association officially endorses high dose vitamin C in the treatment of Covid-19.

More and more news about Vit C use began to surface. The most significant one came on March 1st, when the Shanghai Expert Panel on Covid-19 published their consensus treatment guidelines on Covid-19.

One senior member of the Shanghai Expert Panel is Dr. Enqiang Mao, professor and chief of emergency medicine, Ruijing Hospital, Jiaotong University Medical School. I and our International Team held a video conference with Dr. Enqiang Mao on March 17th with some of the Vit C experts worldwide, including Dr. Paul Marik whose study of using HDIVC to treat sepsis in 2017 caused a renewed worldwide interest in VC’s clinical use. Dr. Apha Fowler, on the CITRIS-ALI trial (the largest HD-IVC trial on sepsis), was also present.

In this video conference, Dr. Mao told the group that all confirmed Covid-19 patients were treated at the Shanghai Public Health Center and the treatment protocols were all discussed among the expert panel members. His team treated ~50 Covid-19 patients, out of a total of 358 confirmed Covid-19 patients in Shanghai.

Hospital treatment of serious and critical COVID-19 infection with high-dose Vitamin C

Dr. Mao told us that the VC patients appeared to improve faster with an average hospital stay that’s about 5 days shorter compared to the 30-day hospital stay for all patients.  There was no death in the VC group and no significant side effects were noted either. There were a total of 3 fatalities of Covid-19 infection, but none of those 3 received IVC treatment.

Guangdong Province Expert Panel officially included high-dose IV VC in the treatment of Covid-19 Treatment.

On March 6th, Guangdong province also published its Expert Panel treatment consensus on Covid-19, which included high-dose Vit C.

Talk with Dr. ZY Peng, the principal investigator of the world’s first HD-IVC clinical trial on Covid-19. 

Click here for the transcript.

After many attempts, we finally were able to invite Dr. ZY Peng to join us in an video conference with our international friends on April 9th, to share with us his experience and insights into Covid-19 and HD-IVC.

Highlights:

1. HD-IVC seems to reduce the inflammation of Covid-19 significantly.
2. HD-IVC seems to reduce Covid-19 paitnet’s ICU and hospital stays.
3. HD-IVC may also reduce the mortality rate of Covid-19 patients, although the number of patients may be too small.
4. Dr. Peng also told the group that his hospital was giving Vit C powder to all healthcare providers and advised them to take 1-2 grams of VC powder daily.  He also said he believes all the major hospitals in Wuhan were giving Vit C powder to their healthcare providers.  (I think this is significant because although the treatment of moderate to severe Covid-19 patients is very important, prevention or treatment of mild cases is probably even more important for obvious reasons. -Richard Cheng, MD).

to be continued.

Covid-19, Vitamin C, Vaccine and Integrative Medicine

-The journey of a Chinese American doctor, caught between the East and the West, the contemporary and integrative medicine.

The Chinese Theater of World War Covid-19

Staying in Shanghai and jumps into action, Vitamin C comes to rescue

The Chinese New Year came and went. People stayed home. The usual festivities were nowhere to see. This was the weirdest Chinese New Year that anybody had ever experienced in the recent history.

Pretty soon, the epidemic seemed to have escaped Wuhan and was spreading to other cities in China, including Beijing and Shanghai. The US Embassy started calling for evacuation of US citizens. My family in US was asking me to go home as soon as possible. I thought about contacting the US consulate in Shanghai for assistance to return home in Columbia. But when I looked at my parents, I saw in their eyes that they wanted me to stay.

My parents, especially my father, has developed a total trust in my medical opinion. Not just because I am his son. He has been benefiting from my anti-aging medicine approaches. Both my parents have high blood pressure. Years ago, their blood pressure readings were in 160-200/95-110 range, even with several blood pressure pills. Later I learned that the 2 basic mechanisms of hypertension is calcium related: blood vessel calcification causing the hardening of blood vessel walls and the constant spasm of the muscles around the blood vessel walls. Calcium is a major intracellular excitatory element, causing muscle cells to contract and the blood pressure to go up as a result.  My mother also had frequent symptomatic irregular heart beats (ectopic beats). Normally the cells at the sinus node in the heart have the highest frequency of cellular beats (excitation) (60-100 beats per minute). When the sinus node is excited (beats), the electric wave is sent through the entire heart, causing a synchronized contraction. All other heart cells can also get excited, but at a lesser frequency.  Therefore, normally the rest of the heart cells are suppressed by the supreme command, the sinus node. But in case the supreme command fails, i.e., sinus node malfunction, the heart cells next in line will take over and control the heart beat. This is a beautiful fail-proof design by mother nature (or by super-natural forces if you prefer). But if for some reason, the heart cells of lower rank get too excited and start beating more frequently than the supreme command, then ectopic heart beats happen. Too much intracellular calcium is a common finding in these situations.

I changed the blood pressure medications of my parents to long acting calcium channel blocker (LA-CCB) and magnesium. LA-CCB blocks the extracellular calcium from getting into cells. Magnesium is a natural antagonist of calcium. Magnesium is not a medicine.  With these two, one drug and one nutrient, I successfully brought down the blood pressure of my parents to the current 125-140/80-85 levels. And my mother doesn’t complain of “palpitations” anymore. With only one drug (LA-CCB, magnesium is not a drug), I achieved what several drugs couldn’t. I have also successfully treated many other hypertension patients and some of them were like my parents, even with several drugs, the blood pressure was still high. I have not found a patient whose blood pressure I couldn’t control.

In a recent physical exam, both my parents had coronary calcium score (CAC) done. CAC is a sensitive, safe, inexpensive and reliable exam for ectopic calcium deposits in the body. CAC also is highly correlated with mortality and heart attack: the higher the CAC score, the higher the overall mortality and heart attack risks.  My father has a zero CAC score and my mother has a very low CAC score.  We need to know that this is very unusual for this age group. The low or zero scores of my parents may have to do with the long time use of vitamin C and a formula of vitamins, antioxidants, mitochondrial nutrients and anti-atherosclerosis nutrients (what I call TotoCell Nutrition) that I have been giving them. This formula was devopled based on my integrative medicine principles. Of course, my parents are pretty happy about this.

Last summer, while I was visiting Shanghai, my father developed acute exudative pancreatitis, a severe and life-threatening disease. He was admitted to the ICU. I requested the high-dose intravenous vitamin C, which the attending doctor agreed, but only to 10 grams a day, not the 30-50 grams/day that I wanted. But even at this dose, my father recovered pretty rapidly. By day 3, his symptoms were all gone, and by day 5, upon my request, he was discharged home to be under my care. My father’s recovery from a severe pancreatitis was much faster than what most other patients of similar disease experienced, according to my literature search.

Through these events, my father developed a complete trust in my medical opinions, which are often different from those other doctors.

And now, with Covid-19, I could see that he wanted me to stay. So I stayed.

Vitamin C

Knowing what I know about vitamin C (VC), I immediately started calling for early and high-dose VC use in the treatment and prevention of Wuhan pneumonia.

Over 20 years ago, when I was in my 2nd medical residency (I completed a medicine residency at Shanghai Medical University) at University of Arkansas for Medical Sciences at Little Rock, AR, where I also obtained my Ph.D. degree in biochemistry and molecular biology, I read a book about VC. I found the evidence was compelling at that time and started taking VC tablets.  Then there was only 500 mg VC tablets available, unlike today, you can find 1,000 mg VC tablets anywhere in US. My interest in VC grew even greater about 10 years ago, especially in the last 5-6 years when I read Dr. Tom Levy’s Primal Panacea and Death By Calcium. Dr. Levy is a board certified cardiologist who also received a law degree. This is reflected in his way of writing, scientific and logical. His books are like a supersized review paper in a scientific journal, conclusions backed up by evidence with lots of references.  His writings are very convincing. I even have translated both Primal Panacea and Death by Calcium into Chinese.

Do you know Vit C (or ascorbic acid) is one of the most studied molecules in the world? There are over 65,000 scientific papers written in the world’s biggest medical library, the National Library of Medicine, hosted at the NIH (better known as Pubmed.gov or Pubmed.com). So next time when someone tells you that there is not enough research on VC, tell them to do their homework better.

I know Vit C has powerful antiviral and antibacterial effects. Vit C has pleiotropic biological effects. VC is also a powerful prototypical antioxidant, boosts our immunity, has an essential role in the synthesis of collagen and is even involved in gene expression.  I’ll talk more about VC later, but suffice it to say, Vit C is a major part of our natural defense system against diseases. This now comes in handy, in the fight against Covid-19. I have always been open-minded. Ever since I was a kid, I was curious in everything. I used to take apart the mechanical clock at home to study how it worked before I was 10. I like to question everything. Unlike many other doctors who probably only read medical journals, I don’t take advises or standard treatment guidelines without my own analysis and digestion. Not only I wanted to know the “how”, I also always want to know the “why”. My interest in Vit C has been mostly in the prevention and treatment of chronic diseases, esp. in the prevention of osteoporosis and atherosclerosis.  Believe it or not, Vit C deficiency is a primary cause of osteoporosis and atherosclerosis and many other disease.  I’ll talk about this later, since the title of this series includes Vit C and integrative medicine. In the past couple of years, I have been invited to talk at various conferences in China and have made many friends and some of them are in the academia and public hospitals, with whom I share much in common, including VC.

I tried all I could to bring VC to the attention of the medical community and the people in power, as there was no other effective treatment for the Wuhan pneumonia patients other than the supportive care. I even volunteered to go to Wuhan, the epicenter, with only one condition that was to allow me to use high-dose VC both orally and intravenously.  When people asked me if I was afraid of the virus, I told them that not I was not afraid of getting sick, but because I have high confidence in VC.  I told them I’d give myself high-dose IVC daily in addition to taking oral VC to prevent catching the virus and to kill it and prevent it from becoming a serious problem, if I did catch it. My call for VC was sent to the top national expert team in Wuhan through 2 separate members on that expert team.  My call for VC also reached the Shanghai top experts and the leadership. There are a few hospitals that were seriously considering of inviting me to Wuhan, but after finding out my US citizenship, they all went radio silent.  I quickly realized this epidemic is not just a public health matter, but probably more  a political and diplomatic matter.

International IVC Medical Support Team

My call for VC quickly drew attention nationwide and even worldwide. Many doctors and scientists responded to my call and a team of International IVC Medical Support Team was formed.

This team includes medical authorities in China, Dr. Hanping Shi (石汉平), top left, professor and chief of surgery, Beijing Capital Medical University. Dr. Shi is the best known cancer nutrition authority in China and his team has been instrumental in promoting nutrition in health care, esp. in cancer treatment.  Dr. Shi also co-founded the Low Carb Medicine China Alliance, promoting healthy diet to combat the ever-increasing metabolic diseases.  Dr. Shi also holds many other important positions including the committee chair of the cancer nutrition of China Anti-Cancer Alliance and committee chair of the Enteral and Parenteral Nutrition Committee of the Chinese Medical Association and of the Anti-Cancer Alliance of China. Through these important and influential positions, Dr. Shi has been promoting nutritional approach to health care, including high-dose IVC in cancer treatment.

Dr. Qi (Kay) Chen, center left, a Chinese American professor of pharmacology, and Dr. Jeane Drisco, top right, professor of medicine, both at Kansas University Medical Center. Drs. Chen and Drisco have done much research including clinical trials on VC, particularly VC’s pharmacokinetics. Our panel also includes a few key figure at the International Society for Orthomolecular Medicine (ISOM), including ISOM’s president, Dr. Atsuo Yanagisaw, center bottom, professor of medicine at Kyorin University, Tokyo, Japan; Dr. Tom Levy, center right, board certified cardiologist and a prolific medical author and international speaker, best known for his work on Vit C books; Dr. Andrew Saul, editor-in-chief of Orthomolecular Medicine News Service and an active VC public educator and author. Dr. Hong Zhang, right bottom, of Beijing Alps Healthtech, also played a critical role.

The term orthomolecular medicine was coined by the late Dr. Linus Pauling, the 2-time Nobel prize winner who devoted most of his later life to the research and promotion of VC.  ISOM has been playing a pivotal role in worldwide promotion of orthomolecular concepts especially VC. Orthomolecular medicine believes that the optimal health comes from internal nutritional balance. We will discuss more on orthomolecular medicine and other alternative medicine later in the book. ISOM has attracted many of the vocal VC believers.

to be continued.

Covid-19, Vitamin C, Vaccine and Integrative Medicine

-The journey of a Chinese American doctor, caught between the East and the West, the contemporary and integrative medicine.

The Chinese Theater of World War Covid-19

Back to Shanghai

It was right after Christmas; the Christmas holiday festivities are not entirely over yet and the traditional Chinese New Year was just around the corner. The Chinese New Year is based on the Chinese lunar calendar and varies every year. In 2020, it falls on Jan. 25^th.

In a festive mood, I packed up and boarded an American Airliner and arrived at Shanghai, known as MoDu (the Magic Metropolis) by the Chinese, the largest city and the financial center in China where I went to the medical school (Shanghai Medical University) some 40 years ago and where I left for US in 1986. In recent years, I have been coming back more and more frequently to visit my parents and to delivered invited speeches in various conferences on health and disease. This time around, I was supposed to attend several conferences to talk about integrative medicine, ketogenic/carnivore diet and Vitamin C, in addition to spending time with my parents who are in their 80s. I have been making it a rule some years ago that no matter how busy I get, I should always spend the traditional Chinese New Year with my parents.

The plane landed in this neon lit metropolis.  The air tasted much fresher than years ago.  The streets were new and clean, no dirt or trash anywhere in the view. Shanghai is a lot more automated technically than any other cities in US or other places.  Garage gates in particular.  Many garages are automated without attendants. With a mobile phone, one scans a barcode and enters a payment, voila, the gate opens. Many streets are decorated with China red; it seems to me everyone is in a good mood.

Rumors about Wuhan pneumonia

Then, Wuhan began to show up on WeChat, a social media APP that more than a billion people can’t live without these days in China. Wuhan is nearly a thousand kilometers west of Shanghai. Shanghainese’s mentality may be similar to that of New Yorkers: Shanghai is THE world center. Anything outside Shanghai doesn’t matter to them.  What happens in Wuhan has nothing to do with Shanghai and life goes on. Also, there were no reports in the official government media of this rapidly evolving epidemic at all. It is the Chinese tradition that towards the year-end of the lunar Chinese calendar, there will be all kinds of celebrating parties from the public governmental agencies to private corporations and citizens. The central Chinese government headed by the Communist party chief is holding elaborate party with thousands of VIP attendees to celebrate the great achievement of this nation under the great leadership of the great party chief. The Hubei provincial and Wuhan city governments were doing pretty much the same: big parties with lots of attendees. In one area in Wuhan, a model region even held a “10,000-family dinner party” where all families in that area gathered together in a huge dinner party to celebrate the new year. This tradition has been going every year for the last 20 years. This is a landmark of achievements and this tradition can’t be broken.

But right after these huge festivities, the government announced the lock-down of Wuhan city, no one was allowed to go out or come in without special permits.  Unofficial reports of a new corona virus epidemic dominated the media and people were getting sick and dying. People were panicking. But from the government sanctioned media outlets, all was clear. There was no imminent danger. Life is good. Let’s celebrate. But people knew better.  The less the government reports, the more people are worried.  With the modern-day internet and wide spread social media, all kinds of news from brave souls in Wuhan and other place appear.  All of a sudden, people were talking about nothing but Wuhan pneumonia.

On Jan. 23^rd, just 2 days before the Chinese Near Year when everybody was getting ready to celebrate, which always involves lots of gatherings, eating, drinking and all the entertainment and craziness found in every culture, Wuhan announced the city-wide lock down: no one can go in or out of Wuhan, a city of more than 10 million people and is the central hub connecting the south with the north and the east with the west, of China.  The rumor was that the Wuhan city lock-down decision leaked out the night before and about 300,000 Wuhan residents escaped the city overnight, before the lock-down at 10 am, Jan. 23rd.

Now this wave of panic rolled over to the eastern seaboard of China, you could feel it in Shanghai. All those New Year’s Eve dinner reservations in restaurants, big or small were cancelled.  People stayed home, not knowing what’s going on.

One of these rumors was about a doctor, Li Wenliang. Dr. Li was an eye doctor in a major hospital in Wuhan. He was among the 8 doctors who first warned his classmates in his WeChat social media group that a SARS like viral infection was detected in a Wuhan wildlife market.  But someone reported his WeChat posting to the government and Dr. Li and the other 7 doctors received admonition from the government for spreading “rumors” to disturb the social harmony in a great country. He was taken by the police at midnight and he was made to confess that he was spreading rumors. Dr. Li was criticized by the official government media, received police warnings.  By all counts, Dr. Li was described as a bad citizen. Later on, it was reported the hospital where he worked was even ready to fire him. The young and unfortunate Dr. Li very soon caught the virus himself and was sent to ICU, where he never came out, sadly. Dr. Li, considered by most Chinese citizens a national hero who warned people of an imminent viral outbreak, died officially as a whistle blower, a “bad citizen”. The whole nation, except some people in power, mourned his death. There was another round of WeChat “complaints” about how the Wuhan pneumonia situation was handled and how the government was too slow to respond to the epidemic and how it tried cover up the epidemic, so on and so forth.  On the one hand these complaints sprang up like the bamboo shoots in the spring, and on the other hand, the government was too busy cracking down on these complaints, deleting those reports or closing down the social media accounts of those who complained, or direct lockup of those “rumors”. There has been a phenomenon well known to the Chinese called “invited to a coffee”, when the National Security Bureau or local police brings someone to an interrogation.

to be continued.