Covid-19 Mortality Risk Correlates Inversely with Vitamin D3 Status | Hacker News Reader

Covid-19 Mortality Risk Correlates Inversely with Vitamin D3 Status

pubmed.ncbi.nlm.nih.gov

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There is a long history of Vitamin D deficiency being linked to cancer, heart disease, respiratory infection, stroke, diabetes, and death. For a detailed discussion of the subject see the blog post: Vitamin D - The evidence

https://www.devaboone.com/post/vitamin-d-part-3-the-evidence...

> "We now have results for over 1500 RCTs on Vitamin D supplementation. Some of the largest and most significant trials are listed and summarized at the end of this article. When tested on its ability to prevent disease, Vitamin D has failed to live up to expectations."

Thousands of peer reviewed research papers have been published that Vitamin D does truly work for cancer and stroke etc and all the above. But then, as the blog points out, none of the claims held once bigger and properly designed RCTs were performed. The only disease provably cured by Vitamin D supplementation was ... Vitamin D deficiency.

Hence I am quite skeptical here as well. The eagerness to embrace Vitamin D as a silver bullet is no different than that of Ivermectin or Hydroxychloroquine.

It is not that simple to cure COVID - people dearly wish it were hence they want to believe.

D3 (and a bunch of other vitamins) might just be a proxy for simply good nutrition or even just wealth. If your D3 levels are alright, maybe everything else in your health is alright?

yes, I think you are onto something, for ever research paper they need to properly disentangle and normalize the various effects - controlling the factors.

Sounds like disentangling vitamin D levels is much more difficult than say controlling for social status, or income, age etc.

Yep. Now is that related to overall wealth of people with low vit-d. Or is it linked to other factors like genetic heritage?

The extreme low cases of vit-d in developed nations tends to have a genetic component or other health thing. But the genetic link I think has been disentangled from overall affluence. I.e. certain people if they take vit-d supplements can improve their overall health.

Its certain correlated with disability. Those who are chronically ill wont be getting out into the sun as much and tend to have low Vitamin D. It is a well known proxy for overall health.

Yes, but unfortunately there is a genetic element which has been disentangled with regard to vitamin d production otherwise. I.e. certain minorities in the developed world have good otherwise health but poor vit-d due to the production being related to absorbed sunlight through the skin

There are relatively few dietary sources of Vitamin D, fatty fish and fortified foods being the main sources. It is quite possible to eat a healthy diet and be deficient in Vitamin D if you do not eat these foods. The principal source of Vitamin D is exposure to sunlight on bare skin and people at northern latitudes cannot get sufficient exposure during the winter.

The title is quite something. The part that made it here seems reasonable enough, as it can be understood as "higher D3 levels help in not dying as much as with lower D3 levels" which is possible.

The other half is "a Mortality Rate Close to Zero Could Theoretically Be Achieved at 50 ng/mL 25(OH)D3" which the abstract argues for because "Regression suggested a theoretical point of zero mortality at approximately 50 ng/mL D3."

Someone sent in the clowns. (after that abstract I'm not sure I want to check out the details)

I agree, that they even have a dosage at which they predict zero deaths is nothing short of ludicrous. It gives away that they authors are unqualified.

Why not go one further, and suggest Lazarus-like effects at 100 ng/mL?

>after that abstract I'm not sure I want to check out the details

There's a fairly short review of why the study is kinda silly here: https://gidmk.medium.com/vitamin-d-covid-19-and-the-promise-...

That article is just a load of snark. It starts off my claiming that Vitamin D is suggested as a cure for all kinds of things, but the science shows that low Vitamin D levels are correlated with various diseases. There is a huge difference between saying low levels should be avoided in order to reduce disease and claiming that there is a cure. Not being able to tell the difference shows a lack of interest or understanding in the basic science involved. Railing against purported false claims is a rhetorical tactic and it is worth noting there are no citations for any of the claimed cure claims.

And the science involved is quite complex as recent studies have suggested that people can become resistant to Vitamin D in a way that mirrors insulin sensitivity. This means that serum levels vary in ways that are very much not directly related to supplementation, especially dietary supplementation.

In any case getting distracted by the "Regression SUGGESTED a THEORETICAL zero point of mortality ..." remark doesn't make sense because even Vitamin D enthusiasts rarely sustain levels much above 40.

Wow, the concept of "Vitamin D Resistance" is truly fascinating. Thanks for sharing this.

ObXKCD: https://xkcd.com/605/

The statement is broadly that this is not intended as a treatment but offers a useful way of deciding how likely a patient is to not respond to initial therapy.

I don't think a sensible person is suggesting a massive dose of vitamin d on a arrival is a cure.

As for the consequence of is the deficiency linked to poor otherwise health that is interesting to disentangle.

This does offer a very good explanation to the idiotic statements of "covid is racist". I.e. if it is linked to vit-d deficiency it offers a way to reduce deaths in minorities. These early concerns suggested that covid would hit Africa for instance really badly, and it is yet to do so.

Several studies indicate that a massive dose of vitamin D on arrival reduces symptoms.

https://vitamin-d-covid.shotwell.ca/

It's proactive, not reactive treatment for a disease. It's part of being healthy in the first place, which prevents developing severe COVID, cancer, heart disease, respiratory infection, stroke, diabetes, and death. It's like a car, you give it oil and maintenance to prevent engine damage, you don't give it oil to fix engine damage.

Acting like binging on Vitamin D is supposed to suddenly cure any of those diseases is a complete misunderstanding how all this works. You can greatly reduce your likelihood of severe COVID and 100 other serious/fatal diseases through simple lifestyle changes, but they're not cures for those diseases. And fixing vitamin D deficiency shouldn't mean you take more pills, it should mean you get more exercise out in the Sun.

Also, if vitamin D deficiency is an underlying cause of severe COVID, that would explain the enormous racial inequality for hospitalization and deaths rates. All these things are linked to the amount of melanin in one's skin. The hospitalization and death rates for COVID are double for people with Native American and African blood, and both groups have much higher rates of Vitamin D deficiency.

https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investi...

https://www.cdc.gov/nutritionreport/pdf/Second%20Nutrition%2...

Right, but the GP-linked study disagrees with your assertion:

“ We now have results for over 1500 RCTs on Vitamin D supplementation. Some of the largest and most significant trials are listed and summarized at the end of this article. When tested on its ability to prevent disease, Vitamin D has failed to live up to expectations."

So no, it does not seem to work

The 1500 RCT's are actually only 31 studies from what I can see. Those studies are do not all overlap either, they are all over the spectrum (D3 and flu, D3 and mortality, D3 and having children with Asthma).

While good sources for specifics, there is a lot of wiggle room for follow up in some of these spaces where the results amount to a single study.

I think the summaries speak for themselves:

> "Vitamin D ... ... did reduce cancer death by 16%"

> "Vitamin D did not reduce the risk of cancer"

Seems like more research is needed here in these specific areas along with what exact version of D3 we are talking about (they are not all manufactured or extracted the same) and if supporting nutrients/lifestyles effect anything.

I think the article just makes the good point that D3 isn't the magic bullet to any and all sickness without really being able to specify with a high level of certainly what it does help with.

Part of the issue is that many vitamin and other health indicators are highly correlated with other things like income status, race, and other significant conflating factors.

D3 also is related to being outside , which would influence the means of infection: lower initial viral load changes outcome.

Actually yes, it does seem to work at least to a limited extent. Maybe do a little more research instead of relying on a single study.

https://vitamin-d-covid.shotwell.ca/

Depression & mental illness too. At least that's why my doc said and had my levels tested.

RCTs are great, but they are almost always underpowered when studying nutritional deficiencies.

For the cited study, the cancer incidence rate was 1.2% in 5 years among 12500 recipients. That's barely 150 patients. Getting statistically significant effects with such low sample sizes is very difficult.

We will have to live with correlational instead of causal studies for nutrition. If you are interested, smoking causes lung cancer hypothesis was based on correlation- which was how cigarette manufacturers attacked the hypothesis. Proving a causal connection between smoking and cancer is much more difficult.

https://towardsdatascience.com/correlation-does-not-imply-ca...

The vast majority of people infected with Sars-CoV2 do not need to cure COVID, as they do not even notice any symptoms.

> The vast majority of people infected with Sars-CoV2 (...) do not even notice any symptoms.

Not true. It has been estimated that asymptomatic COVID-19 represents at most around 35% of the cases.

* https://journals.plos.org/plosone/article?id=10.1371/journal...

* https://www.sciencealert.com/over-a-third-of-covid-infection...

The studies mentioned are for supplementation. I'd be interested to see studies on vitamin D benefits through sunlight exposure instead. It may be that these studies are proving not that increasing vitamin D levels can prevent disease, but that supplementation is ineffective.

For what it’s worth, I had a physical in my mid-20s where my doctor saw my vitamin D levels were low, so he told me to supplement with vitamin D. I take 10,000 IU with vitamin K about 5x/week. I am 35 now and I happened to check my levels around Jan 2020, to make sure I wasn’t overdoing it. I was at 53 ng/mL, which was perfect.

The pandemic came around, and while a lot of people around me got sick, I never did, but I had also been good about mask adherence. So I was a little surprised in August 2020 when my doctor gave me a COVID antibody test (blood draw), just to see, had come back positive, considering I had felt completely fine through that whole period.

Then again a few months later, when my SO came down with covid, needless to say we had extremely close contact during the infectious period, and I was still completely fine.

I’m not trying to be a vitamin D evangelist or anything, of course I could just be one of the lucky ones when it comes to covid, but I feel like it’s a cheap and easy thing to try if you aren’t currently supplementing. And of course, I am vaccinated as well now.

RE: your last sentence. High dose supplementation of vitamin D should be done after consulting with your doctor (like you did). As a fat soluble vitamin, our bodies sometimes struggle to dispose of the excess. Therefore a person with "normal" vitamin D levels who begins supplementing at high levels is potentially risking some side effects. It's always good to be monitored in situations like those.

It seems you are doing exactly that, which is great.

> I take 10,000 IU with vitamin K about 5x/week. I am 35 now and I happened to check my levels around Jan 2020, to make sure I wasn’t overdoing it. I was at 53 ng/mL, which was perfect.

As a counter example, I took 5,000 IU per day and almost ended up over the 100ng/dL upper limit. I had to reduce my supplementation to avoid overdose.

Vitamin D supplementation is very person-dependent, so I recommend anyone supplementing with higher dose supplements (5000IU and up) check their blood levels every few years.

1. Does your SO take VitD as well?

2. Interesting that you didn't give it to them when you had covid.

What brand of vitamin d and k do you take?

https://www.amazon.com/gp/product/B00ECH40MQ

I have been collecting studies related to treatment and prevention of the common cold for a while now. Every time I have a cold, I spend some time growing the list.

So far, Vitamin D3 is one of the more promising treatments in the list.

Here are two interesting RCTs regarding Vitamin D and respiratory tract infections:

Preventive Effects of Vitamin D on Seasonal Influenza: https://journals.lww.com/pidj/fulltext/2018/08000/preventive...

Vitamin D Supplementation for the Prevention of Acute Respiratory Tract Infection: https://academic.oup.com/jid/article/202/5/809/1746565

You can add a bunch of paper from here:

https://www.devaboone.com/post/vitamin-d-part-3-the-evidence...

Thanks, I will.

Hasn’t this been known for over a year and a half now? This isn’t the first study on Vitamin D. Some past discussions on HN:

https://news.ycombinator.com/item?id=24912172

https://news.ycombinator.com/item?id=23119949

https://news.ycombinator.com/item?id=23023703

Another comorbidity is obesity, which can also cause Vitamin D deficiency.

https://news.ycombinator.com/item?id=26924786

An interesting implication of all this is that the authoritarian measures used to manage the pandemic are effectively a subsidy. Those who are young or healthy or have a nutritionally balanced diet are taking on pains (lockdowns, mandates) to create a lower risk situation for everyone else. Personally I feel it is better for governments to provide education and strong guidance, but to ultimately favor individual choice and stay away from top down measures. With COVID, those who are young have incredibly low IFR to begin with, and they could have gone about their lives and built up antibodies naturally, which would then make it safer for everyone else anyways.

This was an observation amongst the vast sea of observations for over a year and a half. It still needed to be studied.

A year and a half ago, and partly even now, the kneejerk response has been "ah, it must be because people with low Vitamin D are doing other inactive things with poor diets and low sunlight" as opposed to something closer to "Vitamin D supplements are a cheap existing solution for a reason we still don't know yet"

The main point of restrictions was to reduce case numbers coming into hospitals and overwhelming them, since COVID patients who do get hospitalized tend to stay there a long time.

If you are a young person who gets into a car crash and you need immediate treatment in the ER, an overwhelmed hospital might either mean sending an injured person into a place crowded with COVID patients, or scrambling to find a hospital that has room. Even now there are still US hospitals turning away ambulances due to lack of capacity.

Thanks for the link summaries.

I fail to understand the down votes.

People downvote Vitamin-D posts because they think that if you talk about Vitamin-D deficiency you are an anti-vaxxer.

Or it could be because the grandparent post contains the common non-sequitur about "individual choice". That rhetoric is pointless in a discussion about public health and ruins a perfectly good comment. An infectious disease does not care what your individual choice is.

It's obviously not a non sequitur, it's the essential tradeoff we're making. We could weld every person into their home for the next month and eliminate Covid, but we don't do that because we're trading off public health maximalism vs individual freedoms. The entire point of the political process is to decide where that line is.

An infectious disease doesn't care about any of that, it doesn't care what your political process is or where you draw the line. It's not a trade off of public health maximalism vs individual freedoms, it never is that simple. Every decision you make there trades someone else's individual freedom by increasing their risk of contracting the disease. Please let's stop dancing around that and trying to play politics here.

The only fool proof solution that exists is to totally quarantine people, but the grandparent post already took that off the table, so even if we wanted to have that discussion there is simply nowhere left for it to go. See what I mean here? This rhetoric doesn't do anything besides shut down the conversation.

Again.

You are advocating ban sex due to HIV. Please stop being so black and white about policy involving human beings and reality.

No I am not, please stop this. You're jumping to the other extreme and that's exactly why I think that type of rhetoric is not helpful. If you have something nuanced you'd like to say then I'd love to hear it.

Personally if I was somewhere where there was an HIV outbreak, and we didn't have adequate resources to test and protect against it, then I would say that abstaining from promiscuous sex and promoting that as a public health measure would be a perfectly reasonable thing to do. That would actually probably help the situation in areas of the world where the ongoing HIV epidemic is particularly bad, which by the way is still a real thing.

promoting as a public health measure vs. mandating as a public health measure

do you see a difference between these two?

I mean, it depends? What is the measure and what are you trying to do?

By that logic we should ban sex due to HIV. This is an extremely dangerous argument...

Yes I must agree, I was being sarcastic trying to call out the groupthink.

> and they could have gone about their lives and built up antibodies naturally, which would then make it safer for everyone else anyways.

“Built up antibodies naturally” is a coy way of saying kill the maximum number of people possible before reaching herd immunity.

Given the rapid pace of vaccine development, strict measures to slow the spread of the virus seemed reasonable. Some countries, like New Zealand and Taiwan, will largely escape the pandemic unscathed.

> “Built up antibodies naturally” is a coy way of saying kill the maximum number of people possible before reaching herd immunity.

This is absurd in the extreme. The proposition was that those that are the least impacted by covid--specifically, those like me who are healthy, young, getting adequate sunlight--should not have to bear the responsibility for those who are vulnerable.

Covid risk for people like me, and us healthy folk are a great large chunk of the population, is less than a typical flu.

Since we don't have as extreme policy responses to the flu, do you characterize that as well as "kill the maximum number of people possible"?

And saying that New Zealand came through unscathed I guess just shows how differently we think. The society has come to accept being forced into isolation, accept quarantines and curfews like their unruly teenagers, accept all manner of tyranny--to you, they're unscathed because they have fewer covid-related deaths. To me, covid-related deaths--which are dwarfed still in the USA by heart disease and cancer and other ailments, don't even rise to the level of general concern.

Then again, I live in Montana. Everyone doesn't care. Only on the internet and talking to Canadian or coastal friends does it come up. Around here, you say covid, and a lot of folks probably think it's a migratory bird--then again, hunting season just opened up.

And with all us ignoring this crazy pandemic, you know what? The world's not ending. No vaccine mandates. No mask mandates. Everyone's "unscathed".

> This is absurd in the extreme. The proposition was that those that are the least impacted by covid--specifically, those like me who are healthy, young, getting adequate sunlight--should not have to bear the responsibility for those who are vulnerable.

We have radically different values.

Of course the strongest and most able in society have to bear the majority of the burdens. That simply seems morally obvious. The rich should pay more taxes than the poor. The young and healthy fight in the military and not the old and infirm. Adult children will make personal sacrifices to save their elderly parents. What about asking the healthy to make sacrifices to protect the weak is unjust?

A world view of “let the weak fend for themselves for the strong should take what they want” is utterly repugnant.

Kids are the least at risk of covid. Should they bear the most responsibility? Lol.

How are kids bearing responsibility? It seems to me kids are doing fine with social distancing, mask wearing and all. Parents complain about their kids masking up more than the kids do.

But the ultimate way kids are being forced to bear responsibility is their parents dying from covid and leaving them as orphans.

https://www.cdc.gov/media/releases/2021/p1007-covid-19-orpha...

https://time.com/6104829/us-covid-orphans/

If you don’t want kids to have to bear responsibility with covid, don’t let their parents die from it.

> Covid risk for people like me, and us healthy folk are a great large chunk of the population, is less than a typical flu.

Is it? There sure seem to be a lot of long-term side-effects with covid that people do not get from the “flu” (and IMO most people say they had the “flu” when really what they had was a cold.)

> Everyone’s “unscathed”

JFC. 17 covid deaths a day this week, and everyone is “unscathed”? What a terrible and false claim to have made.

I won’t dwell on the thousands—likely tens of thousands, based on the state’s cases—of your fellow citizens who didn’t die, they’re just permanently disabled. “Unscathed.” Wow.

> Some countries, like New Zealand and Taiwan, will largely escape the pandemic unscathed

You've been lied to. It's an endemic disease which 100% of the population will eventually get. It's just that with vaccines a lot fewer older people will die, and a lot fewer middle aged people will experience health issues for an extended period of time. Before vaccines came to market, I could understand what they're doing, but now it doesn't make any sense: they're just postponing the inevitable - the only way out is through. They should vaccinate as many people as they can and remove all restrictions.

Started taking high levels of d3 a few months before covid, as I had very low levels. (Autoimmune)

A year later and I got covid. A few scary nights. I recovered but had a sharp increase in micro-clotting. Something that was an issue before Covid. I had to double blood thinners to keep symptoms under control. Took six months before I could lower dosage again.

Covid aside I’m much healthier since upping d3. I had been bed ridden with uncontrollable migraines the year prior.

What is your dosage?

3000u a day

Good to hear this has helped you :)

And a down vote for wishing someone well... Lovely community

D3 might be a proxy for age, as I thought older folks were to take D and Calcium to reduce the chance of osteoporosis. It might also be a proxy for overall health, as those short of D3 are probably not eating "well-balanced diets, ..." that marketeers are fond of talking about. It's also possible that it has a direct effect on the result, which would (as mentioned already) make it an excellent complement of vaccination. One reduces the chance of the ultimate problem, one reduces the chance of duration/problems. And it's cheap.

From the second paragraph in the abstract, it seems that they adjust for age: "Mortality rates from clinical studies were corrected for age, sex, and diabetes."

Vitamin D also correlated heavily with race which it doesn’t seem they adjust for?

Had not considered this - it's a good point. There is a lot of fortified food in the N American, possibly Western European diet which includes D3 (particularly for milk drinkers). But milk drinking is limited to particular gene families as I thought it was a (quite) recent mutation...

Does it adjust for other vitamins? People with sufficient vitamin D levels likely take supplements along with other vitamins so it may be that it's not just vitamin D, but it in combination with other vitamins. If this study just gave people vitamin D supplements and nothing else then it may be that it didn't have needed "supporting vitamins".

People with sufficient Vitamin D levels may also spend more time outdoors. For some, this may indicate more exercise as well. The primary source of Vitamin D naturally is sun exposure. So lifestyle factors other than eating play a large role, like time outdoors, and how far north one lives.

But I would expect older people taking D3 for (pre)osteoporosis would generally be high risk for COVID. I know this thread is overflowing with anecdotal information but two family members in their sixties had completely asymptotic covid infections. Neither was generally healthy (obesity in one, asthma in the other) but both supplemented with Vitamin D3.

Vaxxed or predelta or just fortunate?

Predelta, still fortune as both only knew they had it because they got tested at work.

Figure 2 in their paper [0] shows the mechanism via which (as they say) vitamin D3 is supposed to improve outcomes of a Covid19 infection. It seems to counteract the negative effects on ACE2 levels that a Covid19 infection has which seem to be responsible for bad outcomes.

[0] Open Access: https://www.mdpi.com/2072-6643/13/10/3596/htm

COVID19 sort of blew the lid on several "health" pandemics that were underway by highlighting them. Vitamin D deficiency is one of them.

The hidden diabetes surge in malnutritioned asian and western countries also comes to mind.

Or the horrendous damage done to the lungs by the smog in the chinese mainland.

Also see: https://www.outsideonline.com/health/wellness/sunscreen-sun-...

"...what made the people with high vitamin D levels so healthy was not the vitamin itself. That was just a marker. Their vitamin D levels were high because they were getting plenty of exposure to the thing that was really responsible for their good health—that big orange ball shining down from above."

There have been a bunch of other studies on vitamin D and COVID-19. Before jumping to conclusions and commenting here I recommend reviewing the existing literature.

https://vitamin-d-covid.shotwell.ca/

https://jamanetwork.com/journals/jama/fullarticle/2775003

As a reminder, you can use the D Minder Pro app to estimate your daily vitamin D intake from sun exposure. It was free during the first year of the pandemic, right now it costs $1.99.

The Apple Watch (or any other smart watch) should have a built-in sun measuring sensor, noting when people have not enough sun exposure to produce the necessary amount of Vitamin D to be healthy. Once AR is there, they could make a game out of it, showing progress bars at the peripery of the eyes. This could make reaching the targets much easier for a lot more people.

That sounds like a good way to get sued over someone’s melanoma.

Easily preventable with a 100 page ToS to agree to before allowing usage!

Wristwatches are often covered by sleeves.

How much sun does that block? Workarounds may be feasible, depending on the mechanism.

The thickness and color of the cloth would affect how strong the SPF is for any given shirt.

That's fine. As long as the sensor is available the user can expose it. I think this is a pretty cool idea, and would yield more accurate measurements than estimating based off of latitude and cloud coverage alone. Albeit it'll all but guarantee tan lines.

> Once AR is there, they could make a game out of it, showing progress bars at the peripery of the eyes.

Are you good?

GPS is sufficient.

I use "UVIMate" app to provide a general ballpark figure on how much time I should spend under the sun:

https://play.google.com/store/apps/details?id=au.com.aershov...

Correlation I get. How are they making the jump to causation?

When the "bradykinin storm" hypothesis [1] was postulated, I already guessed that D3 would be a potent suppressor of Covid-19 mortality & likely prevention of the "Long Covid" syndrome.

Glad to see my guess is validated.

Human beings have been living in europe for over 100,000 years. White skin doesn't seem to be older than a 10,000 years (see the skin analysis of the first briton). I don't think it would have taken so much time to evolve white skin had it really had the importance that is being attributed to it nowadays. I am very skeptical about its importance on preventing not only covid but also many other deseases.

Anything that kills you mostly only after prime child-birthing years does not matter to evolution, and human behavior and diet has changed just a bit over the last 10000 years.

> Anything that kills you mostly only after prime child-birthing years does not matter to evolution

That's...very much not true. Any disease that doesn't effect the chances of children closely related to the exposed person being born and surviving to adulthood does not matter much to evolution, but killing the exposed person before or during prime childbearing years isn't the only way to effect that.

Living grandparents are also increasing the survival chances of their grandchildren.

Finally, finally and finally!

It's not a good idea to have so many nested try blocks.

This is another long discarded bit of snake oil. If there were genuine home remedies for Covid that you could buy at the grocery store, we'd have told you about it. It turns out there are only two: vaccines and masks. It's healthy to have the recommended amount of Vitamin D, but not at the expense of a vaccine and a mask.

You decide: https://www.ncbi.nlm.nih.gov/pmc/articles/instance/8541492/b...

Put a mask on and breathe on a pair of glasses.

Then please explain how the water molecules can pass through while other aerosols cannot.

Water particles aren't getting through. Please look up how condensation works, it's about a difference in temperatures.

Water particles absolutely are getting through. Yes the glasses are colder and breathe is warmer but it is still the water vapor from the hot moist breath that is the primary source of the water condensate.

While water particles do pass easily, viruses may not as respiratory aerosols are orders of magnitude larger about 1.6-5um vs. water at 0.27nm

Please look up the size of individual H2O molecules (which are what you exhale, not water drops).

It isn't the water molecules passing through the mask from your mouth. Your body is warmer than the air around you most of the year (unless you live in the tropics). It is mostly the heat of your breath passing through the mask, then hitting the cooler surface of the glasses, and making the moisture in the air that is already outside your mask condense on the glasses.

Im bored to death of Covid arguments, but I bet if you had to choose, healthy Vitamin D levels would be more effective than masks both for the individual and society.

Your bet is based on falsehoods, so it's quite fortunate you don't make these decisions for all of us. I'll take the other side of the bet any day.

Who is the “we” you speak for?

Yeah, you should have a well-rounded set of defenses. I don't think anyone is saying vitamin-D is a silver bullet.

Maybe. E.g. most Americans are still ignorant to the effect of obesity on severity, good advice would also include trying to lose a pounds a week, as it would be more effective than cloth masks once you catch it (which everyone will eventually, vaccinated or not)

I just don't understand how anyone could be against studies that basically say being deficient in an essential nutrient might lead to worse health outcomes.

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