Obesity and poor health have been identified as probably one of the highest risk factors associated with severe disease. This has been known since April 2020 and largely confirmed since then 8 9 10 11 .

12 months have passed and no active campaigns for encouraging sport, better diet, have been conducted in most countries.

Instead population was pushed to stay home, stock on unhealthy foods and pushed onto fast food which stayed open in many countries when sports activities were kept closed and outdoors restaurants and cafes were closed.

Encouraging people to stay active, healthy, facilitating nutritious foods and providing nutritionists support for those who need it, is feasible, its cost is minimal compared to cost of other measures.

Such interventions make population stronger against this disease and probably many others. Yet it is disregarded by most countries.

Obesity reduction may have saved lives and should have been facilitated to population to have that choice, engaging in exercise following a healthier diet may have led to results as studies show within 6 months before second epidemic phase. Instead, conditions were created to increase obesity possibly increasing deaths in addition to other psychological and health side effects.

Active actions to reduce obesity and improve nutrition come with little risks and high benefits including for reducing severity of Covid19 12 .

It has been identified that a large portion of the population in many countries is vitamin D deficient. It has also been accepted that higher levels of vitamin D is helpful with most respiratory diseases.

Studies have confirmed this association for COVID as early as April and it has largely been confirmed since then 13 14 .

A recent meta-analysis comprising a little less than one million people shows that vitamin D deficiency is associated to susceptibility, severity and mortality 15 .

Experimental trials have shown efficacy including on the elderly, reducing significantly mortality 16 17 .

This further validates what has been known for years associating good vitamin D levels to improved outcome for respiratory diseases 18 .

Campaigns to help correct vitamin D levels were not conducted in most countries in spite of its benefits for covid and beyond. Instead, lockdowns and masking may have led to further vitamin D deprivation causing harm in adults and children.

If we are searching for best options, it would be easy with vaccination campaigns happening to propose to those who refuse vaccination a vitamin D correction plan. It could also be proposed to those who accept vaccination, such correction and compare all causes mortality for all 4 groups during ongoing vaccination phases 3 and 4.

Evidence as to benefit is significant for covid and much more, risks associated to reaching optimum vitamin d levels are low with high short- and long-term benefits.

In addition to vitamin d, other nutraceticals, commonly used, safe and well understood provide sufficient evidence to be used such as Quercetin, Vitamin C, Zinc Sulfate, Artemesia tea...

Trials with Nigella Sativa have shown very satisfactory results reducing by 4 mortality rate, duration of hospitalization for severe cases and recovery time for moderate cases 19  20 .

In parts of the world Nutraceticals have been used within safe ranges with evidence of efficacy. Some parts of Asia and Africa, used nutraceticals and faired better than Europe and much of America where in some cases, offical position was to deny any possibility of efficacy and recommend people to move away from all nutraceticals failing to further explore benefits.

For that matter, from an aethical point of view, a safe nutracetical with possible benefits would have to be considered and proposed to a patient at risk. Not doing it maybe objectionable.

Ivermectin is safe drug that has been known for decades, used thoroughly and its effects well documented.

As a treatment, it is by definition safer since only given to those who need it, who are already sick and doesn't put at risk other healthy individuals.

In terms of safety, it is safer than any of the vaccines who have undergone a short safety assessment and would have to be administered to healthy individuals with some known side effects and others to be discovered in the short and long term.

Multiple independent RCT trials have been conducted involving more than 2 282 patients. Almost all show indecently efficacy on different categories of populations with great significance. There may be a 75% reduction in mortality with a confidence interval of 95% 21 22 . Sample sizes of these trials taken together largely exceed those used for any of the validated vaccines whom all had efficacy samples below 1 000 and most had even lower efficacy samples. Many such trials for Ivermectin were independent and free of conflicts of interests.

In addition to RCT results, multiple observations in slaughter houses, nursing homes and doctors' experience have led many doctors to largely use it in multiple countries and their experience seems to confirm trial results mentioned.

Ivermectin is a cheap public domain molecule that would interfere with major interests and all new studies must be involve individuals beyond any suspicion of conflicts of interests. The fact that independent researchers confirm a same trend provides even stronger evidence. Treating successfully sick people is safer than injecting healthy individuals with products that are yet to be understood on the short and long term.

Looking at the big picture, South Africa’s curve reverted after doctors massively decided to start using ivermectin in spite of agencies advising otherwise. They may have saved lives. The government, under such pressure decided to privilege Ivermectin’s use followed by a sharp fast improvement.

Based on known safety and evidence showing it was likely effective, some states have embraced Ivermectin and many doctors in other countries where doctors still have freedom of prescription have used it base on evidence and ethics. In other states, some governments have restricted doctors from performing their duty of helping patients with best available science through pressure or even blocking supply thus depriving patients from a chance of a better outcome.

At this stage, further fair independent studies can be conducted to establish extent of efficacy but until then the evidence for risk/benefit is largely favorable and likely more convincing than that of any vaccine.

Early multi drug treatment sequenced and dosed as per clinical directions combined with some nutraceticals has shown positive results for many patients to the extent that when doctors can exercise their duties, it has become de facto standard of care by doctors using best available data to best help their patients 23 24 25 26 27 .

This is happening at a time where many health agencies are dismissing or delaying such solutions using different evaluation standards and not paying sufficient attention to long-term side effects of new molecules. Such agencies failed to contribute to improving on use of such emerging solutions and focused their attention on dismissing all solutions and recommend waiting for vaccines and treatments provided by private organizations with limited challenges of their studies or replication requirements.

Given that multi-drug therapy sequenced and dosed as per clinical directions has become de-facto standard of care in most world areas, all new interventions whether for treatment or for prophylaxis should be compared to multi-drug therapy and not to a placebo in terms of evidence, niches, benefits and risks both short and long-term.

Early outpatient treatment with low doses Hydroxychloroquine combined with a Macrolide for patients without heart conditions has been ousted without a real scientific conclusion

Hydroxychloroquine and Macrolides are known treatments. Their safety and counter indications are well established both short and long term which is not the case for vaccines whom benefit of conditional emergency authorization with short and long side effects under discovery.

There have been several outpatient early treatment studies both RCT and observational showing efficacy. There have been a few studies indicating no benefit. Some of the few latter studies have been criticized for bias due to conflicts of interests.

The Lancet gate was a demonstration of manipulation to prove a ridiculous claim as to hydroxychloroquine being dangerous. The lancet study was retracted. Based on one fallacious study that needs to be investigated, the discovery clinical trial had its hydroxychloroquine/Macrolide early outpatient arm interrupted leaving people in doubt. This calls for further questioning. Other large studies involved patients in late stage, did not use above mentioned proposed by therapy nor did they use suggested dosage proposed by successful studies.

Failing to demonstrate absence of efficacy or efficacy, contradicting studies, studies being stopped before a clear conclusion, stopping doctors or even hospitals from continuing studies proves further failure of many institutions. Investigations are warranted.