Important...
The Marik's COVID-19 Protocol was updated on April 3rd...
https://isom.ca/wp-content/uploads/2020/04/EVMS_Critical_Care_COVID-19_Protocol-04.06.2020.pdf
It's written for physicians (and now includes graphics), but here's an excerpt relevant to those of us here...
Prophylaxis
While there is very limited data (and none specific for COVID-19), the following “cocktail” may have a role in the prevention/mitigation of COVID-19 disease, especially amongst the most vulnerable citizens in our community; i.e. those over the age of 60 years and those with medical comorbidities. While there is no high level evidence that this cocktail is effective; it is cheap, safe and should be readily available. So what is there to lose?
• Vitamin C 500 mg BID and Quercetin 250-500 mg BID
• Zinc 75-100 mg/day (acetate, gluconate or picolinate). Zinc lozenges are preferred. After 1-2 months, reduce the dose to 30-50 mg/day.
• Melatonin (slow release): Begin with 0.3mg and increase as tolerated to 1-2 mg at night
• Vitamin D3 1000-4000 u/day (optimal dose unknown). Likely that those with baseline low 25- OH vitamin D levels and those > living at 40 degree latitude will benefit the most.
Mildly Symptomatic patients (on floor):
• Vitamin C 500mg BID and Quercetin 250-500 mg BID (if available)
• Zinc 75-100 mg/day
• Melatonin 6-12 mg at night (the optimal dose is unknown)
• Vitamin D3 1000-4000 u/day
• Enoxaparin 40-60mg day (if not contraindicated; dose adjust with CrCl < 30ml/min)
• Optional (and if available): Chloroquine 500 mg PO BID for 5 days or hydroxychloroquine 400mg BID day 1 followed by 200mg BID for 4 days
• Observe closely
• N/C 2L /min if required (max 4 L/min; consider early t/f to ICU for escalation of care).
• Avoid Nebulization and Respiratory treatments. Use “Spinhaler” or MDI and spacer if required.
• Avoid non-invasive ventilation
• T/f EARLY to the ICU for increasing respiratory signs/symptoms
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@jjraak @Indy51 And here's one more protocol that I learned about tonight. This will be of interest to those of you who are at "high risk"...
Dr. Vladimir Zelenko is a primary care doctor in the US. He practices in area one square mile in size with a population of 35,000. He himself is a cancer patient. He wanted to get ahead of the coronovirus so looked at the protocols used in S. Korea and France. With that information, he has treated 911 patients with a positive test result for COVID-19 or symptoms - (fever. cough, diarrhea, loss of taste or smell, etc.). He has one treatment approach for high risk patients, another for low risk patients. Outcomes to date: 0 deaths, 3 patients intubated - (2 still on, 1 off respirator), 6 patients admitted w/bacterial pneumonia for IV antibiotics - (2 now at home). He's using hydoxycholroquine, azithromycin, and zinc sulfate, all oral medications. Protocol is listed in video. Treatment goal is to
avoid hospitalization. My kind of doctor...