Monday, February 8, 2021

Treat Your Own COVID

 Concerned Parties,

  The question that I, as a COVID-19 Early Treating Physician, blogger, and human being with friends and family, get asked about COVID is "What can I do myself, because my doctor says there's no treatment outside the hospital".

  There are multiple effective supplements and repurposed medicines to treat COVID outside the hospital, which people should take to avoid having to go inside the hospital and get IVs and breathing machines.

  As a Public Health Physician (MD), acting in the interest of the good of other human beings, with no anticipation of reward, I would like to give advice to all readers, to reduce their risk of mortality and morbidity during this pandemic. 
This is the advice I give my patients.
I won't accept any payment for this advice. 
Give your neighbor a bottle of vitamin-D. Don't try to give me anything of value.

An Ounce of Prevention:
  Vitamin D deficiency is a major risk factor for catching COVID-19, being sick enough to need hospitalization, and dying from it.
Don't take that risk, please. Vitamin-D comes from sunshine entering superficially into the skin, and causing a photochemical reaction that creates vitamin-D. The great majority of people who do not work outdoors are deficient in vitamin-D, mildly, moderately or severely. Black people in New York and in Northern Europe, rich and poor alike, were some of the most deficient in vitamin-D last spring. Do you recall how that went?
Above and below the sub-tropics, the winter sun is too weak to produce vitamin-D, even if you can bare your skin at midday.
  Vitamin-D supplementation is cheap, safe and effective. Somebody may have already screamed, "Don't take too much" at you. I agree.
What's a good dose and what's "too much". The dose I have taken for over a decade is 1/8 of 1 milligram per day. That is 125 micrograms, or 5000 units. 
 1 mg of vitamin-D3 is 40,000 units. Weird, right? 1 mg sounds like nothing, and 40,000units sounds like WAY TOO MUCH.
I have been checking pre-treatment and treatment vitamin-D levels on people since 2006 and I'll say that if you weigh 100# or more, you can safely take 5000 units per day of vitamin-D for as long as you may live. I have seen a couple of people get slightly high levels after years of 10,000 units per day, not any sign of toxicity, and they backed off to 5000 units after a month off. Levels normalized.
  You can take 10.000 units (1/4 mg) per day for the first 2 months, to get your level up into the normal range. 
I recommend it, especially if you have extra fat. Vitamin-D distributes into fat, slowing the rise in blood level.
Upper mid normal blood level appears to be ideal.

  Zinc has been known since the 1990s to shorten the severity and duration of  "some common colds", namely those caused by coronaviruses.
The studies used ttreatment dosages of roughly 150 to 250 mg per day of zinc, usually as lozenges, spread out through the day in divided doses. 
What zinc does inside a cell, infected by a coronavirus, is to reduce its ability to make more coronaviruses. That is ideal in the period of exposure and early infection, to reduce viral replication enough to let the innate immune system keep the virus from getting the better of you.

  Take 50 mg per day of oral zinc, as a tablet or lozenge, together with 250 mg of Quercetin, also readily available, a natural product of onions and other vegetables. Quercetin helps zinc get into cells, which is where zinc is effective. (It's really hard to eat enough onions to get that much.)

  Prescription antiviral prophylaxis may also be appropriate for some people with weaker immune systems and higher risk of severe COVID-19, such as those with diabetes, obesity, sleep apnea, heart disease, kidney disease and cancer. Almost no western doctors will prescribe hydroxychloroquine or ivermectin for this purpose, after the politicization of hydroxychloroquine last spring when then President Trump advocated for it. 
The science of its efficacy in prophylaxis has been born out. 
In medical workers, both hydroxychloroquine and ivermectin weekly prophylaxis are about 75% effective, reducing infections by 75% in the group taking either, compared to the similar groups not taking weekly prophylaxis.
  You likely just heard the unfair bad press, not things like The Lancet admitting later that its anti-HCQ data from "Surgisphere", compiled from all of those hospitals, was actually not compiled from hospitals, but fabricated. Big headline; small retraction much later.
  Hydroxychloroquine prophylaxis would need to be prescribed, and is dangerous enough in overdose to have killed the poor guy who took the fish tank product last year. I'm not advising you to try to get any, nor to take it. (It is preferable as prophylaxis in pregnancy, an uncommon need.)

  Ivermectin has a remarkably broad safety profile, and has been served up about as many times as McDonald's hamburgers, to man and beast alike, for various forms of worms and parasites. It does cause birth defects in rats, when given at high doses, so don't use it in pregnancy, please.
Like most medicines to treat coronavirus illness, ivermectin does different things against the virus, than it does on regular days. Ivermectin inhibits the transport of the viral RNA into the cell nucleus, where it would be transcribed, manufacturing new viruses. It does other things, like reduce inflammation during cytokine-storm, in the second and third weeks of illness, helping the people who get really badly sick. Ivermectin is effective in prophylaxis, in early illness and also in later, severe illness, and through multiple mechanisms. Ivermectin is what I prescribe since last August.

  Ivermectin is now available mail-order from India, and from a reliable source. 
The preventive, "prophylactic" dose of ivermectin is based upon body weight, and it can be taken weekly, once an initial level inside of the cells is established. Ivermectin leaves the cells very slowly, so it can just be topped-off once per week. There are some slight variations on this, but I'll describe the one I prescribe. It uses the same body-weight dosing that you will find wherever you look up ivermectin dosing for humans or animals. For every 5 kg, or 11 pounds of body weight, a person takes 1 mg of ivermectin at that dose.
For most people I treat, that is 12 to 18 mg of ivermectin per dose.
For COVID-19 prophylaxis, this dose is taken Day #1, Day #2 and then every seventh day after that. 
If you forget, take it when you remember, and get back to the original schedule after that.

The Pound of Cure:
  I'm sorry if you have to do this, but it is mostly the same, with higher doses, and some more additions, to help avoid systemic damage.

  If you have not been taking vitamin-D3 for long, increase your dose to 5000 units 3 times per day for 10 days. 
The best thing is if you can get calcifediol, an immediately bioavailable form of vitamin-D, which does not need slow activation in the liver, and which saved lives and reduced ICU admissions in a Spanish hospital study. We can't get it in the US.

  Increase your dosing of 50 mg zinc and 250 mg quercetin to 3 times per day, also.

  Add 1000 mg of vitamin-C 3 times per day to the vitamin-D, zinc and quercetin.

  Aspirin is sometimes added in treatment of active disease, because SARS-CoV-2 inflames the lining of arteries and arterioles, causing clotting in small and large blood vessels. Aspirin is used as an anti-clotting agent. If you have mild illness, related to nasal symptoms, some fatigue, headaches and body aches, but no fever, no diarrhea, and no breathing problems, you probably don't need aspirin.
  However, if you have systemic illness, including fever, breathing problems and/or gut problems like diarrhea and vomiting, you stand to benefit from 1 to 2 tablets of 325 mg aspirin per day. The sicker you are the more likely that 325 mg twice per day is for you. 
Clotting issues persist, so this should continue 30 days. If you have been taking 2 per day, and feel pretty well after 10 days, then it is good to back down to 1 per day. A lot of lung problems come from the blood-vessel side, not the air side. This is a weird infection.

  Ivermectin dose for treatment is the same for the first 2 days, the cellular loading dose of 1 mg per 5 kg or 11# on days #1 and 2 of treatment.
This is followed with that same dose on days #4 and 6 of treatment, and that is the full course. 
Many physicians dose for fewer than 4 days, and so have I, but this seems to reduce the number of days of feeling bad in my experience.

  I typically also treat with 10 days of 100 mg doxycycline twice per day, which is Dr Borody's protocol, as widely used in India, to very good effect. Doxycycline is a broad spectrum antibiotic, which will treat any secondary bacterial infection on top of COVID Pneumonia, and which also has some antiviral benefits. It is also anti-inflammatory, which is of benefit.

  You would be well served to have an accurate thermometer and pulse oximetry devices at home. You need to know if you have a fever. You can presume that you have systemic illness at that point. You need a decision point and a fever over 100.5 degrees F is a good one. Temps between 99.5 and 100.5 might mean early/mild illness. Early experience in China was that people fared worse with things like ibuprofen and naproxen. I have not seen good follow up on that in the west. Still, I'd choose acetaminophen for symptoms.

  The pulse oximeter shows pulse and calculates blood oxygenation. It's good for measuring heart rate. 
Sicker people's hearts beat faster. I see it all the time. A heart rate over 110 means you are getting much sicker. 
Don't ignore it!
It is good to buy an inexpensive pulse oximeter and get to know what your usual baseline is. For most people it is 97% to 99% saturation. It will be lower if you live at high altitude. Dropping 2 points from normal means your lungs are not working right. It likely means COVID Pneumonia, if you have a positive test, already. Some people will read a little higher than they really are, so if you read a little low (95%), and feel short of breath, you may actually need oxygen. You may need to go to a hospital. 
If your pulse oximeter reads 93% or below, you really should be promptly evaluated at a hospital. 
You might need to check in.

  One dramatically important feature of COVID-19 is just how fast people can go from not-too-bad to choosing between ICU and the morgue.
Really fast. An hour or two. 
Rising heart rate and falling oxygen mean that it is time to go to the nearest real hospital ER. 
Don't drive yourself, please. You may become confused or pass out at the wheel.


Swiss Policy Research has a very good list of medical articles about all the treatments I have listed, except doxycycline here. (Thanks Bill)

Swiss Policy Research has information about how ivermectin works here, and it is also the group who arranged for the delivery of ivermectin from India to those abroad who place orders. Jeremy in Devon informed me of this link, and he also informed me that his shipment came in, "enough to treat his whole village". I think that was a little under 2 weeks for him, but it might have been a little over that. (Brexit notwithstanding...)

Yours In Service,

John Day MD


  1. A response from the experts on Merk's statements.

    Well worth reading and forwarding:

    1. Thanks, Amigo! Ivermectin is very bad if it competes with your products; pure evil...

  2. I have been taking quercetin & C & D & zinc almost from the outset of Covid, but am interested in augmenting with ivermectin per your and the FLCCC's protocol.

    Does the organization require a prescription for ivermectin from a U.S.-based doctor to be supplied to them before they can ship ?

    If so, is there any way to locate a local doctor who will supply such a prescription ?
    If there is no easy way to locate a local doctor, are you willing to prescribe it ?

    Many thanks,

    1. Hi Vince, People tell me they have placed and received orders without Rx being required.

  3. No prescription needed.

    You'll be buying from Kachhela who are the same folks linked on the SWPRS site. Their name is on the box.

    But you have to pay before they ship. I used a Revolut account to pay but a regular bank wire would work.

    1. Hi Amazed,

      I've sent around a dozen emails to places in India, including 3 or 4 to Kachela directly, a couple via the medicinedropshipper, and even one to the person listed as Kachela's owner/director on a Indian business information website.

      Is there any secret word or magic phrase you could pass along?

      Before retiring I dealt in importing to and exporting from the USA, so I use simple, non-colloquial English when I ask them for a quote on price & shipping, but so far I have yet to receive a single reply.


    2. You tried this?

  4. Thanks, Amazed,

    Good to know there's no prescription required.

    I sent them an enquiry earlier today, so I'm just waiting for them to send me a quote with a total price including shipping and their banking/payment info.

    I'll post a comment here when the package arrives.

    Might as well give a boost to companies that perform well.

    Thanks again

  5. As well as IVM they also supply Doxycycline.

  6. how long can you take ivermectin prophylaxis - once a week for how many weeks? I can't seem to find this information anywhere. Thanks to anyone who knows where to get this info.

    1. It appears to be safe in long term weekly use, but how long? That is an open question, not definitively answered, that I am aware of. I don't recommend it for people who are at lowish overall risk. I have only prescribed it prophylactically for a very few patients with multiple medical conditions.

  7. I've been taking 15mg IVM once every two weeks since the beginning of November. I shall continue to take it prophylactically until mid-March. As with all Coronaviruses, there is a seasonal aspect to SARS-Cov-2, hence why I shall cease the prophylaxis at that time.

    Interestingly, every single person in my immediate circle of friends (around 20 people aged 15-83) came down with Covid-19 between mid-November and mid-December and tested +ve. They mostly experienced mild flu-like symptoms, except for one who had bad flu and one with rather peculiar gastric symptoms. All fully recovered within a week or two, and all are fine today.

    1. After the 2 day intracellular-level loading dose, every 2 weeks topping-off-the-tank should also be fine, but weekly might be a bit more insurance for those with serious underlying medical conditions and debility. I'm tracking opinions of experts on the Covid-19 Treating Physicians list, too.

  8. I should add that I don't drink alcohol a day before I take it, and for two days after I take it.

    1. Hadn't been aware of this before and after alcohol consumption restriction. Is strictly necessary?

    2. I don't know how strictly necessary or how much alcohol, myself. Nobody I am treating for acute illness is drinking alcohol, and the very few who are taking it prophylactically are also not drinking alcohol. They have multiple medical problems. I can't give advice from experience.

  9. Just published - in Journal of Clinical and Diagnostic Research

    "CONCLUSION(S) - Ivermectin is suggested to be a promising effective chemoprophylactic drug against COVID-19. "[Ra]_F(Sh)_PF1(SY_OM)_PFA_(OM)_PN(KM).pdf

  10. Perhaps you read this?

    1. Now I have:
      According to Illich, the medical establishment has become a major threat to health. For society has transferred to physicians the exclusive right to determine what constitutes sickness, and who is or might become sick. And health-care has become a sick-making enterprise via a conceptual switch. That is, an intense engineering effort has converted (or caused people to believe) that survival, that is, being alive, does not depend on the performance of organisms but rather on various technical manipulations.

  11. Can you advise on how to use this protocol with children?

    1. What I and we at our clinic generally advise on vitamin-D dosing is to figure 5000 units per day for 100#, and to go down proportionately from there as a daily dose, so 80# would get 4000 units per day. Also, if the whole family takes 5000 units, subtract a day of the week for every 14 pounds, so an 86 pound child would get 5000 units for 6 days per week and 30# child would get 5000 units on 2 days per week.
      I just don't know on the other doses. I'm not aware of studies. Children tend to do so well.

  12. Yet another arrow to add to the quiver.

    Budesimide 800mg inh. b.i.d

    BTW - the Indian Pharmacy suggested by SWPRS is able to provide Budecort 200. This is the equivalent of Pulmicort.

  13. Replies
    1. Pulmicort inhaler (budesomide) is a useful adjunct for those who are already having early COVID pneumonia, but still with pulse oximetry 95% or better. Starting it when chest x-ray shows mild interstitial pneumonia, or oxygen saturation starts to drop would be good.

    2. Oxygen saturation below 95% doesn't mean a person should not use Pulmicort, but means "don't proceed without medical consultation".

  14. Great Info. Regarding Zinc: studies say elemental zinc is best but some forms of zinc (sulfate) May only contain about 25% of elemental zinc. Also taking over 50mg long term is harmful as it depletes copper. May supplement with Copper. Regarding D3: One study found that D3 taken upon infection at a dose of 50,000IU was safe and very effective short term. These studies were found in PubMed. I’ll try to look them back up and send them to you. Some might say your advise is not so important now that we have a vaccine but I believe it is more valuable than ever due to the limitations of vaccines effectiveness over time and the fact that we may well run into a new strain that will render these new vaccines useless. Thanks again. Your a great human being.